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• v.36(22); 2021 Jun 7

Modern Health Journalism and the Impact of Social Media

Keya ganatra.

1 Seth Gordhandas Sunderdas Medical College & King Edward Memorial Hospital, Mumbai, India.

Armen Yuri Gasparyan

2 Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, UK.

Latika Gupta

3 Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Scholarly journals are hubs of hypotheses, evidence-based data, and practice recommendations that shape health research and practice worldwide. The advancement of science and information technologies has made online accessibility a basic requirement, paving the way for the advent of open access publishing, and more recently, to web-based health journalism. Especially in the time of the current pandemic, health professionals have turned to the internet, and primarily to social media, as a source of rapid information transfer and international communication. Hence, the current pandemic has ushered an era of digital transformation of science, and we attempt to understand and assess the impact of this digitization on modern health journalism.

Scholarly journals are hubs of hypotheses, evidence-based data, and practice recommendations that shape health research and practice worldwide. For centuries, such journals have served professional societies striving to solve closely related societal and healthcare issues. Some of the most successful and influential journals have emerged as the essential platforms for aggregating and publicizing scientific breakthroughs. One such example is Nature with its exclusive role for the global scientific community and individual researchers generating and testing unique hypotheses.

The advancement of science and information technologies has made online accessibility a basic requirement for comprehensively covering large volumes of scientific literature and synthesizing new evidence influencing global health. Keeping this in mind, the Budapest Open Access Initiative first coined the term “Open Access” back in 2001 and paved the way for publicly disseminating and archiving scholarly works which may improve education, research, and practice all over the world. 1 , 2 To meet the growing demands of open search engines, platforms, and databases, the Directory of Open Access Journals (DOAJ) was launched in 2003 to register open-access journals across all academic disciplines and in all languages. 2 , 3 Over the past years, the number of DOAJ listed periodicals has increased from initial 300 to more than 16,000, representing 125 countries.

Open access publishing, with its diverse quality characteristics, access options, and business models, has offered enormous opportunities for all researchers and authors who aimed to publicize their works and receive the global readership response. The global initiative has been embraced by all stakeholders of science communication. 4 As a result, an atmosphere of uninterrupted education and research has been created to offer equal opportunities to all able scholars and disseminate their knowledge via online platforms, networking sites, and various social media channels. 5 The new academic world has opened and exposed its once securely guarded resources to public views, criticism, and (re)use. With unprecedented growth of social media in the past decade, these platforms and related aggregating services have become inseparable parts of most advanced journals and bibliographic databases such as Scopus. The integration of traditional and alternative open-access media has broadened the global viewership (readership) and, at the same time, necessitated a selective approach to what is posted and disseminated online. 6

In the time of the current pandemic, health professionals have turned to the Internet, and primarily to social media, as a source of rapid information transfer and a reflection of the dynamic changes in the global health. 7 , 8 Furthermore, in light of the current situation, several journals have ceased to release printed versions of their issues and have completely adopted the web-based approach, marking the end of the paper-based era, and heralding the onset of the modern digital era of health journalism.

Social media have come to the fore as reliable platforms for online research, emergency meetings, and networking sites for aggregating various audio and video materials and gauging specialist and general public views on the ongoing pandemic. 9 , 10

Social media see millions of active users accrue on a regular basis, with Twitter currently having approximately 350 million users. 11 An example of how the medical community has turned to social media for the spread of knowledge and communication is the international paediatric critical care community, which studied the use of the Twitter-generated 2016 hashtag #PedsICU in the COVID-19 pandemic. 12 The study demonstrated a rise in the use of this hashtag along with coronavirus-related hashtags, the most popular of which were links to open-access resources. 12

The integration of social media with scholarly journals increases viewership and readership, immediately reflecting on published contents and contributing to science mapping metrics such as altmetrics 13 ( Fig. 1 ). The transit of journal clubs to social media such as Twitter further increases the implications of scholarly articles for education. The online interaction of students with their mentors enables uninterrupted education and quest for knowledge in the time of crisis and travel restrictions. 14 Social media is increasingly used to conduct survey studies and generate emergency data that immediately influence public health strategies. Numerous online survey reports are now published with support of global social media users, sharing their views on old and emerging diseases and reflecting on health infrastructure. 15

The main drawback of information dissemination through social media that may negatively impact online users' health is the lack of peer review and professional filtering options. Such a drawback became apparent during the initial stage of the pandemic when unchecked information on COVID-19 therapies received a huge social media attention and misinterpreted by the public as globally endorsed. 16 , 17 This has become increasingly apparent in the current pandemic situation, where misinformation regarding the ill effects of the vaccines have gained enormous support on several social media platforms, providing momentum to the anti-vaccine movement, and hindering the efforts of the national administrations to carry out a successful vaccination drive. Additionally, a recent survey demonstrated that nearly 62% of scholars rely on social media for retrieving information on COVID-19 which may be erroneous and dangerous for patient lives. 17 Authors sometimes upload their non-reviewed and preliminary data on social media, leading to sparks with severe repercussions for the scientific community. 17 As such, experts in social media (digital editors) should be able to verify the credibility of sources prior to post-publication promotion.

An important aspect of scholarly publishing is quality peer review by experts who can evaluate logical flow, methodological rigour, evidence, and ethical grounds of research and reviews. The reviewers' primary responsibility is to provide an objective evaluation, helping editors to select and publish flawless articles. It appeared, however, that the peer review itself is deficient due to several loopholes allowing substandard, unethical, and fraudulent articles find their way to the global readership. Several solutions have been proposed to choose the best reviewers, create their registry, and increase the transparency of the review. 18 The widely promoted Open Researcher and Contributor IDs (ORCID) and Publons reviewer profiles have become instrumental for increasing visibility of the best reviewers and likelihood of their repetitive engagement in quality evaluations. 19 The Publons platform itself is integrated with Altmetrics.com; and such an integration further increases visibility of the reviewer evaluations.

Another critical aspect of modern health journalism is visibility of scholarly articles on reliable bibliographic databases and advanced search platforms to allow researchers retrieving validated local and international documents. 20 The Scopus database and the Open Ukrainian Citation Index (OUCI; https://ouci.dntb.gov.ua/en/ ) are perhaps the best examples of how Open Access, digitization, and social media have jointly transformed post-publication promotion and scholarly reuse of scientific information. Scopus and OUCI publicly display Plum Analytics social media reports (Plum Prints) next to traditional citations to allow comprehensive evaluation of covered documents.

In times of massive (mis)information flow, personalised feeds and sets of recommended items selected by digital tools and platforms may help further common academic and learning interests. 21 Powerful automated algorithms of social media may automatically select and offer relevant information to individual users such as busy clinicians and health journalists. This approach, however, creates a room for bias when dealing with controversial matters. Users may be served specific content tailored to their scientific beliefs or right-winged versus left-winged online persona, bringing in potential for confirmation bias. 22 , 23

In the past few years, scientific research, and health journalism have been greatly influenced by numerous ethical issues. The ethics committee of every organisation addresses these issues; the primary responsibility of these ethical guidelines is to ensure the safety of all beings' dignity, human and otherwise, incorporated in these projects. However, it is nearly impossible to apprehend every possible scenario that may present, and hence these guidelines are undergoing constant modification to adapt to the evolving science.

The current pandemic has ushered an era of digital transformation of science, which has provided an important platform not only for rapid exchange of information and international scientific communication, but also for a more focused and streamlined approach to indexing, accessing, and referencing the large volume of scientific literature that has presented itself in the past years. The integration of social media as a digital means of health journalism has further broadened the readership of these scholarly journals and opened doors to public review. However, if left unchecked, these online platforms could prove to be a festering pool of misinformation that could disintegrate relations between the scientific community and the general public. Hence, there is felt the need to regulate and streamline the current flux of information by a joint effort of academicians and scholarly journals for better advancement in education and research.

Disclosure: The authors have no potential conflicts of interest to disclose.

Author Contributions:

• Conceptualization: Ganatra K, Gasparyan AY, Gupta L.
• Data curation: Ganatra K, Gupta L.
• Visualization: Ganatra K, Gasparyan AY, Gupta L.
• Writing - original draft: Ganatra K.
• Writing - review & editing: Gasparyan AY, Gupta L.

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Expert Commentary

Health reporting: Semester-long course on covering the science, policy and business of health care

Semester-long course on covering health care in the United States, including investigating wrongdoing in health and medicine, and interpret health in political, socio-economic and medical contexts.

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This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License .

by The Journalist's Resource, The Journalist's Resource May 3, 2012

This <a target="_blank" href="https://journalistsresource.org/health/health-reporting/">article</a> first appeared on <a target="_blank" href="https://journalistsresource.org">The Journalist's Resource</a> and is republished here under a Creative Commons license.<img src="https://journalistsresource.org/wp-content/uploads/2020/11/cropped-jr-favicon-150x150.png" style="width:1em;height:1em;margin-left:10px;">

Health is one of journalism’s most complex and important reporting beats. Health care spending consumes about 17% of the U.S. economy, and the high cost of medical treatment affects everyone sooner or later. This beat touches on politics; economics and resource allocation; medicine and disease; business finances, marketing and sales practices; and consumer regulation and the law. It also involves conflicts of interest not only in the health professions but within the media as well. Someone covering health is expected to be expert in most of these topics and proficient in analyzing the growing amounts of health system data becoming available.

Course objective

This course is designed to acquaint reporters with all aspects of the health beat and teach them how to write compelling narratives about the U.S. system, investigate wrongdoing in health and medicine, and interpret health in political, socio-economic and medical contexts in ways that serve the public interest.

Learning objectives

The syllabus is designed to strengthen students’ core competencies in several areas:

• Finding and analyzing background reading for stories.
• Using observation to augment reporting.
• Analyzing government documents dealing with inspection, enforcement, and regulation of health facilities and other medical enterprises.
• Finding and interpreting data that measure the cost and quality of health care facilities
• Improving interviewing skills.
• Evaluating varied sources of information while connecting the dots for analysis and contextual reporting.

Course design

This course will acquaint students with all domains of health reporting. They include public and community health, the business of health, health policy, reporting on drugs and disease, and consumer health. Assignments will help them develop knowledge in these domains but also strengthen their ability to report and write about them.

There are three groups of readings for this course: general readings that apply to writing all kinds of health stories; books; and magazine articles or Internet readings that apply to particular class topics. General readings help students with writing and are meant to be suggestions for instructors to assign as optional reading.

Note: There may be more readings suggested for each class than an instructor may want to assign. Instructors may want to select readings based on course emphasis for the semester.

Optional general readings:

• “The Media Matter: A Call for Straightforward Medical Reporting,” L. Schwartz, S. Woloshin, Annals of Internal Medicine , February 2004.
• “A Journalist’s Guide to Writing Health Stories,” Gordon Guyatt et al., American Medical Writers Association Journal , Winter 1999.
• “Politics and the English Language,” George Orwell.
• “First a Story…,” Columbia Journalism Review , November 2002.
• Charles E. Lindbloom, Edward J. Woodhouse, The Policy-making Process ; Prentice Hall, 1992.
• Marcia Angell, The Truth About the Drug Companies: How They Deceive Us and What to Do About It ; Random House, 2004.
• Marion Nestle, Food Politics: How the Food Industry Influences Nutrition and Health ; University of California Press, 2007.
• Jill Quadagno, One Nation: Uninsured: Why the U.S. Has No National Health Insurance ; Oxford University Press, 2006.
• Theodore Marmor, The Politics of Medicare ; Aldine Transaction, 2nd Edition, 2000.
• Institute of Medicine, To Err Is Human: Building a Safer Health System ; National Academies Press, 2000.

Chapters to be read from these books are listed for relevant class.

Assignments

There will be four short assignments and one final in-depth story students can do in any medium — print, broadcast or web package. Assignments are as follows:

Short assignments

• An 800-word blog post on the U.S. health system.
• An 800-word blog post comparing health statistics for two communities.
• A 1,000-word story discussing the nursing-home inspection report (Form 2567) for a facility of a student’s choosing and comparing it to data for the facility found on the government’s Nursing Home Compare site and to his or her own observations from visiting the nursing home.
• A 1,000-word consumer story on the topic: “Should you join a clinical trial?”

Final assignment

Students can choose between:

• A story about a hospital using quality and safety data, its marketing efforts, its patient mix, its charges, prices and negotiating leverage — in short, everything a patient would need to know before choosing that hospital.
• A story about the marketing of a controversial drug — one that may have a questionable safety profile or efficacy, high cost or limited use. It will be an examination of how the drug came to be, how it was sold and what it contributes to better health, if anything.

Assignments for in-class discussions

• Week 6: Choose a local hospital and look at how three different rating organizations evaluate it and be prepared to discuss in class. NO WRITTEN PAPER
• Week 7: Examine the disciplinary actions for doctors and nurses in the state and be prepared to discuss the findings in class as well as possible stories. NO WRITTEN PAPER
• Week 9: Choose a widely advertised drug and observe how it is marketed in different media. Be prepared to discuss its side effects, marketing channels, and the ads’ effectiveness in communicating risks and benefits to the public. NO WRITTEN PAPER
• Week 10: Choose a news report of a medical study and be prepared to evaluate it for the class using the criteria from Health News Review. NO WRITTEN PAPER

Weekly schedule and exercises (13-week course)

The assumption of this syllabus is that the course will meet twice a week. It is also assumed that students will have completed at least one basic reporting class before taking this course.

Week 1 | Week 2 | Week 3 | Week 4 | Week 5 | Week 6 | Week 7 Week 8 | Week 9 | Week 10 | Week 11 | Week 12 | Week 13

Week 1: Uniquely American health care

Previous week | Next week | Back to top

Unlike other developed nations, the United States does not provide a universal right to health care. Instead, it uses a system of private insurance, and health care is a commodity to be bought and sold with minimal regulations. Although the 2010 Affordable Care Act gave more people the right to buy health insurance, it did not guarantee that providers had to accept it. Nor did it mean every American will have insurance.

Class 1: Health care in the American context and the privileged position of business

Discussion: Why we have the system we do and why it is so hard to change. The politics of the Affordable Care Act.

Readings: The Policy-Making Process , all chapters.

Class 2: The best health care in the world?

Discussion: The points of similarity and difference between American health care and other developed countries. Students will be asked to compare and contrast health care in other countries based on the readings and OECD data.

• “Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care,” The Commonwealth Fund, 2007.
• “Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, 2010 Update,” The Commonwealth Fund, 2010.
• OECD health statistics portal .
• “U.S. and Other Health Care Systems Compared” (PowerPoint), Humphrey Taylor, Harris Poll, April 4, 2012.

Week 2: What makes healthy people and communities

Many factors determine people’s health, and it’s not necessarily the kind of insurance they have, their genetic predisposition or medicines. The food we eat, the money we have, where we live, our jobs and the stress we experience play a big role in health.

Class 1: The social determinants of health

Discussion: Class takes the population health quiz and discusses answers, then discusses the Whitehall Studies in The Lancet article, stress, job satisfaction and health care inequality.

• “Health in an Unequal World,” The Lancet , December 5, 2006.
• “Class: The Ignored Determinant of the Nation’s Health,” The New England Journal of Medicine , September 9, 2004.
• “Inequalities Are Unhealthy,” Monthly Review , Volume 56, Number 2, June 2004.
• “Nobel Winners Live Longer, Say Researchers,” The Guardian , January 17, 2007.
• “Population Health Quiz,” Population Health Forum.

Class 2: Reporting on differences in community health

Discussion: Finding health statistics for various communities, what they tell us, and how to use them.

• “The Reversal of Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United States,” PLoS Medicine, April 22, 2008.
• Students should familiarize themselves with U.S. county health rankings, census data, and databases from  The Commonwealth Fund , Robert Wood Johnson Foundation , and University of Wisconsin .

Assignment due this week: Write an 800-word blog post comparing the U.S. health care system to those of other developed nations. Is the U.S. system “the best in the world,” as some claim? If so, by what measures and for whom? If not, in what way and for whom? Be sure to use supporting data.

Week 3: The public’s health

The media often give scant attention to public health unless there is a disease outbreak or environmental disaster. Public health issues generally fall into two groups — traditional public health problems like measles epidemics and newer ones such as obesity and vaccine controversies. Students will learn how to cultivate sources in their local health departments and identify ideas for stories that further public health.

Class 1: Covering disease outbreaks and vaccine controversies

Discussion: Class will examine and critique coverage of the H1N1 outbreak and examine controversies over childhood vaccinations.

• “How Social Networks Shaped Disease Transmission During 2009 H1N1 Pandemic,” Journalist’s Resource.
• “Public Should Receive More Complete Warnings,” CBS News Investigates, August 19, 2009.
• “Drug Makers’ Push Leads to Cancer Vaccines’ Rise,” New York Times , August 19, 2008
• “We Are Not Immune: Influenza, SARS and the Collapse of Public Health,” Harpers , July 2004.
• “Chiropractors and Vaccination: A Historical Perspective,” Pediatrics , April 1, 2000.
• “The Legitimacy of Vaccine Critics: What Is Left After the Autism Hypothesis?” Journal of Health Politics and Law , 2012.

Class 2: Covering the new epidemic — obesity

Discussion: Examine how the obesity epidemic has been framed and discuss ways to cover the story beyond the obvious.

• “Disparities in Obesity Patterns Among Adolescents,” Journalist’s Resource.
• “Evaluating Sugary Drink Nutrition and Marketing to Youth,” Journalist’s Resource.
• Food Politics : Part 2, “Working the System”; part 3, “Exploiting Kids, Corrupting Schools.”
• “The Media and Obesity,” Obesity Review, 2007.
• “Supersized Bias II,” Media Research Center, December 14, 2004.

Helpful resources: Covering Obesity: A Guide for Reporters , Association of Health Care Journalists.

Assignment due this week: An 800-word blog post that compares the health of two communities using data from U.S. census data, The Commonwealth Fund , Robert Wood Johnson Foundation , University of Wisconsin and Community Health Status Indicators .

Week 4: How the United States pays for health care

America has a bifurcated system of health insurance based largely on employment with coverage supplied by private insurers. Medicare, a social insurance program, covers the elderly and disabled people; Medicaid, a means-tested welfare program, covers the poor for health care and the middle class for long-term care.

Class 1: The private insurance system

Discussion: This class will examine the role of employers in providing insurance and how private insurance carriers work, how they select risks, price and market their products, choose doctors for their networks, and decide which claims to pay.

• One Nation Uninsured , chapters 2, 5, 6, 7.
• “Health Insurer Tied Bonuses to Dropping Sick Policyholders,” Los Angeles Times , November 9, 2007.
• “How Insurers Reject You: BlueCross BlueShield of Texas’ Blueprint for Denying Health Policies,” Slate , February 10, 2010.
• “How Private Health Coverage Works: A Primer,” Kaiser Family Foundation.
• “Health Reform and Medical Bankruptcy in Massachusetts,” Journalist’s Resource.
• “Insurers Alter Cost Formula, and Patients Pay More,” New York Times, April 24, 2012.
• “Cuomo Aims to Salvage Health Pact,” Wall Street Journal , April 27, 2012.

Class 2: The public insurance system

Discussion: This class focuses on how Medicare, Medicaid, and the CHIP program provide coverage for the elderly, the poor and children from low-income families. Students will learn the differences between social insurance and welfare programs, and understand the sales and marketing of Medicare Advantage plans and Medicare supplement insurance that add a private dimension to the Medicare program.

• “Medicare: A Primer,” Kaiser Family Foundation, April 26, 2010.
• “Medicaid: A Primer,” Kaiser Family Foundation, June 22, 2010.
• The Politics of Medicare , chapters 1, 9, 10.
• “Covering Medicare” archive , Columbia Journalism Review .

Week 5: Covering long-term care

As the U.S. population ages, long-term care has become a serious topic to cover. It involves investigating nursing homes, assisted-living facilities and other care options in the community, and reporting on the quality and safety of their services. Most of these facilities operate as for-profit businesses whose financial goals sometimes conflict with the need to provide good care. Students will learn how to judge nursing home finances using such tools as Medicare cost reports, annual reports, and documents filed in lawsuits.

Class 1: Nursing homes and assisted living facilities

Discussion: This class will explore how nursing homes changed from non-profit to for-profit providers, the lobbying clout of the industry, and the role of Medicaid in paying for long-term care. Students will examine the state and regulatory systems for nursing homes, state inspection reports, and the lack of oversight for assisted-living facilities. It will also discuss how consumers and reporters can evaluate nursing homes using government data and simple techniques of observation.

• “Nursing Homes: Business as Usual,” Consumer Reports , September 2006.
• “Nursing Home Guide,” Consumer Reports .
• “Trust and Neglect: Special Report on Nursing Homes in Michigan,” part 1 (others optional), Detroit Free Press , December 11, 2011.
• “Falsified Patient Records Are Untold Story of California Nursing Home Care,” Sacramento  Bee , September 18, 2011.
• Medicare’s Nursing Home Compare database , Association of Health Care Journalists.
• “At Many Nursing Homes, More Profit and Less Nursing,” New York Times , September 23, 2007.

Helpful resource: “Covering the Health of Local Nursing Homes,” Association of Health Care Journalists.

Class 2: The forgotten services — home care, board and care homes, food programs, and Medicaid waivers

Discussion: This class will teach students how these programs work and are regulated, how to find stories from community advocates, and how to evaluate the quality of health care they provide.

• “Seniors for Sale: Exploiting the Aged and Frail in Washington’s Adult Family Homes,” Seattle  Times , November 17, 2011.
• “Hunger in America,” The Nation , March 30, 1998.
• “Home Alone: Adult Health Center Cuts Devastate Elderly, Disabled,” New America Media, October 27, 2011.

Assignment due this week: 800 to 1,000 word story evaluating inspection reports for a chosen nursing home.

Week 6: Covering hospitals

Hospitals account for a third of U.S. health care spending. They play competitive games to attract patients, often through promotion of expensive medical devices and services. Hospitals are big businesses and enjoy patient loyalty in ways most enterprises do not. They also can be unsafe and vary in the quality of care delivered, a reality that conflicts with hospitals’ “good guy” image.

Class 1: The hospital as a business enterprise

Discussion: Students will learn how to analyze hospital financial statements such as 10k and 990 filings, understand charity care, marketing, executive compensation, hospital regulation and state survey inspection reports. They will also examine the myth of hospital competition as a way to lower health care costs and the trend toward consolidation.

• “Medical Debt Puts More at Risk,” The Bergen Record, January 22, 2012.
• “In Their Debt,” Baltimore Sun (parts 1, 2, 3), December 21, 2008.
• “The New Goliaths,” The National Journal , February 17, 2012.
• “Hospitals’ Geographic Expansion in Quest of Well-Insured Patients: Will the Outcome Be Better Care, More Cost or Both?” Health Affairs , April 2012.
• “Debt Collectors Pursue Patients Inside Hospitals,” New York Times , April 25, 2012.

Helpful resources: “How to Cover Hospitals” and “Tools for Covering Hospitals,” Association of Health Care Journalists.

Class 2: Hospital safety and quality

Discussion: Government data increasingly show that hospitals can be unsafe. This class will discuss sources of safety data and how to use it to frame stories. Students will also learn about the ratings schemes for hospitals, how to separate the reasonable from the questionable, and whether any of them have relevance to patients.

• “Do No Harm: Hospital Care in Las Vegas,” Las Vegas Sun (parts 1, 2, 4), June 27, 2010.
• “How Our Hospitals Unleashed a MRSA Epidemic,” Seattle Times , November 16, 2008.
• “Should Health Journos Use Hospital Safety Data?” Columbia Journalism Review , March 12, 2012.
• To Err Is Human , chapters 2, 3, 6.
• HealthGrades website .

Assignment for in-class discussion: Students should choose a hospital in their community and look at three different rating schemes to see how the selected facility stands up. Consider what a consumer would do with the ratings.

Week 7: Covering the health professions

Covering health care professionals — doctors, nurses, dentists, therapists — has long been a staple of the health beat, but in recent years it has taken on new importance as professionals increasingly advertise their services. We will explore state and federal regulatory systems that are designed to ensure patient safety but often fail to do so. We will also evaluate safety and quality data available from government agencies and learn how to differentiate rating schemes that are self-serving and those that may be useful to journalists.

Class 1: How we regulate doctors, nurses and the rest

Discussion: In this class, students will learn how to use information and data about practitioners from such sources as state licensing boards and the National Practitioner Data Bank . They will explore the larger question: Why bad doctors and other professionals continue to practice medicine.

• “When Caregivers Harm: America’s Unwatched Nurses,” ProPublica.
• “Missouri Secretive, Lax on Doctor Discipline,” St. Louis Post-Dispatch , December 12, 2010.
• “Fatal Mistakes,” AARP Bulletin, November 2004.

Class 2: The malpractice myth

Discussion: Contrary to popular belief, malpractice lawsuits are not responsible for the high cost of U.S. health care. The academic literature is full of suggestions that would address this contentious issue and result in more equitable compensation for those injured by medical practitioners. Students will discuss defensive medicine and learn about the politics, the options, and how to understand the spin from lawyers and doctors so they can report with more knowledge and nuance.

• “Righting Wrongs,” AARP Bulletin , April 2006.
• “Excluded Voices: Health Care Costs,” Columbia Journalism Review , March 18, 2011.
• “Medical Malpractice,” The New England Journal of Medicine , January 15, 2004.
• “Surmounting Myths and Mindsets in Medical Malpractice,” Urban Institute, October 2005.
• “Malpractice Risk According to Physician Specialty,” Journalist’s Resource.

Assignment for in-class discussion: Students will examine disciplinary actions against doctors and dentists (or any other health professional the instructor chooses) in their state and be prepared to discuss their findings and suggest possible stories based on what they find.

Week 8: The pharmaceutical industry, part 1

Drug makers and manufacturers of medical devices are some of the most profitable businesses around. They enjoy considerable public and political support and spend billions of dollars on advertising and marketing to ensure that the public and politicians think well of their efforts. While many companies’ products have improved health, firms also market drugs and high-tech equipment that boost the cost of care without providing commensurate benefits to patients.

Class 1: Drug industry basics

Discussion: Class will examine how the drug and medical device industry creates new drugs. Students will learn about research and development costs, patent protection, and the industry’s profitability.

Reading: The Truth About the Drug Companies , chapters 1 through 6, 10

Class 2: How the U.S. regulates drugs and devices — the FDA approval process

Discussion: Health reporters need to understand how the FDA regulates drugs and devices, what the rules are, what approval means and does not mean, political pressures the FDA faces. Students will consider the question: Is the public well protected? To prepare for class, students will browse the FDA website and familiarize themselves with FDA documents such as proceedings of advisory panel meetings, adverse event reports, black-box warnings, labeling rules, advertising regulations and warning letters to advertisers.

• “Stronger Cautions Backed on Bone Drugs for Women,” New York Times , September 10, 2011.
• “The High Cost of Failing Artificial Hips,” New York Times , December 27, 2011.
• “New Models of Implants Not Better, Study Finds,” New York Times , December 23, 2011.
• “Group Faults The F.D.A. on Oversight of Devices,” New York Times , April 13, 2011.
• “Eli Lilly Said to Play Down Risk of Top Pill,” New York Times , December 17, 2006.
• “Political Lobbying Drove FDA Process,” W all Street Journal , March 6, 2009.

Week 9: The pharmaceutical industry, part 2

Class 1: How the industry markets to doctors and patients — detailing, selling sickness, disease advocacy groups

Discussion: In this class, reporters covering the pharmaceutical industry from the business, health or consumer perspective will become acquainted with the ways the industry increases the market for new drugs.

• “Should Health Advocacy Groups Disclose Funding?” Pharmalot, January 13, 2011.
• “The Fight Against Disease Mongering,” Public Citizen Health Research Group Health Letter, May 2006.
• “Following the Script: How Drug Reps Make Friends and Influence Doctors,” PLoS Medicine, April 24, 2007.
• “The Thin Pill,” Wired magazine, October 2006.
• “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick,” PLoS Medicine, April 11, 2006.
• The Truth About the Drug Companies , chapters 7, 8, 9.

Class 2: How the industry uses the media to market its products

Discussion: This class will examine direct-to-consumer advertising, the industry’s use of social media and traditional media, and how the media themselves have played a role in helping to market pharmaceuticals.

• “ADHD’S Facebook ‘Friends’,” Los Angeles Times , March 30, 2009.
• “A Decade of Direct-to Consumer Advertising of Prescription Drugs,” The New England Journal of Medicine , August 16, 2007.
• “Bitter Pill,” Columbia Journalism Review, July 2005.
• “New Drugs: A Dose of Reality — the Press Too Often Plays Up the Positive,” Columbia Journalism Review September 1999.
• “Giving Legs to Restless Legs: A Case Study of How the Media Helps Make People Sick,” PLoS Medicine, April 11, 2006.

Assignment for in-class discussion: Choose a widely advertised drug and evaluate the effectiveness of the commercials. Look for evidence of risks and benefits, warnings and usefulness to potential users.

Week 10: Understanding medical studies

Most health reporters will be asked to report on new medical studies, and the temptation will be to report on the usually glowing findings touted in press releases. But reporting on what the studies really find and interpreting what they mean is tricky. This class will acquaint students with some basic epidemiological concepts and help them learn the criteria for reporting useful and accurate information to the public. Students will also learn where medical news comes from, how it is disseminated, and the politics of medical journals.

Class 1: How to read and interpret medical studies

Discussion: This class focuses on the nuts and bolts of reading studies. Students will learn concepts such as absolute and relative risk , number needed to treat and the hierarchy of evidence . They will also learn about journal embargos and how to interpret news from medical conferences. Students should familiarize themselves with blog posts on Embargo Watch and Retraction Watch .

• “Bitter Pill,” Columbia Journalism Review , July 2005.
• “Tips for Understanding Studies,” and “Review Criteria,” Health News Review.
• “Coverage by the News Media of the Benefits and Risks of Medications,” The New England Journal of Medicine , June 1, 2000.
• “Studying a Study and Testing a Test: How to Read the Medical Evidence,” Annals of Internal Medicine November 7, 2000.
• “Mixed Grades for Medical Coverage,” Columbia Journalism Review , April 22, 2011.
• “Now You See It, Now You Don’t: Why Journals Need to Rethink Retractions,” The Guardian , January 15, 2011.
• “Ethical and Scientific Implications of the Globalization of Clinical Research,” The   New England Journal of Medicine , February 19, 2009.
• “Randomized Control Trials: Observational Studies and the Hierarchy of Research Designs.” The New England Journal of Medicine , June 22, 2000.

Helpful resources: Covering Medical Research: A Guide for Reporting on Studies, Association of Health Care Journalists; “Levels of Evidence” and “Evidence-Based Medicine Glossary,” Oxford Centre for Evidence-based Medicine.

Assignment for in-class discussion: Find a news report of a medical study and be prepared to evaluate the story according to the criteria from Health News Review.

Class 2: Clinical trials and IRBs

Discussion: In this class the focus will be on clinical trials and how they work, the risks and benefits of joining one, what they mean for drug safety and efficacy. Class will also discuss the Institutional Review Boards (IRBs) that scrutinize the methodology and procedures used in every clinical trial. It will examine how well participants are protected.

• “The Right to a Trial,” The New Yorker , December 18, 2006.
• “The Biotech Death of Jesse Gelsinger,” New York Times , November 28, 1999.
• “Ten Years Later: Jesse Gelsinger’s Death and Human Subjects Protection,” Bioethics Forum, October 22, 2009.
• “Ethical and Scientific Implication of the Globalization of Clinical Research,” The   New England Journal of Medicine , February 19, 2009.

Assignment due this week: 1,000-word consumer story on whether a patient should join a clinical trial.

Week 11: The high cost of medical care

The U.S. spends more on health care than any country in the world. A large chunk of that outlay is spent on high-tech treatments of unproven worth that contribute to the overtreatment that Americans experience. Paradoxically, overtreatment exists alongside the lack of treatment for people who need care but cannot get it. Historically, businesses and practitioners have resisted attempts to control what they can charge, and there have been few attempts by the government to limit what health care providers and sellers charge.

Class 1: Why are costs so high? The paradox of overtreatment and undertreatment, and the myths of preventive care

Discussion: This class will explore the differences between the way the United States and other countries control medical costs. Students will examine the cost-control methods called for by the health reform law, cost differences among U.S. localities, the paradox of over- and undertreatment, and the myths of preventive care. Students will familiarize themselves with the Dartmouth Atlas of Health Care and geographic variation in cost and quality of health care and the recommendations of the U.S. Preventive Services Task Force .

• “The Obama Administration’s Options for Health Care Cost Control: Hope Versus Reality,” Annals of Internal Medicine , April 7, 2009.
• “Health Care Spending: The Basics; How Much Do We Spend on Hospitals?” (part 1), Century Foundation, April 4, 2008.
• “The Cost Conundrum,” The New Yorker , June 1, 2009.
• “Bundling Payments to Curb Health Care Costs Proves Difficult to Achieve,” RAND, November 2011.
• “Benchmarking Preventive Care Utilization,” Milliman Research Reports, March 21, 2011.
• “Excluded Voices: An Interview with Rutgers Professor Louise Russell,” Columbia  Journalism Review , June 16, 2009.
• “Is High Spending on Cancer Care ‘Worth It’?” Reuters, April 9, 2012.
• “An Analysis of Whether Higher Health Care Spending in the United States Versus Europe Is ‘Worth It’ in the Case of Cancer,” Health Affairs , April 2012.
• “In Long Drive to Cure Cancer, Advances Have Been Elusive,” New York Times , April 24, 2009.
• “Mammogram Study Reignites Controversy on Breast Cancer Screening,” ABC News, September 29, 2010.
• “New Mammogram Guidelines Are Causing Confusion, But Here’s Why They Make Sense,” Our Bodies, Ourselves Blog, November 18, 2009.
• “The Quality of Health Care Delivered to Adults in the United States,” The New England Journal of Medicine , June 26, 2003.

Class 2: Covering medical technology

Discussion: Health and business reporters will be asked to report on new medical technology, and as in the case when they cover new drugs, the press release too often becomes the story. But there is much more to reporting about technology that explains how it contributes to the country’s high health care tab.

• “The Case of CT Angiography: How Americans View and Embrace New Technology,” Health Affairs , November 2008.
• “Covering Medical Technology: The Seven Deadly Sins,” Columbia  Journalism Review ,September/October 2001.
• “Unproven for Older Women, Digital Mammography Saps Medicare Dollars,” Center for Public Integrity, October 17, 2011.
• “Digital Mammography No Better than Film for Most Women Despite Increased Costs,” Center for Public Integrity, October 17, 2011.
• “The Evidence Gap” series (instructors can choose readings), New York Times .
• “Excluded Voices: An interview with Andrew Dillon,” Columbia Journalism Review , August 18, 2009.

Week 12: Ethics and conflicts of interest in health reporting

Health and medicine are full of conflicts of interest, which are inevitable in profit-making enterprises that characterize the U.S. health system. Health care sellers such as pharmaceutical companies, hospitals, health care professionals, and insurers often advertise in the news media, making it difficult to bite the hand that feeds.

Class 1: Conflicts in the medical business

Discussion: This class will focus on ghost writing at medical journals, financial ties between doctors and drug companies, drug company influence in hospital purchasing, and financial support of patient advocacy groups that appear to advocate for patients but instead help drug companies.

• “Financial Transparency Skin-deep at Medical Journals,” Reuters Health , June 8, 2011,
• “Dollars for Docs,” ProPublica, September 7, 2011.
• “Respected Physicians Call for End of Conflicts of Interest with the Drug Industry” and  “From Lancet : Just How Tainted Has Medicine Become?” MedicationSense.
• “Under the Microscope,” Boston Globe , January 22, 2006.
• “At Medical Journals, Writers Paid by Industry Play Big Role,” Wall Street Journal , December 13, 2005.

Class 2: The media’s own conflicts of interest

Discussion: This class will discuss how the media’s own interests team up with players in the medical enterprise to keep the public in the dark. Many news outlets, particularly television networks, depend on advertising from drug companies and hospitals that push products and services that might not be in the best interests of patients. Students will discuss such questions as: How do reporters get their work published when there’s pushback from management? How do journalists maintain their integrity when asked to shill for health-care providers or sellers? When is it acceptable to work for a health care business?

• “Epidemic,” Columbia Journalism Review March/April 2007.
• “Another Cozy TV-Hospital Partnership,” Columbia Journalism Review , April 1, 2011.
• “Unhealthy Alliances Between Hospitals and TV Stations,” Columbia Journalism Review , August 12, 2008.
• “In South Carolina, another Hospital/Journo Alliance,” Columbia Journalism Review , January 20, 2012.
• “News Director Quits Over Hospital Deal,” Columbia Journalism Review , January 25, 2008.

Week 13: Understanding the traps in health reporting

The course will conclude this week with a discussion of the obstacles and pitfalls health reporters sometimes encounter. Each class should also fold in a wrap-up and evaluation of the course and allow students to present their final stories if there is time.

Class 1: Finding sources and using real people in your stories

Discussion: Students will learn the dos and don’ts for telling patient stories and learn about websites that can be helpful as entry points for good reporting. Class will focus on how to choose people to humanize stories, dealing with canned anecdotes provided by advocacy groups and others, and how to go into peoples’ homes for one-on-one interviews that can either make or break a story.

• “Woman Featured in State Journal Article Died Before Publication,” Wisconsin  State  Journal , July 22, 2011.
• “Reporter Offers Advice on Avoiding Embarrassing Incident,” Association of Health Care Journalists, August 3, 2011.
• “Lessons of a $618,616 Death,” Bloomberg Businessweek , March 4, 2010.
• “What Patients Really Want From Health Care,” JAMA , December 14, 2011.

Class 2: Avoiding the trap of misleading or wrong “facts”

Discussion: Incorrect information has a way of creeping into health stories. Sometimes it results from disinformation campaigns by stakeholders or government agencies; sometimes it results when reporters don’t make the extra call or two that would produce the right fact or number. Students will discuss ways to avoid these mistakes.

• “Nine Lives of a Disputed Fact,” Columbia Journalism Review , March 16, 2012.
• “McKinsey Backpedals on Health Care Reform Study,” Mother Jones , July 2011.
• “Meet the Bay State’s Uninsured,” Columbia Journalism Review , September 26, 2011.
• “Census Data Produces Opposing Views of the Uninsured in Massachusetts,” Boston  Health News , September 11, 2009.

Final paper due today

A special thanks to Trudy Lieberman , of University of Nebraska-Lincoln and Columbia Journalism Review, for help in writing this syllabus.

About The Author

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Why does health journalism matter?

Mar 19, 2019

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Dr John Lister, Coventry University. Why does health journalism matter?. Impact of health reporting. “Surveys continue to show that the vast majority of the public get most of their information about science from the mass media.” Science and the Media Expert Group, January 2010

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• health reporting
• health policy
• health professionals
• wider health reporting
• news values versus balance

Presentation Transcript

Dr John Lister, Coventry University Why does health journalism matter?

Impact of health reporting • “Surveys continue to show that the vast majority of the public get most of their information about science from the mass media.” • Science and the Media Expert Group, • January 2010 • Misinformation or inadequate information on medical issues can kill • MMR, • If 70% of A&E attenders can be treated at Urgent Care Centre – are you/your child in the 70% or 30%?

Health affects everyone Almost no other news/specialist topic has such a universal audience in all media. Story lines include: • Reader’s own health • Availability /affordability) • Health care systems – changes, costs, Quality • Keeping/getting healthy • New treatments/effectiveness of treatments

Main sources of health news • Mainstream media UK (end 2013). Estimates: • >50 million daily readers of newspapers • >14 million accessing newspaper info online • Tens of millions in news audiences for TV & radio • Compare with specialist health press • <300,000 weekly readers of BMJ, Health Service Journal, Nursing Standard, Nursing Times & more specialist media combined • Plus online readers – maybe 1.5-2 million monthly – almost all health professionals & academics

Who is reporting on health? • Surveys of health reporters show few have any specialist training: • and most of these trained as health professionals or science degrees before becoming reporter • Most specialist reporters centred in specialist health trade press: • Tiny audience compared with mainstream media • Few training courses in Europe, all small • Few employers invest anything in training • As a result: self taught journalists, trying to cope with complex stories & newsroom pressures

News values versus balance • Mainstream news media approach stories as NEWS, not from scientific interest. • Nuances don’t fit well into this framework. • Traditional news values (Galtung & Ruge): • RELEVANCE for target audience (& NEWS) • TIMELINESS (immediacy: happening now) = little time for checking, balance, or scientific critique • SIMPLIFICATION – can it be described simply? • ELITES: can story be linked to a famous person? • NEGATIVITY: bad news sells (simplify) • GOOD NEWS: also sells (simplify)

Reporting frames understanding – and limits response • Weaknesses in reporting not limited to reporting clinical trials and medical innovation • Misinformation can also disenfranchise • If a story or an aspect of a story is not in the media, public don’t know & cannot react • Reporting of English health reforms, Obamacare • Some stories achieve prominence, despite centring on inaccurate information • “13,000 excess deaths in failing hospitals” • ‘Rise in GP support’ for charging for appointments • A nuanced story to rectify an inaccurate report will not reach same audience

Time to take POLICY seriously • Various guidelines circulated on reporting clinical trials, & campaigns waged (Goldacre, BMJ, Lancet, etc): • Gary Schwitzer/healthnewsreview – 10 points • Science Media Centre – 10 points • All seeking to ensure proper reporting of source, context, cost, timescale and critique. • Problems where these principles not applied: • audience misled, false expectations • unjustified panic where dangers exaggerated, absolute risk not clearly defined.

Need to raise bar on health policy reports • We need a similar framework to encourage critical reporting of HEALTH POLICY and other non-medical stories • This is my attempt at developing Gary Schwitzer’s ten points for wider health reporting

Think before you report • No wish to tell journalists what to think or say • But crucial to ensure that more thinking & critique are developed • Ways to critique rather than recycle endless stream of press releases & PR-guided material • Ways to put stories in context – political, social, economic – and find news stories that may otherwise be missed. • Angles to explore the story – local, clinical, practical, managerial, statistical, financial, etc. • Ways to bring in balancing voices

An ethical journalist must be a critical journalist • Ways to do the job better, with more satisfaction, value added and possible feedback • Without critical approach, journalist is simply transmitting ethical approach of PR/ news source • “Stenographer,” loudspeaker or messenger – not a journalist offering any professional input • Randolph Hearst • “News is what people don’t want you to know: everything else is advertising” • Better health journalism benefits us all.

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Sept. 27 Journalism Institute program to focus on public health

Beth Francesco

[email protected]

September 16, 2024

Public health and health care delivery may seem to go hand in hand to the public they exist to serve. But partnerships for the public good often are complicated by a patchwork of elaborate administrative practices, ownership, funding models, and other systemic barriers resulting in less effective results despite a shared mission of serving healthy, thriving communities. 

Knocking down the silos to collaborative health systems that drive improved outcomes is vital to addressing our most pressing public health issues.  Join us over Zoom  at 1 p.m. on Friday, Sept. 27. to learn from experts whose solutions-oriented approaches on critical public health issues have shown how innovation and disruption, particularly in times of crisis, can radically shift how communities can access care. 

Journalists play a large part in sharing those stories and exploring the barriers. 

Jointly produced by the Common Health Coalition and the National Press Club Journalism Institute, the 90-minute conversation will highlight research on high-impact public health and care delivery system partnerships while addressing the core components of their success. Expect a robust discussion on practical aspects of these important collaborations.  Registration is open ; participants may submit questions in advance of the session by emailing [email protected] .

The featured initiatives were published in a  special themed issue  of the New England Journal of Medicine , guest edited by Nicholas Stine. The edition includes articles, case studies, and research reports on coordination across public health and care delivery, COVID 19 response, tuberculosis screening, the 2022 mpox outbreak, pediatric asthma intervention, abortion and reproductive health care, and public health data.

Program participants will gain a deeper understanding of critical public health care issues, including global pandemic preparation and response, reproductive care, data sharing and technology; practical applications of effective, proven strategies for tackling tough public health issues; exposure to a new network of in-the-field experts and information resources; and Connections with new partners and sources in public health equity and community

Guest speakers will include: 

• Alice Abernathy , co-author of  Strengthening the Provision of Abortion and Sexual and Reproductive Health Care Post-Dobbs: An Initiative of the Philadelphia Department of Public Health
• Ingrid Johansen , co-author of  Knocking Down Public Health and Health Care Silos: An Innovative Covid-19 Health Equity Response
• Jennifer E. Layden , co-author of  Plugging Public Health Data into the Health IT Ecosystem to Protect National Health
• Mary P. Mercer , co-author of  The San Francisco Health Systems Collaborative: Public Health and Health Care Delivery Systems’ Response to the Covid-19 Pandemic
• Yolande Pengetnze , co-author of  Pediatric Asthma Surveillance System (PASS): Community-Facing Disease Monitoring for Health Equity
• Ed Prewitt ,  editorial director, New England Journal of Medicine’s Catalyst
• Moderator:  Nicholas Stine , University of California, Berkeley

About the Common Health Coalition

The Common Health Coalition brings together leading health care organizations in pursuit of a reimagined health system — one in which the nation’s health care and public health systems no longer operate in parallel but work hand in hand, with better health for all as the common goal. Health care and public health institutions responded to the COVID-19 pandemic by forging novel, impactful partnerships to support emergency response, data and information sharing, and infectious disease detection. The Common Health Coalition was formed to cement these types of crisis-driven strategies and others into existing infrastructure and strengthen the partnership between the health care and public health systems, particularly to advance health equity. 

About the National Press Club Journalism Institute 

The National Press Club Journalism Institute promotes an engaged global citizenry through an independent and free press, and equips journalists with skills and standards to inform the public in ways that inspire a more representative democracy. As the nonprofit affiliate of the National Press Club, the institute powers journalism in the public interest.

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Analysis suggests self-reporting of health may lead to underestimation of health inequalities in England

by Queen Mary, University of London

A first-of-its kind analysis of data collected from England's annual health survey found that of the people who reported their health as "poor," those living in areas of high deprivation are likely to have worse health than those living in the least deprived areas. The research has been published in BMJ Public Health .

This could mean that we are underestimating health inequalities across England, and could have implications for public health practice and policy informed by self-reported health data.

Researchers from Queen Mary University of London and the University of Warwick analyzed data collected from over 14,000 participants of the 2017 and 2018 waves of the Health Survey for England. They compared participants' simple self-reported health (SRH) statements with a more detailed health-related quality of life measure, EQ-5D, which was collected at the same time.

The analysis assessed differences in the relationship between SRH and EQ-5D by Index of Multiple Deprivation (IMD) quintile, a widely-used measure of deprivation.

The study found that self-reported good health declined with increasing deprivation, from 82.9% in the least deprived quintile to 63.9% in the most deprived quintile. Analysis also found that participants living in the most deprived two quintiles of areas in England who report poor health have lower EQ-5D scores—and therefore worse health—than would be expected based on their deprivation quintile and SRH status.

While additional research is needed to explore this further and quantify any impact on measures such as healthy life expectancy that incorporate SRH data, this study suggests that basing public health funding and interventions on SRH alone could result in an underestimation of health inequalities based on deprivation .

Oyinlola Oyebode, Professor of Public Health, at Queen Mary University of London, said, "Self-reported health is a widely used measure of health, most importantly, in England, we use it to calculate healthy life expectancy. Our analysis suggests that using self-reported health might underestimate socio-economic health inequalities , which may mean that resources and interventions are not appropriately targeted to the most vulnerable neighborhoods or people."

Rosanna Fforde, Honorary Research Fellow at the University of Warwick and Consultant in Public Health at Sandwell Council, said, "Understanding any systematic variation in how people self-report their health is important because this single question measure of health is so widely used, including in large surveys and the Census.

"The resultant large number of responses provides us with valuable granular insights into patterns of health, but this also means that it is important to explore whether 'good' health means the same thing to everyone."

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55 Best Journalism-Themed Templates for PowerPoint & Google Slides

With over 6 million presentation templates available for you to choose from, crystalgraphics is the award-winning provider of the world’s largest collection of templates for powerpoint and google slides. so, take your time and look around. you’ll like what you see whether you want 1 great template or an ongoing subscription, we've got affordable purchasing options and 24/7 download access to fit your needs. thanks to our unbeatable combination of quality, selection and unique customization options, crystalgraphics is the company you can count on for your presentation enhancement needs. just ask any of our thousands of satisfied customers from virtually every leading company around the world. they love our products. we think you will, too" id="category_description">crystalgraphics creates templates designed to make even average presentations look incredible. below you’ll see thumbnail sized previews of the title slides of a few of our 55 best journalism templates for powerpoint and google slides. the text you’ll see in in those slides is just example text. the journalism-related image or video you’ll see in the background of each title slide is designed to help you set the stage for your journalism-related topics and it is included with that template. in addition to the title slides, each of our templates comes with 17 additional slide layouts that you can use to create an unlimited number of presentation slides with your own added text and images. and every template is available in both widescreen and standard formats. with over 6 million presentation templates available for you to choose from, crystalgraphics is the award-winning provider of the world’s largest collection of templates for powerpoint and google slides. so, take your time and look around. you’ll like what you see whether you want 1 great template or an ongoing subscription, we've got affordable purchasing options and 24/7 download access to fit your needs. thanks to our unbeatable combination of quality, selection and unique customization options, crystalgraphics is the company you can count on for your presentation enhancement needs. just ask any of our thousands of satisfied customers from virtually every leading company around the world. they love our products. we think you will, too.

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MoSCoW Prioritization

What is moscow prioritization.

MoSCoW prioritization, also known as the MoSCoW method or MoSCoW analysis, is a popular prioritization technique for managing requirements. 

  The acronym MoSCoW represents four categories of initiatives: must-have, should-have, could-have, and won’t-have, or will not have right now. Some companies also use the “W” in MoSCoW to mean “wish.”

What is the History of the MoSCoW Method?

Software development expert Dai Clegg created the MoSCoW method while working at Oracle. He designed the framework to help his team prioritize tasks during development work on product releases.

You can find a detailed account of using MoSCoW prioritization in the Dynamic System Development Method (DSDM) handbook . But because MoSCoW can prioritize tasks within any time-boxed project, teams have adapted the method for a broad range of uses.

How Does MoSCoW Prioritization Work?

Before running a MoSCoW analysis, a few things need to happen. First, key stakeholders and the product team need to get aligned on objectives and prioritization factors. Then, all participants must agree on which initiatives to prioritize.

At this point, your team should also discuss how they will settle any disagreements in prioritization. If you can establish how to resolve disputes before they come up, you can help prevent those disagreements from holding up progress.

Finally, you’ll also want to reach a consensus on what percentage of resources you’d like to allocate to each category.

With the groundwork complete, you may begin determining which category is most appropriate for each initiative. But, first, let’s further break down each category in the MoSCoW method.

Start prioritizing your roadmap

Moscow prioritization categories.

1. Must-have initiatives

As the name suggests, this category consists of initiatives that are “musts” for your team. They represent non-negotiable needs for the project, product, or release in question. For example, if you’re releasing a healthcare application, a must-have initiative may be security functionalities that help maintain compliance.

The “must-have” category requires the team to complete a mandatory task. If you’re unsure about whether something belongs in this category, ask yourself the following.

If the product won’t work without an initiative, or the release becomes useless without it, the initiative is most likely a “must-have.”

2. Should-have initiatives

Should-have initiatives are just a step below must-haves. They are essential to the product, project, or release, but they are not vital. If left out, the product or project still functions. However, the initiatives may add significant value.

“Should-have” initiatives are different from “must-have” initiatives in that they can get scheduled for a future release without impacting the current one. For example, performance improvements, minor bug fixes, or new functionality may be “should-have” initiatives. Without them, the product still works.

3. Could-have initiatives

Another way of describing “could-have” initiatives is nice-to-haves. “Could-have” initiatives are not necessary to the core function of the product. However, compared with “should-have” initiatives, they have a much smaller impact on the outcome if left out.

So, initiatives placed in the “could-have” category are often the first to be deprioritized if a project in the “should-have” or “must-have” category ends up larger than expected.

4. Will not have (this time)

One benefit of the MoSCoW method is that it places several initiatives in the “will-not-have” category. The category can manage expectations about what the team will not include in a specific release (or another timeframe you’re prioritizing).

Placing initiatives in the “will-not-have” category is one way to help prevent scope creep . If initiatives are in this category, the team knows they are not a priority for this specific time frame. 

Some initiatives in the “will-not-have” group will be prioritized in the future, while others are not likely to happen. Some teams decide to differentiate between those by creating a subcategory within this group.

How Can Development Teams Use MoSCoW?

  Although Dai Clegg developed the approach to help prioritize tasks around his team’s limited time, the MoSCoW method also works when a development team faces limitations other than time. For example: 

Prioritize based on budgetary constraints.

What if a development team’s limiting factor is not a deadline but a tight budget imposed by the company? Working with the product managers, the team can use MoSCoW first to decide on the initiatives that represent must-haves and the should-haves. Then, using the development department’s budget as the guide, the team can figure out which items they can complete. 

Prioritize based on the team’s skillsets.

A cross-functional product team might also find itself constrained by the experience and expertise of its developers. If the product roadmap calls for functionality the team does not have the skills to build, this limiting factor will play into scoring those items in their MoSCoW analysis.

Prioritize based on competing needs at the company.

Cross-functional teams can also find themselves constrained by other company priorities. The team wants to make progress on a new product release, but the executive staff has created tight deadlines for further releases in the same timeframe. In this case, the team can use MoSCoW to determine which aspects of their desired release represent must-haves and temporarily backlog everything else.

What Are the Drawbacks of MoSCoW Prioritization?

  Although many product and development teams have prioritized MoSCoW, the approach has potential pitfalls. Here are a few examples.

1. An inconsistent scoring process can lead to tasks placed in the wrong categories.

  One common criticism against MoSCoW is that it does not include an objective methodology for ranking initiatives against each other. Your team will need to bring this methodology to your analysis. The MoSCoW approach works only to ensure that your team applies a consistent scoring system for all initiatives.

Pro tip: One proven method is weighted scoring, where your team measures each initiative on your backlog against a standard set of cost and benefit criteria. You can use the weighted scoring approach in ProductPlan’s roadmap app .

2. Not including all relevant stakeholders can lead to items placed in the wrong categories.

To know which of your team’s initiatives represent must-haves for your product and which are merely should-haves, you will need as much context as possible.

For example, you might need someone from your sales team to let you know how important (or unimportant) prospective buyers view a proposed new feature.

One pitfall of the MoSCoW method is that you could make poor decisions about where to slot each initiative unless your team receives input from all relevant stakeholders. 

3. Team bias for (or against) initiatives can undermine MoSCoW’s effectiveness.

Because MoSCoW does not include an objective scoring method, your team members can fall victim to their own opinions about certain initiatives. 

One risk of using MoSCoW prioritization is that a team can mistakenly think MoSCoW itself represents an objective way of measuring the items on their list. They discuss an initiative, agree that it is a “should have,” and move on to the next.

But your team will also need an objective and consistent framework for ranking all initiatives. That is the only way to minimize your team’s biases in favor of items or against them.

When Do You Use the MoSCoW Method for Prioritization?

MoSCoW prioritization is effective for teams that want to include representatives from the whole organization in their process. You can capture a broader perspective by involving participants from various functional departments.

Another reason you may want to use MoSCoW prioritization is it allows your team to determine how much effort goes into each category. Therefore, you can ensure you’re delivering a good variety of initiatives in each release.

What Are Best Practices for Using MoSCoW Prioritization?

If you’re considering giving MoSCoW prioritization a try, here are a few steps to keep in mind. Incorporating these into your process will help your team gain more value from the MoSCoW method.

1. Choose an objective ranking or scoring system.

Remember, MoSCoW helps your team group items into the appropriate buckets—from must-have items down to your longer-term wish list. But MoSCoW itself doesn’t help you determine which item belongs in which category.

You will need a separate ranking methodology. You can choose from many, such as:

• Weighted scoring
• Value vs. complexity
• Buy-a-feature
• Opportunity scoring

For help finding the best scoring methodology for your team, check out ProductPlan’s article: 7 strategies to choose the best features for your product .

2. Seek input from all key stakeholders.

To make sure you’re placing each initiative into the right bucket—must-have, should-have, could-have, or won’t-have—your team needs context. 

At the beginning of your MoSCoW method, your team should consider which stakeholders can provide valuable context and insights. Sales? Customer success? The executive staff? Product managers in another area of your business? Include them in your initiative scoring process if you think they can help you see opportunities or threats your team might miss. 

3. Share your MoSCoW process across your organization.

MoSCoW gives your team a tangible way to show your organization prioritizing initiatives for your products or projects. 

The method can help you build company-wide consensus for your work, or at least help you show stakeholders why you made the decisions you did.

Communicating your team’s prioritization strategy also helps you set expectations across the business. When they see your methodology for choosing one initiative over another, stakeholders in other departments will understand that your team has thought through and weighed all decisions you’ve made. 

If any stakeholders have an issue with one of your decisions, they will understand that they can’t simply complain—they’ll need to present you with evidence to alter your course of action.  

Related Terms

2×2 prioritization matrix / Eisenhower matrix / DACI decision-making framework / ICE scoring model / RICE scoring model

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