For the past 40 years, I have been talking to journalists about research. Often, it has been at a press conference being arranged by the organizers of a national or international meeting. I have also frequently been asked for my opinions about a research study carried out by someone else.
Discussions with the medical press are essential to the proper dissemination of information to colleagues. Researchers have a responsibility to ensure that reporters are receiving a valid scientific message.
The leading medical journalists are well informed and ask good questions. They understand that the scientific process is slow and messy, and they appreciate the importance of debate, criticism and uncertainty.
But talking to the lay press is an entirely different experience. With a few exceptions, journalists who are not immersed in the world of medicine have little appreciation for the process by which medical advances evolve. They want a clean exciting news story. But research studies do not generally lend themselves to the unambiguous declaration of a newly discovered truth.
The problems often begin even before a journalist is ever involved.
Suppose a physician is about to present or publish an important paper. Many medical schools forbid researchers to communicate with the press unless the school's press office mediates the interaction.
However, the relationships between researchers and medical school press offices are often incredibly frustrating. In my experience, the office personnel typically know little about medicine, and most do not know how to write. Yet, they are tasked with writing the press release about the paper.
I have spent hours carefully explaining my work to public relations staff. No matter how much effort I put into the discussion, I often receive a draft of the press release that is riddled with inaccuracies or misses the whole point of the study. All too often, I end up rewriting the entire release.
What happens next? The press office needs to "sell" the story to the lay press, which typically has little interest in small incremental advances in science. So the press office is often tempted to exaggerate the story to get someone's attention.
Just before the paper is published, reporters call investigators to talk about their research. Somehow, they have the impression that the new study is going to transform science or the practice of medicine -- or assumptions about health.
A typical interview comment: I understand that your work is a breakthrough and has major implications for health.
The correct response: Really? I don't think scientists should generally use such phrases.
A reply: Well, is it a breakthrough or not? If you want me to cover your research, I only have time for this story if it is a breakthrough. So is it a breakthrough?
Of course, most of the time, the answer is no. But some physicians cannot resist the opportunity to get attention for their work. Others might feel that the story provides them with a chance to demonstrate their worth to the leadership of the school.
The regrettable reply: Well, it could eventually be a breakthrough.
The subsequent story: Researchers at medical school report study that could well represent a breakthrough in the treatment of freckles.
Suppose the researchers only studied mice. The study shows that a drug can prevent fear of cats in mice. The lay reporter asks how soon the new treatment will be used in people who fear cats.
The researchers know that the work may have no applicability to people, since human studies routinely fail to replicate findings in mice. But in their zeal, some are not so cautious. Their reply: If everything goes well, this could lead to a new treatment for people who fear cats, but it will take years.
The text from the news story: New discovery could well lead to a breakthrough treatment for people who fear cats within a few years.
Think this is bad? It can get much worse.
A great deal of press coverage is focused on observational studies, often in areas where metrics are poorly established, and the confounding of results is an insurmountable problem. Many of these studies are hypothesis-generating or entertaining at best, but often, a reader of the story will never know that.
The hypothetical story: Researchers find a link between not eating tomatoes and anger. So if you want to lead a calm life, you should eat more tomatoes. (I picked tomatoes, because in the 1600s and 1700s, people in America generally thought that tomatoes were poisonous and did not eat them, thus undoubtedly contributing to the emotional turmoil that led to the American Revolution.)
Junk science? Absolutely. But thousands of people will click on the article. And media outlets know that.
A few times in my career, I carried out research that had real implications for the public. I knew that the risks of talking to the lay press were enormous, and I spent a lot of time getting the message right. Every time I heard that the lay press wanted to talk to me, my emotional response was never excitement. Instead, my overwhelming feeling was caution. The goal was to gingerly inform, rather than purposely inflame.
A journalist once asked me if the process of talking to the press was similar to the process of talking to patients in clinical practice. My reply: absolutely not! In talking to patients, I make every effort to make sure that they understand. In talking to the press, I make every effort to make sure that they do not misunderstand.
But sadly, some physicians are addicted to the lay press. They have learned exactly how to feed the hunger of journalists, and they understand how to deliver perfect sound bites. And journalists know they can call them at short notice for a reliably sensationalist viewpoint that includes a juicy quote.
Such musings may be great stuff for blogs. But they are not research, and they are not news.
Medical knowledge evolves in a process that is not typically characterized by newsworthy events. The complex oscillations and deliberations of medical research are not well-suited to the goals of the lay press.
Whether the message is one of hope or risk, researchers who seek to deliver unambiguous excitement or shock through the lay press only aggravate public mistrust in medicine and the scientific process. When the emotional needs of physicians and the lay press are aligned, we should all worry.
Disclosures
Packer recently consulted for Actavis, Akcea, Amgen, AstraZeneca, Boehringer Ingelheim, Cardiorentis, Daiichi Sankyo, Gilead, Novo Nordisk, Pfizer, Sanofi, Synthetic Biologics, and Takeda. He chairs the EMPEROR Executive Committee for trials of empagliflozin for the treatment of heart failure. He was previously the co-PI of the PARADIGM-HF trial and serves on the Steering Committee of the PARAGON-HF trial, but has no financial relationship with Novartis.