I remember once consulting for an ophthalmology company introducing a new product. My job was to provide media coaching to a panel of researchers who’d done the FDA testing. There was one doc, though, who didn’t bother to show up for my prep session. He was a very confident type who strolled in five minutes before the company’s press conference.
He thought, “I save people’s sight. I certainly don’t need any help speaking to some medical journalists.” I didn’t take it personally. I was payed the same whether he showed up or not.
Still, I had to hide a smile when he proceeded to make an on-camera ass of himself.
Here are some of his mistakes:
He spoke to his colleagues, not to consumers
He was nervous so he asserted his superiority by using medical jargon
His long rambling answers backed into his main point (He “buried the lead.”)
He rocked back and forth in his chair
His tie was crooked, his hair askew
He was purposely unexcited (because emotion is a no-no for doctors.)
He looked down while he was speaking
The irony is when the press release was over, he thought he’d done a great job. He’d maintained his medical dignity and hadn’t lowered himself by becoming a “performer.” He’d maintained that all-knowing nonplussed demeanor that works with other doctors and students.
The problem is it doesn’t work with consumers.
It doesn’t work first because the cat is out of the bag: most consumers know that they’re capable of understanding their medical treatments. The onus is on you. If you can’t explain a treatment at a level they can understand, they don’t blame their own ignorance, they blame your inability to communicate.
Second, like it or not, appearance counts. TV especially is a very intimate medium. You see someone up close and you judge him or her exactly as you would at a dinner table: by their posture, their haircut, their ability to look you in the eye, the clothes they wear, the timbre of their voice, the degree of their enthusiasm. It’s an unfortunate media fact that someone who looks like an expert will prevail over someone who actually is one. It’s not fair, but it’s reality. You can look bad in front of the media…or you can bother to raise your game.
Obviously, take a long look in the mirror before you any media encounter.
Less obviously, spend ten minutes to anticipate the questions the media will ask. In patient histories, you respect getting to the point quickly, so does the media. (You start with “chief complaints:” reporters start with “lead paragraphs.” Good reporters won’t ask esoteric questions that won’t be useful. All their questions will be bottom line. “How does this treatment work?” “Who can benefit from it?” How popular will it become. (It’s not brain surgery; but of course neither is brain surgery.)
And practice direct answers to these questions. Answer the question then elaborate on why you made the answer you have.
I suspect this all sounds to many doctors like some kind of sell-out. In some ways it is. But the choice is yours. You can hold your nose, play by the media’s rules, and make a good impression. Or you can hide behind the illusion that you’re good at everything. And then like my absent ophthalmologist, be the last to realize just how badly you’ve failed.
I was talking to an infertility specialist client recently about his new procedure when he casually said, “I want you to get me on Oprah.” Anyone in marketing knows getting on Oprah is the Holy Grail for exposure. But my client made it sound like he had an original idea. All I had to do was make a phone call.
I decided then and there that working in marketing was just like working in television: I was destined to be underestimated by everyone around me.
When I was in TV, doctors would always come up to me and say, “What a cool job you have! Who did you know to get that job?” The implication being anyone could do what I did. Naturally, I must know someone in the business.
If I asked if you could be a TV reporter, you’d probably snicker and say, “Of course.” However, if I asked, “Can you write a screenplay? “You’d say, “No!” If I asked “Could you direct the resulting movie?” You’d say, “Of course not.” If I asked, “Could you act in that movie? You’d say no.
Yet TV reporters are the screenwriters, directors, and stars of their own daily two-minute movies. Your writing has to be conversational and written to video, you have to create a sequence of shots that has its own rules of consistency, and finally you have to have the charisma and energy to keep someone’s attention for up to five minutes at a time.
Few people have those characteristics.
All of which brings us back to Oprah. She’s also a very hard nut to crack. First she’s not crazy about a lot of medical stories; she feels their payoff to viewers is too often far in the future. Second, the show won’t do an entire hour about one client’s terrific new treatment. You can’t pitch a single treatment with Oprah, you have to pitch a larger theme (eg. New breakthroughs in weight loss!) in which your client’s treatment is simply part of a larger issue.
Another factor: Oprah’s show is very faddish. Different topics (eg the economy, mental illness, relationships) go in and out of style. For instance, cosmetic surgery is in-style when the economy is up, but less appealing to the show’s producers during an economic downturn. When medical stories in general are on the outs, a cure for cancer would have trouble getting her attention.
Finally, client physicians considered for segments literally get “screen tests” first. One of Oprah’s producers comes visiting, talks to you, and decides whether you’re impressive enough, and likeable enough, to go on her show.
That said, I did get one doctor on Oprah but that was almost by accident. One of Oprah’s Chicago producers happened to see a local weight loss ABC-TV story I’d placed for a client. That producer happened to have a weight problem herself, sought my client’s help, and then rewarded him.
I’m not particularly and Oprah fan (I’m not sensitive enough), but I appreciate how much power her show has. I have clients who are still picking up patients from an Oprah segment they did ten years before.
If you have an idea, especially one that fits into a larger overriding theme, go on. Pitch it to Oprah. But realize the competition is stiff. And it takes a heck of a lot more than a single phone call.
Doctor referrals have become more cutthroat than ever.
I was talking to a prospective client today, an orthopedic surgeon, about his lack of referrals from primary care doctors. He’s a pioneer, the first to do several minimally invasive techniques, but the primary care docs ignore him…and he thinks he knows why.
“I don’t take care of them,” he says. “I don’t give them their regular gift certificates. It’s not overt; it’s not quid pro quo. It’s more subtle: gift certificates for Christmas and other holidays, paying for occasional dinners. I just can’t do those things.”
Maybe I’m naïve but I was startled to hear that referrals are now so openly for sale. But I imagine that primary care has seen such a decrease in income, some doctors capitalize on the only leverage in the system they have left: the power to refer patients to specific specialists.
A similar conflict-of-interest occurs among the increasing number of salaried doctors. Another client, a pain expert, recently told me he never sees patients from a particular large practice run by a local hospital. “Their job,” he says, “is to funnel patients to the hospitals that pay their salaries. I don’t practice at those hospitals so I don’t see any of their patients.”
Fortunately, both clients are doing well because doctor referrals aren’t what they used to be. More and more consumers, helped by the internet, are choosing their own doctors. To what degree? Here’s an example: we once represented a cardiology practice of over 50 doctors. Yet in this massive, widespread practice over half their patients were self-referred (which always makes me smile. Our niche, Direct-To-Consumer medical marketing is definitely a growth industry.)
My (admittedly very roundabout) point is the realities of doctor referrals have changed..and that means any mass mailings you do to potential referring docs have to change as well.
My clients usually don’t get it. They’re always frustrated. They always have better mousetraps: same day hip replacements, non-invasive varicose vein treatments, better Lasik results, pioneering lifesaving treatments for CHF, AAAs, AF, etc. So they want mailings that describe to potential referrers how their patients can benefit from what they offer. And my reply?
“Unfortunately, what’s best for patients is usually not the issue. It’s not enough to have something to offer a doctor’s patients; you have to offer something to the doctor as well.”
The bottom line is there are two things you have to stress in any mass mailing:
• How A Doctor Will Profit By Referring Patients To You
• That You Will Not Steal Their Patient
Of course, any letter should begin with the case for why a new treatment benefits patients. But then you have to subtlety turn a corner. If you’ve got a safer percutaneous treatment for abdominal aneurysms, for instance, you casually mention that the referring doctor will be used for all the required follow-up visits and testing. You have to make it crystal clear that the doc will get copies of discharge notes and other impressions and that “your patient will return to your care” immediately after the procedure.
Sometimes a letter’s “call to action” can be more blatant. For a hearing clinic’s mailing, we offered a free hearing screening device to those who called. For a producer of balance testing equipment, we offered a highly profitable Medicare reimbursed testing arrangement.
The point is in this new era any mass mailing has to motivate potential referring doctors by referring to more than what’s best for just their patients. The medical pie has become too small for that kind of altruism.
I don’t like that reality. But I wouldn’t help anybody if I ignored it.
What does it take for doctors to realize their world has changed!
I write this because an article this morning notes some doctors require patients sign a “gag order” barring them from criticizing their physician on the internet. It’s a reaction to all the patient-run web sites that rate doctors.
Now I understand some of the scorn. Patients don’t have the faintest idea of what good medicine is. They’ll give you a great rating because of your concerned “bedside manner” without the faintest idea your incompetence is sending them to an early grave. I get it. In fact, I wouldn’t be surprised if you were taught to look down on good bedside manner as the tip-off to medical incompetence. After all, that’s what I was taught.
Who, you wonder, are patients to judge us? But now they do…and it matters. It may not seem fair but as they say in the movies, “Don’t blame the player, blame the game.”
Patients run the game. I remember reporting 25 years ago on a new Minnesota phenomenon called HMOs. HMOs promised their members first dollar coverage, no nickel and diming, if patients agreed to see the doctors within their network. Independent doctors just laughed. They had a sacred bond with their patients. No one would desert them just to save a few bucks! So much for patient loyalty. Those doctors spent all their time writing transfer slips for their patients. Then when they had almost no patients left, they reluctantly agreed to join the network and play by the HMO’s rules. (I remember an HMO executive telling me that his company had studied how much of a reduction in premiums it took for patients to switch doctors. It turned out patient loyalty was worth $20 per month. ) The entire transfer of power in the medical system took about two years.
HMOs surveyed their members on whether they’d gotten good care and made a surprising discovery. Patients reported a good experience if the receptionist smiled at them, if there was coffee in the waiting room, if the doctor seemed to care about them. The one thing that was irrelevant was an individual doctor’s competence. Since patients couldn’t judge that anyway, they based their satisfaction on everything else! As far as HMOs were concerned, that made doctors commodities and their individual medical skills almost irrelevant
Yet the self-defeating arrogance of physicians persisted. Sometimes it was even directed at me. “Why,” doctors would openly ask, “aren’t you practicing medicine yourself? What’s a doctor doing on TV?” Their tone really asked, “What’s the real reason you’re not like us? You couldn’t cut it, could you?” I now have a better handle on their hostility. They were mad at me partly because I’d made a different choice, and partly because I was a small part of the very forces that now threatened their careers. All my medical stories worked from the implicit assumptions that patients should ask questions and that, to some degree, they could understand their bodies and take part in their own care. At the time this was not a change in attitude most doctors appreciated.
Now it’s twenty five years later. Primary care doctors are moving toward a salaried existence, nurses in cubicles dictate medical care, and patients armed with information are determined to play a role in their own health care.
Yet today’s headline shows even now a small number of doctors still live in the past. They think they can squelch by fiat any criticism of their performance. I’m reminded of those last few Japanese still fighting WWII years after the surrender has been signed.
Thriving in the new medical world means playing by the new rules. That means
• Acknowledging that bedside manner counts
• Caring about the opinions of your patients, not just your colleagues and
• Marketing your skills directly to patients (who now make their own choices)
Some doctors will never adapt. They’ll stubbornly cling to the illusion that their power is absolute. And they’ll continue paying the price.
A client of mine was recently on the CBS Morning News. The infertility expert had helped pioneer a new treatment that allows some women to get IVF without receiving large doses of hormones.
I was recounting my success to another infertility expert when he looked at me flummoxed. “I’ve been doing that same procedure for years,” he said. “Why is he getting national publicity?”
The answer is simple. Me. Nobody knows you’re a pioneer unless you tell them. The onus in today’s medical world is on you to tell your story.
I suppose it’s always been this way. Marconi didn’t invent the radio and Babbage didn’t invent the computer (any more than Al Gore invented the Internet). That history has credited them with these inventions is simply a triumph of public relations. Some things never change.
Drawing attention to yourself has always been the rule in every profession…except medicine. Since referrals came from colleagues, doctors could afford to take the high road and play down their achievements. Indeed, when I was a medical intern at Duke, drawing attention to yourself (“showboating”) was the worst imaginable sin.
Good doctors didn’t have to care what anyone thought of them…except their colleagues. Nothing else mattered.
Now it does matter. Because consumers are choosing their medical care for themselves. They choose the doctor they’ve heard of, the doctor they saw on the news or read about because that means he/she must be good (or why would they have been on the news?)
Of course, that thinking couldn’t be more fallacious. Whether a doctor is on the news depends on whether they have a good story to tell, whether they’re physically close to the TV station, whether they’re available, whether they treated the reporter’s wife and, oh yeah, how skillful they are.
The media is deteriorating faster than medical practices. The assembly line of patients pales compared to a reporter’s assembly line of stories. Thanks to stripped down newsrooms, fewer reporters now have to produce more material for more news shows than ever. These reporters don’t have the luxury, and frankly often don’t care, if they’re interviewing “the best.” They just want to get their stories done.
The “news” isn’t the news. It’s just an arbitrary trimming down of what’s happened in our world. (I suspect we watch it so we can delude ourselves that we comprehend the bigger picture around us.) The stories and people on the news are chosen by personal preference, logistics, and whether they meet someone’s agenda.
That doesn’t depress me; it excites me. It’s empowering because it means I can (and have) put anyone on the news. How often have you watched a story and thought, “I’ve got far more interesting stories in my own practice!”
Whether or not those stories get out is almost entirely up to you. It doesn’t matter whether you’re the best or the first…just ask my infertility friend.
I was reminded of a client this morning when I read that the White House is worried about companies and organizations associating themselves with President Obama’s popularity.
My client is one of Barack Obama’s doctors.
What do you do in that situation? The President has seen you regularly for years. Recently, he quietly visited your office, a Secret Service agent, his hands clenched at his waist, posted outside your door. Inside, trying not to take himself too seriously, the President joked with you. “Don’t be too tough on me,” he said. “If I scream right now, the Secret Service will come in and shoot you.” And you both laughed.
Now you’ll be flown to Washington several times a year to continue treating the President.
Your career focus has always been preventive health. Now part of you wants to use your newfound credibility to help spread some important health messages about lifestyle and the need for early detection tests. And yes a little part of you wouldn’t mind the world knowing: I’m trusted by the most visible man in the world!
But an even bigger part of you is determined not to exploit a treasured friendship. What you dread more than anything else is a chastising phone call from the White House saying, “Please cease and desist any mention of your relationship with the President.”
Besides the obvious concerns about national security, there are concerns about decorum and, of course, the doctor-patient relationship.
On the other hand, when I was a medical TV reporter, I interviewed the President’s doctors on several occasions. That’s partly because, based in Minneapolis-St. Paul, I often covered the Mayo Clinic. I remember when President Reagan had prostate surgery in Rochester, I had no problem locating the urologist who performed it and interviewing him. Nor did I have problems getting medical information when the former President had brain surgery for a subdural hematoma. There was no talk of national security or the doctor-patient relationship then.
In those instances, those concerns were trumped by the opportunity to educate citizens about health and inform them about their President. (And trumped perhaps also by the Mayo Clinic’s desire to get some attention of its own.)
So the question becomes: can you use the “bully pulpit” of being a Presidential doctor to spread some lifesaving health messages without jeopardizing that valued relationship.
My client and I are walking that tightrope together. Our thinking right now is to be very cautious; to never make any Press Release about the President himself. Instead, to make it about the important public health message my client wants to spread. However, deep in the Press Release is a single, almost passing, reference to my client’s Presidential connection.
This is a unique opportunity to do some good (for the public and for my client). But my overwhelming goal is to err on the side of caution. In the absence of any consistent guidelines, we’ll follow the most basic medical guideline of all: do no harm.
Many doctors still don’t know the first thing about using the web.
I was reminded of that when I talked to a plastic surgery client yesterday. He told me he that he intended to devote more marketing money to his web site next year. Then in a knowing voice, he made some incredibly naive comments.
First he looked at me wondrously and said, “I don’t even market my web site but somehow a quarter of million people have found it.”
“Is that a quarter of a million hits or a quarter of a million visits from potential patients?”
“What’s the difference?”
“Hits just means your site has been acessed a computer. 95% of the time that hit just comes from a robot search engine like Google that’s just analyzing your site for inclusion in its directory. Visits means a person whose interested in your site has visited and stayed more than a few minutes. Web developers will give you the number of hits to impress you, but it means nothing. Ask about the number of visits.”
Then came the second bit of naivte’. I asked, “Do you keep a blog?”
“No. Just how do you keep a blog on your site and what could you possibly have to say?”
“I say exactly what I tell every client all the time. That to survive doctors have to give up old habits and market themselves, that means acquiring new habits like patting themselves on the back and being acommodating to the media. It means seeking attention even if that was once considered bad form”
I continued, “That doctors have become commodities in the health care system to be played off each other. And that that’s just the way insurers, hospitals, and medical device companies want to keep it. Those players don’t care about the quality of care you provide. In fact, they don’t want you to excel because then you become more valuable than your colleagues and cease to be a commodity. They’ll punish you for trying to elevate yourself above your peers. Your hospital doesn’t want you to excel because your colleagues will be upset. Likewise your insurer seeks only uniformity…a cookbook-driven algorithmic-driven mediocre, but acceptable, level of care. Consistent, unimaginative care that insures no doctor has price leverage and none can threaten the insurers
power.”
“I tell them the implicit contract doctors had with society has been broken. That they, the smartest students of their generation, spent sleepless years of their lives and hundreds of thousands of dollars to become physicians. In return society once promised them a no-risk guaranteed upper-middle class existence. However, now doctors were paying their heavy dues and being told by managed care that ‘We’ll judge your worth, just like we judge any other employees worth. Not by the effort you put in, but by simple suppy and demand.” A brain surgeon will be told that it’s incredible what he/she can do, it’s miraculous, but unfortunatly there are ten other brain surgeons who will do the same thing for half the money. Thus are colleagues pitted against each other..and thus is excellence a threat to the status quo.”
“I tell docs, especially pioneers in their fields, that their biggest threat is from the younger, less experienced, less expensive docs following in their footsteps. If they pioneers don’t keep telling the world about their experience, precisely why they’re the best (Lasic pioneer, IVF Lab, plastic surgeon, minimal invasive hip surgeon, etc.), then they’ll become commodities as well.
“If you practice excellence, you are obligated (for patient’s sakes and your own) to spread that message. And that requires marketing yourself just as anyone in any other business markets what they do.”
I summed up, “Spreading that message, following marketing developments, and giving doctors, (as well as hospitals and medical device companies) that marketing advice is what our blog is all about.”
“How do you know,” he asked, “if anyone reads all that?”
“You can download and configure a program such as Webalyzer that’ll give you all the data about your site your need and you can check it whenever you want. For instance, I know 80% of the people who visit my web site enter via my blog site. That tells me the blog site is the main reason people are motivated to come back. (Which is, by the way, a blessing and a curse because ultimately, my web site’s purpose is to get more clients, which means I’d like a lot more new viewers coming to the site. I have to work on that.)”
The bottom line is my client is very marketing saavy. But even he has a lot to learn about marketing on the internet. The good news is its all pretty simple….and a little knowlege of what internet marketing is really about can transform your practice.
The reason is because we represent pioneers. Pioneers do innovative, often controversial procedures and journalists feel compelled to tell both sides of the story. Pioneers by definition are not in step with their colleagues. They’re risk-takers, sucessful, and welcome change….all of which tends to generate some dissent among their peers.
This case involved a surgeon. Both the WSJ and Tribune went on about his unique skills and the fact that patients came from around the world to see him. But then came the inevitable dissent. The surgical colleague who says, “It’s still too early to say if his technique is really better.”
If you think about it, the journalist has to give at least some disclaimer. If not that medical writer makes one doctor friend and a thousand doctor enemies. When you profile a pioneer, you’re talking about a minority by definition. More than enough colleagues are just waiting to bring him down.
I told this to another client, a reproductive endocrinologist recently. He’s just become the first American doc to succced with a new form of IVF called IVM (for In Vitro Maturation.) I told him I’d probably get him some coverage but I also outlined the story that’ll result.
“You’ll first see your pregnant patient getting ultrasound, then tight shots of the miracle fetus, then a joyful sound bite, then a shot of you in the lab, then you explaining why IVM is so important, then another colleague talking about how it’s premature to get too excited, and finally the story will end with the ecstatic parents-to-be.
I continued, “The story will increase your prestige and drive patients to your practice. But don’t expect it to be a Valentine. Reporters aren’t interested in helping you. They’re doing this story because it will make the phone ring. But they also have to look in the mirror. They want to feel they’re offering a balanced presentation.”
The bottom line is if your message gets on TV or in the newspaper, you and your practice will almost certainly benefit. But unless you’re paying for the story yourself in some glossy “pay-to-play” magazine don’t expect total homage.
The bad news is you won’t get it. The good news is you don’t need it.
The situation is similar for some providers of dental implants, infertility treatments, orthopedic operations, Lasik, audiology services, and other quality-of-life services.
Providing quality of life treatments has lots of advantages: you treat common problems with larger markets, you get paid out of pocket, you don’t deal with insurance companies, and you deal with happier patients.
One of the greatest benefits? You don’t always deal with life-and-death.
One of the greatest weaknesses? You don’t always deal with life-and-death. That Lasik procedure, gastric bypass, new hip, new set of teeth, or new baby can usually wait a little longer, till patients are past this economic crisis.
So if you practice quality-of-life medicine, what can you do to ride out this recession as well?
Well here’s some advice based on what’s succeeding for our clients:
Focus on Your Less Expensive Alternatives
Plastic surgeons are having more success with “liquid face lifts” using fillers than the real thing.
Cosmetic dentists are doing more bonding and partial restorations and fewer dental implants (a widespread trend, profits of implants companies have plummeted).
Infertility experts are offering longer courses of Clomid and other therapies before turning to IVF
Part of the reason these professions are scaling down is because fewer patients than ever are qualifying for the loan programs that often finance their procedures.
Focus on Very Low Cost Marketing That Has A High ROI
Many of ourclients are backing away from expensive print ad campaigns and TV commercials. They’re focused on the most cost-effective marketing:
Press Releases - these are less expensive and far more credible than print ads or commercials. (When viewers see something on the news, it instantly elevates your medical organization.)
Mass Mailings - usually to potential referring colleagues (e.g. a CV surgeon with a new procedure might choose to mail all local cardiologists.) The cost of a large mailing list is rarely more than a few hundred dollars. What’s more while referral patterns are notoriously tough to break, you just need to succeed on about one in every thousand letters for the mailing to be successful. (Not to speak of the fact you’ve laid some groundwork with all those doctors who didn’t respond.)
Update Your Web Site - and put more stress on your more affordable procedures
Turn Your Service From a “Want” Into A “Need” - For example, a new set of teeth can be life-saving for a senior citizen, a gastric bypass can be similarly life-saving, and that plastic surgery is essential for competing in a tough job market. Almost every “quality-of-life” specialty is essential for some segment of the population.
One thing you shouldn’t do ( except as a last resort) is to lower your fees. Your future lies in being a “top tier” provider who’s worth the extra cost you charge. You’ve worked very hard to develop that reputation; don’t tarnish it now.
What’s more once you start competing on the basis of price, the game is over. That’s the case, for instance, with primary care practitioners…and you’ve seen where that’s lead.
Make your marketing efforts efficient and you’ll have far less trouble riding out the current recession. And the good news? When this economic cycle is over, your “Johnny-Come-Lately” competition will have been winnowed out. And you’ll be better positioned than ever.
The parallels between doctors and journalists continually fascinate me.
Both professions value getting right to the point and putting personal emotions aside. Both are ending a “golden age,” have lost control of their professions, and have become commoditized. Both face tough ethical choices to survive. And both are losing their own voices.
I write this because reporters at the Chicago Tribune now face the unthinkable: that advertisers will write their own stories for the paper….and readers won’t know the difference. Staffers are debating a management trial balloon that the paper remove the “advertisement” disclaimer that keeps many newspaper ads from looking like legitimate stories.
The Tribune has already been trending in this direction. So-called “advertorials” have been looking more and more like traditional newspaper copy. The font is becoming more similar, the disclaimer smaller. In fact, I’m told most readers already can’t distinguish between advertorials and legitimate stories.
But formalizing this policy would be a total capitulation. The media’s already leaky “iron curtain” between sales and editorial would become a spider’s web. Space in the paper’s “news hole” would be up for sale.
Not that that’s new. Community papers assign reporters to write stories about their advertisers all the time. So do glossy Chicago magazines. It’s an implicit time-honored “pay-to-play” tradition i.e. we’ll be glad to write an article about you, if you buy some advertising first.
I remember reading about a newspaper restaurant critic of 27 years who was fired because she wrote a negative review about a major advertiser. The restaurant pulled the plug on its advertising….and the paper pulled the plug on its reporter. The publisher made no apologies. “We’re not in business to lose advertisers,” he explained. Not even lip service to editorial integrity. Commerce conquereth all.
Even back when I was in TV, there was an implicit understanding that reporters didn’t bite the hand that feed them. (For instance, you used to see lots of investigative reports on corrupt car dealerships. No longer. Car dealers spend too much money. The oxymoron now is you only investigate the organizations that can’t hurt you ie. the have-nots. You kick the downtrodden and ignore those who need scrutiny most.)
You can only imagine how all this sits with idealistic journalists who entered the field “to make a difference.” They know they’re now pimping for the very establishment they wanted to bring down. Perhaps they use the rationalization I used to use (in both medicine and journalism): “at least” I told myself “the good I do outweighs the bad.”
But many doctors have taken that argument to the breaking point…and now many journalists have as well.
If it’s any comfort, the new respectability of “pay to play” journalism is likely to injure my firm as well. I learned in TV that good stories are everywhere. My firm succeeds because getting exposure for clients is “all in the telling.” Our clients profit because I know what kinds of stories reporters are looking for and how to slant those stories to meet their needs.
But if a newspaper’s editorial space is simply sold to the highest bidder, those skills become worthless.
Here’s the bottom line: the big “secret” in the media has always been that what we call “news” is totally arbitrarily. We choose to highlight just a fraction of the world’s “newsworthy” stories every day. Power comes from setting the agenda.
I’ve watched that power inevitably shift upward. Twenty-five years ago, we reporters had that power, then show producers and newspaper editors, then news directors and managing editors, then most recently newspaper publishers and TV general managers. Now that power is moving to those who pull the most strings of all, the people who pay the bills.
That’s a final similarity between medicine and the media: ultimately, the man with the gold makes the rules.
