What if you wanted your story to be broadcast on NPR…with evidence to back up the implication that you’re somehow on the receiving end of poor medical practice? That might concentrate a person’s mind a bit.
This issue isn’t whether or not folk are interested enough to keep tabs on trends or whatever, or know what it is they’re looking at … but rather whether or not it’s possible to easily fact check a story that doesn’t appear very plausible on first blush. I could see why reporters might not bother…if they have a dramatic story in mind and possession of all the facts might refute it, it wouldn’t make sense to look.
Not exactly true. A person will get a list that needs to be taken into context. Couple personal examples. My cholesterol runs about 220-230, that is high. However, given my HDL is 80, lipo protein A is normal, my CRP (c reactive protein) is low end of normal, and my coronary artery calcium score is low, neither me nor my physician is going to get excited about it. Then there is my creatinine level (measure of kidney function) is elevated (it worried my physician at my first visit) but I am slightly larger/more muscular than the average male my age and my creatinine has stayed the same over the past 8 years (and was the same for 8 years prior to seeing him), again, neither of us are getting excited.
I can think of several scenarios with “normal” labs but given the correct context, they turn out to be bad.
I think it is great that people can take a more active approach in their healthcare, but if they depend on “Google, MD” to give them context, not sure it is going to work out too well.
My husband also with the creatinine. Even as a older geezer, he still carries a fair amount of muscle…naturally a poster child for Fast Twitch Man and with minimal weight training (I complain that he builds muscle just by bellyaching about me leaving my weights lying around) Creatinine always elevated. His CBC is usually a bit of a stunner as he has what’s now called Benign Ethnic Neutropenia. Has known about it since medical school days. Given the high prevalence in people of African descent, it’s a bit of a surprise that it’s such a surprise to new to us PCPs.
To your point on the normal labs not always being good when taken in context, here’s a perfect example, given the mention of liver disease upstream…the return of LFTs to the “normal” range when a really sick liver finally starts to decompensate. That’s a sad thing to have to explain to a patient…especially if a they’ve gotten hold of their results ahead of time and subjected themselves to the Google Bamboozle and believe they’re on the road to healthy.
My current PCP does something that I thought was going out of style…schedules bloodwork a week prior to the office visit (or a person gets it done independently if desired, I guess) and doesn’t post to the patient portal until results have been discussed. My intervention cardiologist will schedule them both for same day appointment …as my husband does also. Turnaround is so slick and speedy within the hospital setting that the delay is barely noticeable.
It’s an interesting conundrum. For example, here’s a portion of story in today’s Wall Street Journal, about people leaving Florida because of the high costs of everything:’ (It’s an interesting story in its own right, but what I want to focus on here is “fact checking”
Florida’s Population Boom Fizzles as High Costs Drive Away Middle Class
Orlando and other Florida cities are either losing domestic migrants or gaining them more slowly, threatening the state’s economic model
Roberto Reyes became fed up with rising rents and other spiraling costs in Orlando, and jumped at a job offer as an insurance agent in Knoxville, Tenn., last July.
He is now paying $2,300 a month for a two-bedroom apartment with a garage in an amenity-rich complex—$150 less than what he paid for a one-bedroom in downtown Orlando. He isn’t spending nearly as much for entertainment and eating out. And his commission-based income climbed to $226,000 in the seven months he has been in Knoxville, he said, far exceeding the $137,000 he earned in his best full year in Orlando.
“I came here to grow to the next level,” said Reyes, 39 years old. “I couldn’t be happier.”
Now if you are the reporter for the Wall Street Journal, do you demand to see his tax returns for “the best full year” in Orlando? Or do you take him at his word? Do you require receipts from his $2450 one-bedroom rental in Orlando, along with some proof that it is, indeed, a one bedroom, and likewise the rental receipts from the Knoxville apartment sowing that it is a 2-bedroom? Do you require that he show you that he is 39 years old?
I do know that at reputable news organizations like the Journal, the Times, and yes, NPR there is a level of fact-checking that goes on, although to what extent I don’t know. But at some point you have to file and do it more than once a week. (There is also time spent in figuring out what story to cover, how to find relevant facts and interviewees, etc.)
So the question becomes: how much do you trust the people you’re talking to, and at what point do you demand proof? I would say if it’s something huge, like accusing tobacco companies of hiding research, you better have the goods, and you better have the right people with the goods. If you’re reporting on the Pentagon Papers, you should probably have the Papers and someone involved. If you’re reporting from the front line of a battle, maybe just interviewing a grunt about yesterday’s firefight is enough and you don’t need to have him pull out his dog tags as evidence.
(If you’re Glenn Beck or Alex Jones, obviously, you don’t care at all. Caveat emptor and all that.)
Don’t really know. Every situation is different; it’s not a factory assembly line where everything starts the same and comes out the same. It’s an unusual kind of assembly line, and I don’t think anybody gets it perfect.
The problem with the knoxville story, as i read your snippet the guy went to a better position as management. The reporter seems to down play that making a different unsupportable point that pay is twice as much in knoxville.
The next level.
“I came here to grow to the next level,” said Reyes, 39 years old. “I couldn’t be happier.”
I don’t know where you got that. The word “management” appears nowhere in the story. Indeed, he says he is “commissioned based” as “an insurance agent”. Managers are not typically “commissioned based.”
(Note: I forgot to add the link to the story, which I will correct after posting this reply.)
Also Note: Knoxville has a low cost of living, estimated to be about 13%-14% below the national average. As I said to one transplant from Baltimore when she was transferred here from Discovery headquarters to HGTV here, “if you can get east coast media wages on top of Knoxville’s cost of living, you can have a very nice life here.”
I see why the guy is happy; significantly better income, significantly better rent prices too. He should have come 5 years ago, before housing prices accelerated.
I work with someone part-time. He is an insurance sales manager. Meaning he recruits fellow salesmen/women to sell the product. He gets commissions and residuals from their sales and his own. He manages them. He works with us elsewhere because he has time on his hands. He makes something north of $100k as a sales manager.
adding he might do the same thing with a reporter. Boast that plain vanilla salesmen are hyper successful. He is in recruitment. Most are duds. It is not an easy job, but some people are naturals.
“I came here to grow to the next level,” said Reyes, 39 years old. “I couldn’t be happier.”
Another one, a cousin of mine in Ireland, works for Huawei. She was here this weekend. She described sales for Chinese nationals working with the company. If a contract is signed, not only the people involved directly with the sale, but also people across the company get commissions. It gives my cousin job security because her contract as a European is worth much less money for the company. People at Huawei seemingly are retired in their 40s. My cousin, a European, is close to 60 years old, and her pension from Huawei is smaller.
It is not unusual for some managers to get a bonus based on the sales of their group, but that does not make them “commissioned based.” Typically the largest part of their compensation comes from the base salary, with a small override on total sales. Our sales people were entirely commission based unless they had been with us for a couple years (or we had poached them from the competition) with a low base salary, against which a draw was leveled and then commissions calculated on top of that.
You could do very well if you were commission based and knew which products to sell. You could take it easier if you just wanted to “do the job” and still have a reasonable quality of life. But in no instance would we have described a manager job as “commission based.”
A lot of us likely think a lot of questions are missed by reporters in all sorts of situations and topics. What we also tend not to do, though, is to think of a question and then supply an answer to that unasked question and attribute that answer to the reporter.
You might not, but if the story is hinging on it…I do. Probably because I am a slow reader. I have to live it the ideas not just scan them.
It is difficult a lot of news stories are posted here to prove massive points, when really the underlying story is floppy. Major points are not explored, which would crack things wide open.
Goof,
I agree that the Huawei example gets much further afield. I was frustrated with my cousin’s explanations. She was not delineating many of the details. Some of it she could not add. Some of her details had mixed information quality. I let it go because she was here for a ceremony for my Dad’s passing this weekend.
It’s entirely possible that the reporter did ask that question, and being an obvious response chose not to include it in the story. Most of these “interviews” take at least 10 minutes, often 30 minutes, sometimes over an hour. It would be impossible to include everything in the transcription in every story, and even if they did there would be somebody saying “”But why didn’t you ask this?”
My wife hosts a monthly group on various philosophical and quasi-religious matters (Buddhism, Reincarnation, Living the Best Life, etc) and she pre-interviews each guest for more than an hour for a discussion group that is barely 60 minutes long. She asks questions I would never think of, and occasionally I am the person saying “But why didn’t you ask this?”
Different people have different brains, and in the absence of evidence to the contrary, there’s really little reason to start inventing conspiracy theories or dark motives when there may be none involved at all.
And that is absolutely true. I have been in the eye of the whirlwind on three major news stories in my life, and I have always wondered how it is that the reporters takes, and the eventual stories that come out can be so different. Rarely are they totally wrong, but just as rarely do they get every teensy detail right, in proper context, and with full understanding. (And even if they do, there is no guarantee that the reader/viewer will come out with the same understanding as someone involved.)
It’s just how it works. If there’s a better way I’m all for it, but so far I haven’t seen it.
But it is not a conspiracy or a darker motive. Stories rotate around a major fact and the major fact is loosely reported. It is fair enough but that does not inspire me to believe a lot of what is in the press.
There is a longer history of hearing tough personal medical information or legal information and trying to get to a reporter. If the professional involved is innocent, their career can still be ruined by a newspaper story. The story is long over; the damage is done. That happens.
We have someone now who has dominated the news cycle for years. Damage done.
If the bear blanks in the woods and no one hears him? A megaphone is a profit center. Just is. Does not take a conspiracy theory to know that.
I equate myself to the Non Profit NPR. Meaning as a singular artist, I have stuff that has never sold, but I also have stuff that has sold for modest amounts of money. A reporter at NPR makes a modest living. Still with the threats to funding and so on, gripping a consensus means making a living. It is seen by anyone as honest.
My upbringing was principles over consensus. Principles and forget consensus might be one way of seeing it. That is not defined as contrarian.