Views And Reviews No Holds Barred

Margaret McCartney: Remember that doctors are more trusted than journalists

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2608 (Published 12 June 2017) Cite this as: BMJ 2017;357:j2608
  1. Margaret McCartney, general practitioner
  1. Glasgow
  1. margaret{at}margaretmccartney.com

In the past few months the Daily Mail has excoriated GPs for letting “millions” down by being “shut in the afternoon,”1 for “failing an estimated 32 000 cancer patients,”2 and for “failing to diagnose patients with early dementia.”3 It often does this on the front page in large font, and I know that these headlines hurt many GPs who work long and hard under intolerable pressure.

Free speech is important, and the press should be able to say what it likes. But it was perhaps predictable that Wikipedia would decide not to use the Daily Mail as a reference in all but exceptional circumstances because of its “reputation for poor fact checking, sensationalism, and flat-out fabrication.”4

If writers at the Mail wish to take a research paper explaining that diagnosing cancer may take more than one appointment5 and turn it into a story of GP uselessness,2 that’s their call. Certainly, some GP surgeries close because they are branch surgeries or are doing house calls. And dementia research has found that raising awareness doesn’t increase diagnosis rates,6 but the GPs are blamed.

The problem of unfair reporting on health is big, and I don’t know how to counter it. A few years ago I thought that, rather than preaching to the converted, it would be more productive to direct my laptop at hostile lands. So I wrote for the Daily Mail a few times, variously, about the harms and hazards of screening and about female doctors not being an NHS apocalypse. Did it do any good? Most likely not.

If writers wish to take a research paper and turn it into a story of GP uselessness, that’s their call

So, what to do? Tackle each misconception diligently, asking for evidence? My instincts want to, and perhaps it helps. It at least provides a record of rebuttal that may be helpful sometime, to somebody. Websites such as Behind the Headlines (from NHS Choices, at www.nhs.uk/news/Pages/NewsIndex.aspx) and the US Health News Review (https://www.healthnewsreview.org/) are often useful, but they can’t undo all of the damage from widespread poor reporting. Honest mistakes will always happen, but bias seems unshiftable. The cycle of printing corrections winds smaller and smaller, such that the consequences for a newspaper or its journalists of learning from error seem negligible.

Maybe it’s a longer game. Some other things make me feel hopeful. Perhaps we should suggest that readers of unreliable news should read books such as Testing Treatments7 or Know Your Chances,8 which are freely available and whose material is shown to improve readers’ statistical knowledge.9 This could even become a routine recommendation in managing any long term health condition. Or the amazing Informed Health Choices project,10 which teaches schoolchildren how to judge health claims and includes jolly songs about evidence.

In the meantime, I still fail to see the point of most of the press releases that drive this news cycle. We can’t sanely discuss how to keep improving in a furiously hostile, wearying media environment devoid of critical thinking. Few people who aren’t GPs understand the complex ecosystem of referrals, diagnosis, and coding—while weighing uncertainty and balancing watchful waiting against the harms of over-investigation.

Maybe we all need to pull down our own oxygen masks. Assume a Zen-like attitude, feel the weight of Mail oppression leaving as it fails to make an impression on our Teflon skin, and remember that doctors are still far more trusted than journalists and politicians.11

Footnotes

References

View Abstract