How to be a media doctor

Leyla Sanai gives some tips on how to flirt with the media

The world of media medicine may seem very glamorous. What fun it must be to argue with politicians while appearing as the medical spokesperson on debates, chat to celebrities on breakfast television, scribble a weekly column in a broadsheet, or be medical adviser on a sharp medical drama. But it's not all hobnobbing with stars and drinking free champagne at parties. The truth is that it's fun but also notoriously fickle and highly competitive.

Doctors are involved in the media in many different areas. Some are journalists, writing columns for medical or non-medical papers; others appear on television and radio, either talking about medical matters or medical politics; some act as medical advisers for television programmes and movies; and a few decide to give up practising medicine altogether in order to pursue a full time career in the media.

This article concentrates on doctors who dabble in the media while retaining a career in medicine, since that's where my experience lies. I've worked in medical journalism, both for medical publications and broadsheets, have given medical advice to television programmes such as Cardiac Arrest, and have appeared on two televised debates for Carlton as a spokesperson for the Scottish health service, as well as a few more minor things such as radio programmes and a couple of "invited audience" television appearances. Other doctors have done far more media work than I, but, for what it's worth, here are my tips on becoming a "media doc."

Decide what you want

Since there are relatively few openings for a career in media medicine, it's worth formulating a plan for achieving what you'd ideally like to be doing and to concentrate on that to maximise your chances of success. If, for instance, you long to be a journalist, start writing articles and sending them off. It's probably easier to start with medical publications rather than submitting unsolicited articles to the broadsheets. Once you've been published in one place, other doors open. If you'd like to appear on televised debates about medical politics, you need to have opinions and to be able to articulate these clearly. My two appearances on such programmes stemmed from the producers reading my letters on medicopolitical topics in the broadsheets.

Appearing on television requires more confidence than scribbling away in the papers, where you can hide natural shyness under an assertive persona. As someone who can be stroppy in print but who hates public speaking, I find writing far more appealing than appearing on broadcasts, but even shrinking violets can overcome stage fright by practising what they have to say beforehand.

Speaking on television requires an ability to state facts and figures in a coherent, concise way: your 15 minutes of fame will be gained only if you capture the audience's attention and blast them with potent, snappy facts. Wittering on incoherently and drifting off on irrelevant tangents will just embarrass everyone, and you might find yourself edited out.

Be determined

There's no point contemplating a career in the media if you go into hiding after your first rejection letter. You have to just shrug and keep trying. Some editors will tell you why they don't feel your article is suitable, and this can be helpful. If they've covered that subject recently or if the topic is not right for their publication, you may yet get mileage from your piece by sending it elsewhere.

However, you might have to be realistic and face the fact that your article isn't the work of art you thought it was. There are also only so many times you can hurl a boomerang: if you keep sending the sorry article off to all the different papers in Britain and it persistently comes home to roost like a faithful homing pigeon, it may be time to lay the poor thing to rest.

Once you've been published by one paper, others may start to take you more seriously. However, the previous experience has to be yours, and it has to be on the right subject.

Develop an area of expertise

There's no point trailing around after every media post going. Offering to be a psychological opinion on Big Brother one minute and a surgical consult on Casualty the next is not terribly wise. Production companies want experts in each field.

The one area where you can get away with covering subjects outside your immediate specialty is when you're writing about simple medical conditions and can glean information from journals and textbooks. When I wrote a column in the Saturday magazine of the Glasgow Herald I covered psychiatric, gynaecological, and obstetric conditions as well as medical and anaesthetic ones, but I was writing about basics, not the latest research in each specialty.

Clarify your position

The production staff on Cardiac Arrest were great and credited the medical advisers. Others don't. One of the production staff of the film Orphans telephoned me at home to ask about the clinical sequelae of an abdominal injury, as one of the characters was to be injured in the film. I spent some considerable time telling her about massive liver lacerations, the person becoming weak from blood loss, pale, tachycardic, shocked, etc. I was rewarded with neither a credit nor a fee. (This was nothing to do with the director, Peter Mullan, who is a man of integrity as well as being a lovely bloke.)

I had a similar experience with a Manchester producer, who left a message on my answering machine asking me to call him back. I spent 45 minutes of my time and my telephone bill at peak rates, giving him information, without any thanks. Imagine telephoning a lawyer and getting his or her opinion for half an hour without offering a fee or credit of any kind. The only thing you can do is become assertive. When I was asked to read the script for a medical ethics programme and correct any medical inaccuracies, I did so and sent the producers a bill. They paid with no questions. It may seem pushy, but after having had a few feet wiped on me, I was tired of being a doormat.

Television appearances

Before you accept an invitation to appear on a television or radio programme, find out exactly what the programme is about and what you'll be expected to talk about, so you can target your comments appropriately. Research your subject: vague,
non-specific comments involving generalisations and "lots of" or "hardly any" sound lame, whereas hard statistics and facts carry clout and power. Make sure you won't be trampling on others' toes--launching into a tirade against your own hospital trust is unwise, especially if you haven't raised the issues in question with your local managers first.

Pay

Some people pay for medical advice, while others don't. For most television and radio appearances, you are not paid, but if you've travelled to another city or stayed the night because you've been asked to appear on a programme, you're entitled to expenses. Don't be afraid to ask--production companies have vast budgets. On the set of Cardiac Arrest, if they needed a ventilator they went out and bought one. NHS intensive care units can't do that, even when it's lives and not viewing figures at stake.

Cut your losses

Occasionally, you're treated so badly by a production company that you should tell them to forget it. I was asked to screen test for a digital television health programme made in Leeds which needed doctors to answer viewers' problems live on air. I was invited down for the screen test on a specific day, and the week before, I telephoned and emailed to make sure I had the right day and address. These were confirmed. Three quarters of the way down on the train to Leeds, I received a call on my mobile telephone to say that the date had been changed to the following week. I wasted eight hours travelling and waiting for connections. Like a mug, I went down the next week. Before the screen test, a rumour went round that local doctors from Leeds were being chosen because the programme didn't have the budget to pay travelling expenses. Yet the production company had known our addresses from the start. I didn't receive a formal letter telling me I hadn't been accepted, just a cursory note three months later thanking me for my interest.

Nothing lasts forever

Media careers have a shorter life span than most other things. To be fair, editors have a duty to keep their papers fresh and challenging, and so a medical column that seemed innovative at the start may look stale after two years. It's always sad being given the boot--there's no easy way to be dumped. If you're told your medical page is being axed to make way for a crystal therapy, colonic irrigation, or blood group diet column, you just have to bite your lip and leave with grace. Don't take it personally. Your conventional medical work will give you stability and security and any media activities are just another spoke in your wheel. And if a spoke breaks and you fall off your bike, what were you always told to do? Get straight back on again, and don't let it dent your confidence.

Leyla Sanai, consultant anaesthetist, Western Infirmary, Glasgow


studentBMJ 2002;10:215-258 July ISSN 0966-6494