The April 18, 2019 CNN headline was a prime example of clickbait: “Feds charge doctors in 8 states in opioid bust, including ‘Rock Doc’ accused of trading pills for sex.”The only problem with this headline? Of the 60 individuals charged, half were not physicians. More importantly, Jeffrey Young, the so-called “Rock Doc” who prescribed nearly 1.5 million pills of opioids and benzos often in exchange for sex, is not even a doctor at all. Young is a nurse practitioner who had his nursing license restricted for similar accusations in November 2018.The media seems to love to hate doctors
Try the same Google search of NPR, but this time, type “nurse practitioners” instead of physicians. The first hit: “How 2 Nurse Practitioners Decided to Help Babies Touched by the Opioid Crisis.” Next up: “As Health Care Demands Grow, So Does the Need for Nurse Practitioners.”
Even physicians contribute to our own media bias. In the April 19, 2019 NPR report “Why do Doctors Overtreat? For Many, it’s What They’re Trained to Do,” family physician Mara Gordon describes a push for excessive testing in physician residency programs. She cites her own story, a case of a young man with rectal bleeding who she referred for a colonoscopy. Gordon bemoans her aggressive referral: “the patient’s bleeding was almost certainly caused by hemorrhoids and watching and waiting for a few weeks would have been safe and helped the patient avoid an invasive procedure.”
As a health and media fellow at NPR, Gordon is following the party line. But as a physician, she knows perfectly well that any ongoing rectal bleeding will warrant a colonoscopy even in young people, as the rates of colorectal cancer are rising precipitously in young adults.
One thing is certain: had Gordon chosen not to refer her patient, and he was later found to have colon cancer, no doubt the media headline would have condemned her failure to act.
Doctors just can’t win. But worse, when physicians face excessive media criticism, patients also lose.
First, the media bias against physicians has inspired a public distrust of doctors. Most physicians are dedicated individuals who hold patient care as sacrosanct. But patients rarely hear stories of these doctors in the media. Instead, they are barraged by terrifying stories of the occasional bad actor.
This may cause patients to become fearful of all doctors and lead to a delay in seeking necessary medical care.
In addition, negative publicity is taking a toll on physicians, who are already facing high levels of burnout. For example, the British Medical Journalreported that a critical portrayal of doctors in the media has a demoralizing effect on physicians.
Forty-eight percent of all doctors are already making active plans to leave the practice of medicine. Damning headlines meant to inspire public outrage against physicians can only worsen the physician exodus from medicine. As physicians leave practice, patients will suffer.
Why such negativity against doctors?
While some media bias may be a simple matter of attracting readership by sensational headlines, funding sources are likely a contributing factor. For example, the Robert Wood Johnson Foundation, which is committed to expanding the role of nurse practitioners across the country, donated $4 million to NPR in 2018 to strengthen health coverage “through new content and coverage areas.”
Examples of this expanded health coverage include an April 15, 2019, NPR piece on the use of artificial intelligence for ophthalmologic exams featuring interviews with nurse practitioners. And the February 2019 report on CVS making drugstores a “destination for health care,” which points out that CVS is easier for patients to get to than doctor’s offices, and asks us to “imagine a world where a patient can walk into a drugstore” and “talk to a nurse practitioner.”
And we can’t forget Gordon’s NPR piece accusing doctors of overtreating patients, which failed to mention studies that show nurse practitioners and physician assistants order more imaging tests, perform more unnecessary skin biopsies, prescribe more unnecessary antibiotics, prescribe more steroids for colds and give more psychotropic medications to children than physicians. If anything, doctors are showing improvement — between 2003 and 2015, the number of skeletal X-rays ordered by non-physicians increased by 441%, while the rate of X-rays ordered by primary care physicians decreased by 33.5%.
However, NPR rarely reports positive news about physicians. Their health coverage failed to mention the February 2019 JAMA report showing that a greater primary care physician supply is associated with lower mortality in the United States. In fact, when I Google “primary care decrease mortality and “NPR,” there is no mention of the report. Instead, here’s the first hit: “Steep Climb in Benzodiazepine Prescribing by Primary Care Doctors.”
Doctors are noticing this media bias and starting to speak out. When NPR’s Planet Money did a segment advocating for nurse midwives, physicians complained so vociferously that the NPR ombudsman wrote an article acknowledging one-sided reporting (“Call the Midwives, But Ring the Doctors, Too“) but offered no retraction or additional information to listeners.
The media has a responsibility to present fair and unbiased information to the public, and that includes accurate reporting about physicians. Patients and physicians must hold media organizations accountable by speaking out against this ongoing assault.
Rebekah Bernard is a family physician and the author of How to Be a Rock Star Doctor: The Complete Guide to Taking Back Control of Your Life and Your Profession. She can be reached at her self-titled site, Rebekah Bernard, MD. This piece was first published on KevinMD’s blog.