Once every few weeks I get to write something extremely serious in the BMJ.
BMJ 2007;335:480 (8 September), doi:10.1136/bmj.39328.450000.59 Observations – Media watch Journalists: anything to declare? Ben Goldacre, doctor and writer, London.
“Drug companies wouldn’t pay for the media to attend their events if they didn’t think it would affect coverage, yet journalists’ competing interests usually remain undeclared.”
Much as I like to fantasise that I am cynical and worldly, as a doctor and a journalist, the world still holds some surprises. Conflict of interest is a subject that creates heat and concern, not least for journalists, who often stumble upon a banal and openly declared interest, and use it to build fantasies of medical corruption and Pullitzer prizes.
Now, while there is good evidence for the venality of pharmaceutical PR – and its success in influencing published academic work – it’s often tempting to point out that the entire culture of academic funding has changed over the past 20 years: and that politicians, journalists, and the public themselves might take some responsibility for the fact that governments choose not to fund academic work.
But that’s a digression: in light of the puritanical stance of so many journalists, I was surprised last week to receive an email circular, from a science writers mailing list. It was from the Aspirin Foundation, a group funded by the pharmaceutical industry, and it was offering – on behalf of Bayer Healthcare – to pay expenses for journalists to attend the European Society of Cardiology conference in Vienna.
Aspirin is without doubt an excellent and cheap drug, but in my naivety I had no idea such things went on. I pinged off a few emails to friends and colleagues, and most poked fun at my innocence – quite rightly – but some were very helpful. Not only is it extremely common for journalists to take money from pharmaceutical companies, but there have been some astonishing cases over recent history, including one memorable case where a PR company invited journalists to “an exclusive preview” of new laser eye technology, with the offer to “discuss free treatment in return for editorial features”.
“I organise the media programmes for a number of medical conferences run by scientific societies”, said one person who, without wishing to be melodramatic, has asked to remain anonymous: “and I reckon at least 50% of the journalists present are paid for by drug companies. They get pretty well looked after too – first class travel, 5 star hotels, posh dinners etc. Some of them indulge in double-dipping… where they are paid a per diem by the drug company and then by the publication that takes whatever they have written. Sometimes they don’t even use the press room, spend all their time in company hospitality suites, and just go to company sponsored satellite sessions and press conferences.”
What was more striking was the range of responses: some laughed at my naivety; some wrote expressing outrage at the insightless venality of their colleagues; and some were emotive and defensive, belittling the notion that there was anything to worry about, and explaining that a journalist can detach themselves and be impartial. It was, in fact, almost exactly the same as the arguments amongst medics, played out in editorials and letters about conflict of interest in academia, over 15 years ago.
Then, as now, it’s easy to become histrionic about conflict of interests (or “competing interests” to give them their more metered title). A conflict of interest is “a situation not a behaviour”, as they say, and simply because somebody receives funding or jollies, that does not mean they will change their minds. But it’s a discussion worth having: only one journalist friend mentioned seeing a declaration of competing interest appear next to their article (it was in the Guardian) and few journalists I spoke to could think of any explicit policies on the subject.
And there are very real dangers in being too close to public relations people: lovely though they may be, their trade is – by definition – manipulation. Drug companies are businesses, with responsibilities to their shareholders, and they wouldn’t pay for journalists to attend their events if they didn’t think it would affect coverage. A journalist’s article is far more credible than a paid advert, after all, for anybody’s money, and more likely to be read by potential consumers.
As we know from medicine and academia, the ways of conflict of interest can be subtle: not just money, hotels, and free eye surgery, but also the “revolving door”: the free movement between “mass media journalist” and “industry copywriter” is every bit as worrying as the gay dance from FDA regulator to drug company.
But most often, it is simply a matter of fostering a relationship. In the 1980s, as any medical student could tell you, the link between aspirin and Reye’s Syndrome had recently been discovered. For non medical readers, Reye’s affects children and is frequently fatal.
And in 1982, the Aspirin Foundation of America – a similar body to the one offering money from Bayer this time – was fighting a successful media campaign against the government’s proposed warning labels on aspirin packages. “The Aspirin Who? Foundation?” It’s much easier to get someone to take your calls when they’ve eaten your food, slept in your bed, or taken your money. And I, for one, in future, will read journalists’ hysteria about academic conflicts of interest with a very wry smile indeed.
Declaration:
I think this might count, I’ve won it twice, as have most newspapers:
www.sciencewritersawards.co.uk/science/past/2005/index.htm
Other than these journalism prizes, I have received no money, no conference travel, no free gifts, no research funding, no paid work, no speaking engagements, no educational grants, no golf club memberships, no nothing. That’s not to say I think it’s bad if people do work for big pharma, or accept this stuff: I just think it’s interesting that there are no routine mechanisms by which journalists can declare them.
ncullum said,
September 7, 2007 at 8:07 am
Frankly, I am surprised at your surprise. This has always been the case. The number of journalists above suspicion and with the skill and insight to write great stories is rarely more than a handful.
The great British public however are well aware of this. Journalists always rank towards the bottom of any poll of “honourable” or “trustworthy” or “respectable” professions – along with estate agents and the like…
Teek said,
September 7, 2007 at 8:27 am
@ ncullum: fair enough, but a helluva lot of people out there take advice from many journalists verbatim, especially when it comes to health and science – just look at the impact the MMR/autism reporting has had. pushing pills by direct advertising is effective, but getting a lifestyle correspondent to endorse your product in an aritcle in a national paper must be like liquid gold to Pharma.
journos might not be trustworthy, but they still exercise a fair amount of influence in our decision-making, so declaration of competing interests would be welcome. never gonna happen mind…
doris said,
September 7, 2007 at 8:38 am
I have read many reports about the gradual shrinkage of state,or government funding in recent years.
I believe that a substantial,and growing number of research projects are now privately funded or sponsored:this reflects government policy:’private good;state not so good’.
At least this report is honest in acknowledging its naivety.A refreshingly candid viewpoint.
On a couple of occasions in the near past,I have noticed that my GP did not take much interest in my reporting of unacceptable drug side effects.
The yellow card system seems to have fallen into disuse:is this possibly a result of drug company pressure?
I mean no criticism in voicing this question,but it does concern me.
doris said,
September 7, 2007 at 9:37 am
My previous entry reads as a lengthy digression;(because I followed the conflict of interest link)>
I should have concluded by broadly agreeing with Spider J:if I read an article about a new drug or treatment in the Guardian,I will probably be inclined to rely on its integrity,whereas an advert will inevitably elicit a very cynical response.
You have to trust some of the people,some of the time,or risk complete alienation and paranoia.
CaptainKirkham said,
September 7, 2007 at 1:34 pm
Superburger, is it relevant to ask why people would be surprised? Some people clearly are. And if nothing else this demonstrates that not everyone does assume that journalists have be paid to attend a conference. If pressed on it, I’d have thought that conference attendance would be paid for by a newspaper. Sure, you might get your conference lunch for free, but the idea of journalists having their flights and hotels paid for too would indeed surprise me. I did not think that this happened.
It is true that being paid to listen to something does not necessarily mean a journalist will change their opinion. The point is though that I want to know! Just like with scientists being funded by a pharmaceutical company, I don’t personally want thing stopped/banned/whatever – what I do want is information so I can make an informed judgement when I read something.
elder_pegasus said,
September 7, 2007 at 1:50 pm
I’d never heard of this happening for pharma, but I’m reliably informed this certainly used to happen in my own industry (games). I seem to recall the wording was “if you want a good review, you take the journalists out, get them p***ed and get them l***ed”….
Oldfart said,
September 7, 2007 at 2:35 pm
If you have a new product, whether it be a new drug or a better mousetrap, you want to get it noticed. I would imagine that paying the expenses of journalists to come to your press conference would be a good way to spread the word. Doesn’t necessarily mean that reports about your product will all be good for you but it might mean that your product name is placed in front of many people with the reputation of the various journalists behind it.
I find that to be very different from say, funding a research effort and paying scientists to research your own product. As with everyone else, scientists like to remain employed and are thus subject to pressure.
prosthesis said,
September 7, 2007 at 4:12 pm
superburger: “that anyone should expect a drug company to be more or less ethical than a car company is a complete mystery.”
exactly. this all relates back to the column Ben did recently about our expectations of pharma being higher than for other industries.
i have (obliquely) dealt with PR firms who work for pharma, and you can bet they all have a stable of tame journos they feed stories out to, invite to press releases etc.
maybe newspapers should publish journalists expenses claims and who paid them 🙂
Despard said,
September 7, 2007 at 8:57 pm
I thought it might mean ‘licked’.
…
But I don’t know what the point of that would be. Ah well, back to writing my thesis…
Bob H said,
September 7, 2007 at 9:43 pm
I think you have found the past pluperfect of the verb laid. As in,
“The journalist would have been laided but professional ethics had gotted in the way.”
See how sensible that sounds?
Littleshim said,
September 7, 2007 at 11:31 pm
Lanced?
Some could certainly do with it.
banshee said,
September 8, 2007 at 11:48 am
Doris – the yellow card system is indeed alive and well. There are 2 levels of reporting by health professionals though – recently licensed medicines (so called “black triangle”) should have ALL adverse effects reported. Less recently introduced medicines should only have more serious adverse reactions reported.
Which may (or may not) explain your docs disinterest.
And, BTW, ANYONE can report adverse effects on the MHRA website – go to www.mhra.gov.uk and follow the yellow colour coded links.
doris said,
September 8, 2007 at 1:30 pm
Thank you,banshee,most useful;I shall look at the website, and your comments could well account for the apparent lack of interest
CaptainKirkham said,
September 10, 2007 at 12:03 pm
Superburger – I don’t know. I’d like to. That’s point. You seem to know. Good for you. Lots of people don’t, and your insistence that people should know doesn’t change that.
nekomatic said,
September 10, 2007 at 1:24 pm
Bizarrely, aren’t travel journalists at the forefront of establishing standards in this field? I’m pretty sure that on the rare occasions that I read the articles about particular destinations, resorts etc in the travel pages, the small print usually includes something along the lines of “(reporter’s name) travelled as a guest of (company)”, making clear that (company) in effect paid for the article.
jj_hankinson said,
September 10, 2007 at 1:24 pm
I think that within the journalism community these corporate-sponsored trips to conferences, trade shows etc. are very much seen as legitimate perks.
Certainly it would seem to me that the IT/technology publications (the sector I know about) are almost 90% polluted with PR guff turned into factoid stories…
RS said,
September 10, 2007 at 6:13 pm
I think it’d look less bad if they didn’t simultaneously have a go at the doctors and scientists for the same actions.
quietstorm said,
September 10, 2007 at 7:41 pm
At the beginning of the thread someone pointed out that surveys frequently list journalism as one of the most least trustworthy professions, yet it is abundantly clear that once a thing is published in a newspaper, people will believe it. After all, where did the MMR hysteria come from if not from the press?
People may claim that they don’t trust journalists, but still believe the things they read in the paper. It’s not logical but it’s plausible… most of us employ a certain amount of doublethink all the time.
Are these surveys a true indication of people’s beliefs and behaviour?
I have much less faith in these surveys than I used to. I was filling in time on a bus one day, and took one of those “self-assessment” quizzes in a magazine, I think it was about health. I wasn’t paying a huge amount of attention, I just filled it in (how many portions of fruit and veg do you eat, how often do you drink, and so on). I later found the magazine when I was emptying my bag and was shocked to see how much I had lied on it! I hadn’t intended to lie, but upon rereading my answers I realised I had said things that I thought people would want to hear.
Does anyone know if there are studies investigating the relationship between the answers people give on these surveys and their actual opinions/behaviour? Sorry for the digression, but it seems to me that a large percentage of the general public do trust what they read in newspapers, and so that makes this discussion important.
kim said,
September 11, 2007 at 1:40 pm
There are two newspapers I know of that have explicit policies on this. One is the Guardian, which requires journalists to declare their interest; the other is the FT, which refuses to publish reports of a trip that has been funded by a third party, full stop.
It’s pretty commonplace in travel journalism for the journalist’s flight and accommodation to be paid for by the holiday company.
JBM said,
September 13, 2007 at 4:32 pm
If the hospitality was being offered by the UK subsidiary of Bayer, then it is covered by the Association of the British Pharmaceutical Industry (ABPI) Code of Practice. Although the rules are generally intended for doctors, they also extend to cover contact with other people, including journalists.
Clause 19.1 is explicit: “Hospitality must be strictly limited to the main purpose of the event and must be secondary to the purpose of the meeting: ie subsistence only. The level of subsistence offered must be appropriate and not out of proportion to the occasion. The costs involved must not exceed that level which the recipient would normally adopt when paying for themselves.” The guidance also states that: “…Companies should only offer or provide economy air travel to delegates sponsored to attend meetings.”
Ben should send his complaint to: complaints@pmcpa.org.uk. Although adherence to the code is voluntary, pharma companies do take sanctions from the committee very seriously – heads have been known to roll following more serious transgressions!
roueche said,
September 14, 2007 at 3:23 am
I’ve been a medical journalist for decades, and either I’m as naive as Dr. Goldacre or the prevalence of conflicts of interest among medical journalists is much much lower than 50%. I’ve written about my reactions to the BMJ article at the Medical Conference Blog, medmeeting.blogspot.com
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