Medicine’s relationship with the mass media is fickle with clinicians praising its judgement one minute (when they are subject to media approval) and cursing its trickery the next (when the object of criticism). The truth is that the media deserves a more reasoned attitude, a view I have come to after working closely with the media for much of my professional life. The story is relatively simple. In the early 1980s (as I was turning 40), I realised (probably later than most people) that the most powerful influence on our day-to-day thinking was the media. Each morning, as we turned on the radio or read the “daily”, it was the mass media that set our minds ticking and our tongues wagging. But this was a source that did much more than tell us the news. It dawned on me how, in so many ways, the media moulded (sometimes for good, sometimes for bad) our attitudes, orchestrated our behaviour, determined societal values and norms, and with ease seemed to shape politics and opinions. Alone, my “discovery” might have had little moment had I not made two further observations and changed the way I saw myself.
Observation one was that the media often got things wrong, and since I assumed (and still do) that journalists were intelligent professionals who wanted to base their output on “facts”, the simplest explanations for errors or distortions were either that the journalists did not have access to the facts, or that the facts journalists obtained were unreliable or partisan, or that the journalists themselves were either technically inept at, or had too little time for accurately interpreting the data. This being so, I reasoned that the media could benefit from independent help.
Observation two related to my role as a clinical pharmacologist. I believed strongly that my key goal in teaching medical students (and doctors) about medicines was to show them how to prescribe properly, and for me this meant how to prescribe in the best interest of patients. To this end I also believed I had a responsibility to educate patients themselves about medicines, for ultimately it would be they who would have to take the products. What I realised in the early 80s was that teaching students, doctors and patients was not enough. If I were to influence prescribing, I would also need to ‘educate’ the media and through it help create an environment in which medicines would be sensibly viewed and used. My instinct to work with the media became so strong that I felt that were I not to “cooperate” with the media, my inaction would be tantamount to negligence, a view that I felt applied equally to all scientists and doctors.
Finally, there was an important matter of how I saw myself. Up until my late 30s I felt that my views were only for local consumption and would not be seen as of value in a wider context. Things then changed and for some reason I felt that my insights and understanding could be of broader interest and might even merit an airing in the mass media. Moreover, I felt that the positions I held were at least as legitimate as those of others which anyway often seemed misinformed or to have ideas that ran counter to the interests of patients. Luckily, through my work with the Drug and Therapeutics Bulletin (then as deputy editor), I had a natural entrée into the media and my media life began.
Over the years I have worked with the media in many guises (appeared on radio and television, written pieces for the press, offered journalists advice in confidence, provided umpteen background briefings etc). Early on I realised that whatever I said or did, I should not alienate my work colleagues (unless there was very good reason) or undermine my professional position as an academic. To this end I was careful only to speak or write within my area of expertise and to make it clear when or if I was “out of my depth”. When pushed either by an interviewer (Paxman is all too good at this) or an opponent in a debate, I often felt pressured to exceed my knowledge base and, to my shame, occasionally I yielded.
My priority was always to be truthful, clear and unambiguous and to remember that my ultimate objective was the welfare of patients and the public. I did not feel cheated if the interviewer/programme chose to take an opposing position to my own. Those working in the media have every right to their opinions and if we did not agree, so be it. What I wanted was that my opinion was heard, was taken into account, and was reported honestly.
I soon leaned to tailor my contribution to the particular venture with which I was involved. Sometimes “journalists” would know little about the issue at hand and I would work with them for hours to put them in the picture. Some programmes were short and snappy (a news bulletin) so ideas had to be condensed into short sentences and presented in the traditional “sound bite”. Some transmissions entailed detailed analyses for specialist audiences with questions from well read journalists and these could be taxing especially if the programme lasted for say 30 minutes so allowing an argument to develop. Then there were programmes that involved debate (usually “live”) where one had to juggle between answering the interviewer (for whom trickery was a byword), responding to an “opponent” (often well versed in the art of undermining), and communicating with an audience of possibly millions. These debates were by far the most challenging and often demanded that I find key words and marshal key facts at a time when tension was high (the media loves tension!), and this I can find difficult.
As part of this work, I also served as an advisor generally on matters relating to clinical pharmacology. At the height of my involvement I would get 2-3 phone calls a week asking for help: checking out stories; identifying relevant directions of enquiry, finding possible authorities to interview etc. More often than not I would advise against pursuing particular leads.
Then there was my role as a go-between. From time-to-time I would receive anonymous “tips” by phone or in brown envelopes (government officials were not above this). How best to pass these on to the media required insight into the media outlets and a close working knowledge of the interests and trustworthiness of the journalists. Sometimes this was not easy.
Working with the media has taken much time (the luxury of being an academic) and effort, but has been great fun and has made me much wiser (my understanding of the need to control the agenda has been invaluable). Compared to when I started I find that the media gives drug provision and drug policy a higher priority, and is aware of the legislation by which the use of medicines is controlled. Patients and patient groups too seem much better informed. As a corollary, “medical” correspondents seem better informed than ever before. Government clearly keeps a close watch on the drug issues covered in the media and uses the media to broadcast its messages. And patients, the public and politicians too seem much more aware of the politics surrounding the use of medicines than when I started. It is difficult to know what influence I have had working with the media, but whatever effect I might have had it has always been chastening when those who say they have seen/heard me never quite know exactly what I said. But the same often also goes after lectures to students and explanations to patients!
Joe Collier is emeritus professor of medicines policy at St George’s, University of London