Bad press for doctors: 21 year survey of three national newspapers
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7316.782 (Published 06 October 2001) Cite this as: BMJ 2001;323:782- Nazia Y Ali, medical student,
- Thoebe Y S Lo, medical student,
- Victoria L Auvache, medical student,
- Peter D White, senior lecturer (p.d.white{at}mds.qmw.ac.uk)
- St Bartholomew's and the Royal London School of Medicine and Dentistry, Queen Mary College, London EC1A 7BE
- Correspondence to: P D White
- Accepted 23 May 2001
Many doctors believe that the media are portraying an increasingly negative image of doctors. 1 2 Is this true? An Australian study found that negative stories were counterbalanced by positive ones,3 yet the newspaper coverage of the General Medical Council investigation into the Bristol paediatric cardiac surgeons was considered to be “emotive and largely hostile.”4 We tested the hypotheses that newspapers have published more negative than positive stories about doctors, and that the ratio of negative to positive stories has increased.
Participants, methods, and results
We studied the Daily Telegraph, Guardian, and Daily Mail so that we could include both broadsheet and tabloid newspapers, and newspapers with different political views. We studied all articles published in November, from 1980 to 2000, choosing November to exclude both holidays and winter bed crises, while parliament was sitting.
We examined either microfilmed editions of the newspapers or electronic databases (when available). We searched for the text words doctor*, medic*, surgeon*, and Dr (having rejected words that did not appear in articles in a pilot study). We counted and coded relevant articles as positive, negative, or neutral towards doctors. We also counted the number of lines in each article, adjusting for the difference between electronic and microfilmed articles. Each newspaper was assessed by a different author of the study. Where coding was not clear cut the article was reviewed by two other authors and a consensus reached. The blindly rated intercoder reliability for 1999 was 72% for total agreement and 100% for agreement by two out of three raters. To minimise year by year variance we calculated three year rolling means (figure), but all statistical analyses used the original data, which were not normally distributed.
The numbers of neutral, negative, and positive articles increased significantly over time (Pearson's r=0.49, 0.52, and 0.44, respectively; P<0.001). The median ratio of negative to positive articles was 2.33 (interquartile range 1.50-3.75) for the whole period, with no change with time (r=0.01, P=0.96). The median ratio of negative to positive lines was 2.98 (1.44-6.89) for the whole period, with no significant change with time (r=−0.04, P=0.74). There was a trend over time for a smaller median ratio of negative to positive articles in the Daily Mail (1.75); ratios in the other papers were similar (Telegraph 2.7, Guardian 3.0) (Kruskall Wallis χ2=5.07, df=2, P=0.08), but there was no significant difference in the ratio of negative to positive lines (P=0.36) in all three newspapers. The peaks in negative reports in 1986-9 and 1996-2000 were related to several incidents being reported at the same time (for example, practising doctors with HIV infections, and allegations of child abuse in Cleveland, in 1987; Dr Kervokian, Dr Shipman, and Mr Ledward in 1998-9).
Comment
Taken together, the Daily Telegraph, Guardian, and Daily Mail contained more than twice as many negative stories about doctors as positive ones, but there was no significant change in the ratio of negative to positive stories over time. The total number of articles about doctors increased over time. These data may have been peculiar either to November or to these newspapers, although there was a consistent trend over time in each of the three papers and no significant difference between the newspapers in their reporting. The newspapers currently have a high level of negative reporting, which may recede, as did the peak in 1989. These data suggest that UK newspapers respond to incidents, rather than deliberately campaigning against doctors. Although we did not directly measure the language used to describe doctors, we noticed that it seems to have become more negative. In spite of this, 89% of the public is satisfied with the way that doctors do their jobs.5
Acknowledgments
We thank Ms Marie Montague and Dr James Le Fanu for help and advice. This research was undertaken as part of the medical degree course at Queen Mary College for three of the authors.
Contributors: NA wrote the initial paper, with revisions from all authors. NA, TL, and VA collected the data. All authors helped to analyse the data, led by PW. PW initially designed the study, with revisions made by all authors. PW is the guarantor of the paper.
Footnotes
Funding None.
Competing interests None declared.