Virtual meetings. Writing about health care reform, Chapter 1. Evidence-based medicine. Conflict of interest. Medical Web 2.0, Whee!
[We have an RSS feed. No orange icon, but click here. If that doesn't work, the URL is http://www.nasw.org/rss.xml]
REMOTE VIEWING — AND LISTENING. It's not an easy century for science writers so far, but the 21st has a few cool aspects too. One of the coolest, especially for an endomorph like me, is that scientific meetings and lectures and useful briefings often are available remotely, either by webcast or telephone.
Not that going to a meeting doesn't have its virtues, the chief one being schmoozing with a critical mass of researchers and fellow scribes. That's a pretty important experience you really can't get any other way.
But dragging yourself out of the sack at 3:30 in order to make a 6 a.m. flight was an undeniable hassle even back in the last century, when at least you could keep your shoes on as you passed through the scanner. And, crucially, few of us could have afforded to do it at all if publications hadn't been paying travel expenses for meeting coverage. Which they hardly ever do now.
But we can still go to meetings. In fact, we can go to them comfortably, coffee mug and bagel-mit-schmear in hand, keyboard on our desks instead of our laps, and even arrayed in our jammies. Lack of schmoozing is a big drawback, and webcasts and teleconferences are imperfect technologies. Still, partial attendance is better than no attendance at all, which is usually the alternative.
The reason I am making lemonade out of the lack-of-travel lemon is that I spent part of this morning — Thursday morning, I mean — in Tucson happily taking notes on a briefing in Washington. The topic was how to write about the massive health reform process Congress launched in the spring.
I got to listen to other writers talk for more than an hour about how it is to cover the chaos that has followed passage of health care reform legislation. Among the things they've been trying to find out is what's actually in that legislation, and how what's there differs from what folks on both right and left have been claiming is there, and what impact it is likely to have on health care in this country.
Not that anybody really knows what the impact will be, as the speakers pointed out. Many effects of the legislation are unpredictable, and not even those involved in writing the bill understand everything in it. Ask a Congressional staffer to explain the meaning of a particular section of the legislation and you may be told, "Hmmm, I don't know what that paragraph means either." Even worse than this honest ignorance, ask several staffers and you may well get several different mutually exclusive answers.
The writers shared tips and advice for hacking your way through this jungle of obfuscation. Joanne Kenen, who writes magazine pieces and runs the New Health Dialogue blog for the New America Foundation, explained how her articles and blog posts feed each other. Julie Rovner, health correspondent for National Public Radio, noted that an enormous amount of what's specified in the law is to be decided later, and that means during the regulatory process. Unfortunately, she lamented, regulation is not a radio-friendly story.
Phil Galewitz, correspondent with Kaiser Health News, advised writers to follow the money and the calendar. Billions are to be ladled out; tracking how it's spent and what it accomplishes (or doesn't) will provide endless fodder for writers. Tracking timelines will also be fruitful; come this fall, for example, there will be big changes in the Medicare Advantage program that's so important to a huge chunk of the older population. And set your calendars for 2014, when the biggest changes in the health care system are scheduled to occur.
Noam Levey, who covers health care policy for the Los Angeles Times/Chicago Tribune Washington bureau, cautioned that the void in actual information about the legislation and what it will do encourages speculation. Critics are aggressively sowing stories of doom and gloom, but, contrariwise, the legislation's proponents are making inflated claims about the miracles that will ensue.
Thanks to one of the sponsors, the Association of Health Care Journalists, you, too, have access to this session even though it's ended. (Full disclosure: I'm a member of AHCJ.) An MP3 version is posted here on the AHCJ web site.
While you're listening, scroll down the page for a long list of resources. They include timelines for implementation of the huge number of provisions in the legislation, fact sheets, summaries of key changes in health care coverage, including changes in Medicare and Medicaid, reprints of relevant articles, and the all-important decoding of jargon. Many come from the session's other sponsors, the Alliance for Health Reform and the Robert Wood Johnson Foundation.
I haven't looked at medical and health care blogs here for a while, so while I'm up, here's a miscellany.
EXAMINING THE EVIDENCE FOR ATTITUDES TOWARD EVIDENCE-BASED MEDICINE. Evidence-based medicine is a buzzword that is forecast to become increasingly central to health-care reform, or so many hope. It means applying the results of scientific research to medical decision-making. Evidence-based medicine is supposed to evaluate clinical studies to assess the risks and benefits of treatment — and lack of treatment. The result is to be rational therapy, rationally applied. Hurray.
Except that patients (and docs, for that matter) have not always been so crazy about conclusions of EBM studies. The recent high-profile example was advice from the United States Preventive Services Task Force to delay regular screening of women for breast cancer until age 50 and to do mammograms every two years instead of annually in older women. The result was widespread high dudgeon among patients, advocacy groups, and physicians — even though the data show that the new measures would reduce harm from overtreatment.
At the Health Affairs blog, Chris Fleming describes a study the journal has just published showing (perhaps not surprisingly) that patient misconceptions and ignorance are behind much of the resistance to national recommendations coming out of evidence-based studies. The fact is that people are convinced that more care and newer care and costlier care is better. But you knew that. Find the paper here.
WHAT IS 5-2-1-0? I get the impression that Katherine Hobson, who writes for the Wall Street Journal's Health Blog, is not mad for Blue Cross Blue Shield's new slogan aimed at encouraging kids to adopt healthier behaviors. It is undeniably cryptic: 5-2-1-0. OK, 5 is probably that daily fruits-and-vegetables thing we've been hearing about for a while. For decoding the rest, consult Hobson's blog post.
EXAMINING THE EVIDENCE ON CONFLICT OF INTEREST. Conflict of interest is commanding increasing attention in medicine and medical research, and with health care reform it's only going to get more so. Here's Kate Travis's useful roundup of recent articles on medical conflict of interest. I'm not quite sure, though, why it's posted on the Science Careers Blog. Cautionary tales for those planning on becoming physicians and biomedical researchers?
EVIDENCE-BASED NINTENDO Wii. If you're truly cutting-edge, you'll want to check out ScienceRoll, where Bertalan Mesko is culling the literature for papers on evidence-based Web 2.0/social media research in medicine. Current topics include employing Google Trends for epidemiological studies, a social-media portal for young patients with Type 1 diabetes, and using the Nintendo Wii gaming system for stroke rehab.
It works.
