MONITORING THE HEALTH CARE BEAT

The vast majority of health stories on local television are medical reports: stories about diseases, lifestyles, experimental tests and treatments. Many of them aren't even local, although they may be "fronted" by a station's reporter or anchor.

Hundreds of newsrooms depend on feed services like Ivanhoe Broadcast News and Medstar Television to provide their daily health reports. Let's face it: issues like insurance coverage, prescription drug costs and access to health care may be important but they aren't easy to cover, especially on television and radio.
That's why we offer the following tips to help you tackle these stories and to make them both interesting and understandable to your audience. Check these links for additional resources. When you see this symbol , click to watch story examples.

People

• Find a central character. The best stories are about people, they don't just use people as an opening and/or closing anecdote. They have what one news manager calls the "RH factor"--real humans. "The art of getting public policy on TV," says PBS's Susan Dentzer, "is to go out an find the person whose plight encapsulates at least some of the issue." Finding people who are willing to go on camera is often difficult, however. It's important to help people understand what the story is about and what it will look like on the air. Reporters have had success finding participants by working through interest groups. Reported by Susan Dentzer for PBS, this prescription drug story features strong central characters and expert analysis of their specific situations.
  
  
• Choose a willing expert. Find an expert who can explain complex issues simply. One way is to ask if the expert you want to speak with is comfortable being called by his or her first name. A PBS producer uses that question as a simple litmus test for finding experts who are willing to forego technical language.
  
  
• Help people speak simply. Experts often speak in their own jargon, which is virtually unintelligible to the general public. Asking better questions can get you better sound bites. Use simple language in your questions, so people will respond the way you talk. Example: Don't ask about morbidity rates; ask how many people are sick. NBC's Bob Hager says he often tells experts that what they're saying won't work on TV. "Remind them they aren't speaking to their colleagues," he says. Susan Dentzer of PBS tells sources they should treat her like a very intelligent 12-year-old. "Because I'm intelligent, they won't talk down to me," she says, "but because I'm 12, they know they need to explain things."
  
  
• Experts may not be required. Not every story needs to include a sound bite from a traditional "expert." You'll probably consult experts but you don't have to use them on camera. Instead, you can summarize their views in simple language and in less time. Besides, people are experts about their own lives. Let them speak about what they know. In stories about children's health, let the viewer hear from children. But be careful to verify all information. Dentzer has found that people are often confused about their specific medical condition, so she asks for permission to confirm information with their doctors and to see supporting documents.

Visuals

• Shoot active interviews. Talk to people while they are doing something connected to the story, and shoot b-roll at the same time as the interview. If you're asking about prescription drug costs, talk while the person sorts through their medications; if you're discussing insurance coverage, talk while looking at their hospital bill. Good communication between reporter and photographer is essential to make sure you have the sound bites you want on-camera. The extra effort required pays off in time saved both in shooting and in the edit room. Explain your need for video before setting up the interview but make clear that you are not asking for anything to be arranged for your convenience. Sometimes experts are too willing to stage activities that they think will be "good TV."
  
  
• Avoid "wallpaper" video. Video should help viewers understand the story, and generic or file tape does little to achieve that goal. In fact, research suggests that when viewers see familiar file tape they conclude that there is nothing new about the story they are watching, and are likely to tune it out. Shoot or obtain fresh and specific video for each story, if at all possible, and write something that helps viewers understand what they're looking at and why.
  
  
• Ask for home video and still photos. Home video and stills can help to put a human face on a story, and offer context for stories in which a main character has undergone dramatic change. For example, a story about hospital errors could use home video to show how a patient appeared before his or her hospitalization.
  
  
• Be careful with video news releases. VNRs can provide you with video you couldn't get any other way. Sometimes they're worth using, but you should ask a few questions first. Would this even be a story if you didn't have the video? Were you working on it already or did it just land on your desk? Whose agenda would you be promoting if you used the video? If you do use it, identify the source of the video, ideally both in track and in a chyron that stays up for the duration. Be extremely cautious about using sound from VNRs from anyone other than a clearly identified official. How can you be sure that someone identified as a patient really is? After all, no one knew that Sony was making up movie reviews.
  
  
• Look for other video sources. JAMA, the Journal of the American Medical Association, offers a weekly satellite feed related to its top story. If you can't downlink the feed, they will send out B-roll. Many big medical groups like the American Heart Association also have sizeable tape libraries. Researchers also shoot video that can be used to illustrate results. And historic footage can show how things used to be, setting up a comparison with the way things are today.

Graphics

• Consider using animated graphics. Animation can help clarify how a complex process works. Research shows that viewers pay attention to animations and are more likely to understand a difficult story using animation than one using static, full-screen graphics. Consultant Tom Dolan concludes from watching focus groups that "they will not zap your channel" when animations are in use. This Eye on America feature for the CBS Evening News by Wyatt Andrews uses animated graphics to make statistics come alive. Experts speak simply and are easily understood.
  
  
• Construct graphics that show rather than tell. Graphics that show how things relate to each other work better than plain words and numbers. If one hospital charges twice as much as another for the same procedure, you might use a bar graph to clearly show the relationship between the two. If a senior citizen spends close to half her income on prescription drugs, you could use a pill-shaped pie chart to illustrate the ratio.
  
  
• Bring document-heavy stories to life by using specific techniques to enliven the actual documents themselves, instead of creating a stand-alone graphic. Former WFAA-TV reporter Valeri Williams says that while it's easier for graphic artists to re-create the information in a document, she insists on showing the actual document for two reasons. "It adds legitimacy in the eyes of the viewer, and it's one more layer of protection if I end up in court." Use a highlighter, or selective lighting to make the important words jump off the page. When shuffling papers, capture the natural sound and use it. Have someone directly involved in the story read the document, like a denial of benefits letter.

Storytelling

• Use analogy or metaphor. Look for a way to explain the issue by comparing it to something else people might already have experienced. Ask the people who know the issue best to help you find an analogy or metaphor. What else is this problem like? Could you compare an insurance company's decision to drop coverage for certain people to a game of "knock-out" basketball? Finding an analogy can lead you to pictures that will illustrate the story.
  
  
• Use "show and tell" stand-ups to explain complicated issues. A visual analogy can often be explained best in a reporter stand-up. Consider using props that can turn a concept into something concrete. A managed care system that rejects patients based on pre-existing conditions could be illustrated using a coin-sorting machine.
  
  
• Vary your format. Not all health stories need to be packages. Consider on-set explainers or nat-sound stories to share an experience or situation with the viewer.

Planning

• Work ahead. It takes time and effort to arrange to shoot in hospitals, doctors' offices, and other locations where patient privacy is an issue. Jaine Andrews, anchor and health reporter at KELO-TV in Sioux Falls, SD, says she began planning a series on heart attacks three months in advance of the target airdate. This gave her time to meet with the hospital's marketing department, cardiac physicians, and ER staff, setting ground rules for the shoot.
  
  
• Share your plan. Involve photojournalists and producers early on in discussions about what the story will show and why it matters. Let the people you will be featuring know what you're doing, as well. Andrews posted notices throughout the hospital explaining why cameras were present and stating that anyone could request that they not be included in the video.

Selling the Story

• Explain the significance. Managers who are used to thinking of health stories as reports on medical "breakthroughs" need to know why a "policy" issue deserves airtime. Make a good pitch to get these stories on. Point out that stories about health care costs and coverage are of almost universal interest, unlike "disease-of-the-day" reports. They also affect people's pocketbooks. And because you will be telling them in an interesting way, they won't fit anyone's preconceived notion of a dull policy story.
  
  
• Find the local angle. Health policy stories affect people in your community. If you look, you can find local groups that are actively involved in just about every aspect of health policy. Critical Condition , an hour-long special reported by Hagit Limor of WCPO in Cincinnati, examines why doctors are leaving the city in record numbers. The strong local focus makes this program matter to local viewers.
  
  
• Highlight viewer interest. Collect and use survey results that make clear how much viewers care about health care costs and coverage. A NewsLab survey of self-described light TV viewers asked what kinds of stories might make them watch more often. Health reports ranked just behind education as the topic of greatest interest, but respondents defined the health beat more broadly than many stations do. They wanted to know about good and bad doctors, about health insurance and nursing homes, not just about the latest diet tip or experimental treatment.
  
  
• Point to ratings successes. Valeri Williams, an investigative reporter who has probed medical issues for WFAA-TV, says these stories can pay tremendous dividends in ratings. "I would challenge any news director in second or third place [in the ratings] to let a reporter work on a health investigation for a few weeks and see what difference those nights, properly promoted, make in the book." Williams has investigated government oversight of vaccines and the performance record of HMOs, topics that drew hundreds of emails and phone calls from viewers.