Doctors' bad press depends on type of newspaper

EDITOR—Ali et al reported on bad press for doctors.1 In a research project with the BMA's public affairs division I analysed all reports on medicine and health science in the 21 major British newspapers published over a period of one month.

Altogether 799 articles were coded into a database and graded according to whether they were positive, negative, or mixed towards, or did not mention, the government, the NHS, individual doctors, and the wider profession. I coded the articles on the basis of a fixed proforma, and when I carried out a blind reliability test on a random series of 30 articles with another coder the total agreement level was 87%.

My data showed a significantly higher proportion of negative articles about individual doctors than positive articles in the tabloids compared with the broadsheets (a ratio of 2.9 compared with 1.4, χ²=6.244, df=1, P=0.013). When analysing health articles that mentioned the government a similar trend became apparent, with a negative to positive ratio of 6.6 for the tabloids and 2.3 for the broadsheets (χ²=4.689, df=1, P=0.030). The difference in the ratio of negative to positive articles about the NHS or the profession as a whole was not significant.

The Daily Mail had a ratio of negative to positive articles of 1.2, closer to the broadsheets than the other tabloids. This possibly suggests that it did not represent a typical tabloid in the study by Ali et al. In comparison 40% of health articles in the Sun were negative about individual doctors (compared with the average for all papers of 18%), and the negative to positive ratio was 6.7.

Negative stories about individual doctors in the tabloids were significantly more likely to generalise to the profession as a whole (in 9.6% of cases) compared with the broadsheets (1.6% of the time, χ²= 4.014, df=1, P=0.045). These types of articles are dangerous as they can create a link in the reader's mind between one bad doctor and the profession as a whole. It was notable that in this case the Daily Mail did seem anti-doctor—18% of articles negative about individual doctors were also negative about the profession.

Although Ali et al concluded that there was no significant change in the ratio of negative to positive articles over time, I believe that I showed that there are significant differences in the ratio across the range of different newspapers. This has important implications regarding the public's opinion of doctors, especially as the Daily Mail, Sun, Express, and Mirror account for 71% of daily newspaper circulation in Britain.