What I might say at the media plenary

The content of the National Health Policy Conference plenary at 2pm today is advertised to be:

The Media’s Role in Health Policy: What role does the media play in health policymaking? Does the media set the policy agenda, or do policymakers set the news budget? Industry experts discuss the delicate relationship between the two.

I’ll be happy if I can make even half of the following points. Other things may come up though.

1. The media do not make policy. They are informative and influential, but not usually determinative. There are many other relevant actors and forces. Think of road signs or GPS. They don’t tell you where you want to go. You know that already. They show you how or how not to get there or what alternative routes might look like.
2. The policy relevant media are broad, including traditional media, academic journals, blogs, Twitter, Facebook, YouTube, etc. The differences among these environments are important. Some institutions and formats are constrained by economics, expectations, and traditional roles. Some are struggling with this. Some are friendlier to researchers in different ways.
3. The marginal cost of participating in the policy debate has come way down via social media. One can inform and influence with no funding, no advertising. This democritization provides freedom and allows for greater diversity of mission. This should be celebrated and more productively exploited. Only 1 out of every 2,500 articles in health care are ever reported by the media. Researchers can help promote policy-relevant work.
4. Recent publications document the media’s role in health policy, as well as the role of researchers.
5. Some caution is warranted since academics and subject-matter experts self-select (as they should) the degree to which they promote work in/to the media. There is risk of sensationalizing marginal or contrarian findings or outliers. More voices that promote the work of the community, rather than just one’s own work or work from one ideological perspective, would help.
6. This, in part, would address conflicts of interest. Be wary of too much self-promotion or too much promotion of the agenda from “one side.” Some media cater to confirmation bias. It’s in their business plan because the economics work.
7. “Truth” is important, yet “belief” often carries the day. As in medicine, in the media there is a lot of eminence-based, rather than evidence-based work. For those of us that love facts and research, this is tragic.
8. Moreover, the media can over-reward hubris. Strong voices are sought and promoted. It is common to see debates between two “pure” positions. However, the idea that one’s latest concept will work perfectly and/or the “other team’s” is fatally flawed in every possible way is not credible. Health policy is hard or we’d have solved the big problems in that domain by now.
9. We’re even having debates over whether evidence is important. Comparative effectiveness research is one such hot button area where this arises (rationing, patient autonomy, guidance by experts). One way to cool the debate and make progress in exploring the policy space is to consider it from a patient safety angle. First do no harm.
10. I encourage researchers to get involved on Twitter and blogs. Promote the work of the community when it is timely and relevant. Press releases are not enough.

AF