Assessing U.S. Health Journalists’ Beliefs About Medical Overtreatment and the Impact of Related News Coverage

ABSTRACT

The United States spends more on health care than any other country in the world, but often experiences poorer health outcomes and lower patient satisfaction than other developed countries. One possible explanation for this paradox is overtreatment, the use of medical tests and treatment for which harms outweigh benefits. Because journalists play a key role in informing people about the health care system, including issues such as overtreatment, it is important to understand how they define the issue and its importance. This qualitative study of health news journalists offers an analysis of journalists’ perspectives on overtreatment coverage. The interviews produced four major themes in regard to journalists’ beliefs about overtreatment and its coverage: journalists’ roles and responsibilities, the medical context, causes of overtreatment, and economics/costs. Journalists view overtreatment as an important but complex issue driven by Americans’ faith in medicine and cultural norms that make uncertainty unacceptable. The medical contexts most associated with overtreatment are cancer testing and treatment and overprescribing. Journalists see themselves as providing information to help consumers make personal treatment decisions, rather than helping audiences understand health policy.

For decades, the American public has expressed dissatisfaction with the U.S. health system; in one recent assessment, two-thirds of Americans graded the overall quality of health care in the country at a “C” or worse (Blendon, Benson, SteelFisher, & Weldon, 2011; Blendon, Brodie, Benson, Altman, & Buhr, 2006). A study of patient satisfaction in 11 Western countries showed greater dissatisfaction with the U.S. system than with those in any of the comparison countries, with more than one-quarter of Americans saying the U.S. health system needs to be completely rebuilt (Papanicolas, Cylus, & Smith, 2013).