sBMJ | How would you cope in the media spotlight?

How would you cope in the media spotlight?

How would you manage the full glare of the media if you were involved in a high profile case and journalists were pursuing you? Dawn Boyall and Matthew Lee from the Medical Defence Union have some practical advice

While many doctors hope it will never happen to them, figures produced by the Medical Defence Union (MDU) reveal that more and more doctors are being approached by journalists investigating accusations about care or treatment. Last year the MDU answered 160 new requests for help from members contacted by the media for comment about a patient's care or treatment. This represents a 25% increase on 2002, when 130 members asked for help.

Journalists on your doorstep

The calls came from doctors involved in a range of cases that were hitting the headlines. Some sought advice because they found themselves the subject of national newspaper campaigns, while others were facing General Medical Council hearings and needed advice because they had been contacted by journalists or doorstepped by photographers. Doctors are trained to tackle complex and distressing situations with calmness and authority, but when approached by the media it can be difficult to remain objective.

One sided reporting

Anyone who has picked up a national newspaper and read about a GMC hearing or a medical negligence trial will know that the reporting of these cases can be very one sided. Because doctors have a duty of confidentiality they are unable to comment on patients' cases, so it is usually the patient's side that is represented. And given that the allegations are often deemed to be far more newsworthy than the doctor's defence, it can be frustrating, to say the least, for the doctors concerned.

Example 1: MMR mix up

A general practitioner inadvertently gave a child the MMR (mumps, measles, rubella) vaccine when the parents had specified they wanted single dose vaccines as their older child had recently been diagnosed with autism. He apologised immediately and explained how the mix up had occurred.

A week later a reporter from a local paper rang the surgery and the general practitioner politely explained that he couldn’t comment. The next day the paper ran a story about the case with the parents saying the doctor may have condemned their child to autism. The story also featured a picture of the harassed looking doctor running to his car to escape the attention of the paper’s photographer.

The general practitioner was angry about the one sided story and concerned about what his other patients would think. He rang his medical defence organisation to find out whether he should ask the paper to print a correction.

While sympathising with the doctor, the MDU explained that he could not put his side of the story over as he owed a duty of confidentiality to the child. The MDU press office also explained that, in their experience, responding to these stories, even in general terms could give the story "legs" - in other words, keep the story running for a longer period in the paper - and that by not responding the story was more likely to die down. The doctor agreed that there was nothing he could say and the press office was able to give him advice about responding to any other journalists who might approach him and about posing for photographs. Fortunately, the doctor did not need to put this advice into action as the story did not appear again.

Doctors' duty

Doctors' legal and ethical duty of confidentiality prevents them from talking about cases, even if the information is already in the public domain. In 1997, the GMC reminded doctors about patient confidentiality when dealing with the media. It advised: "Always treat as confidential any information you learn in a professional capacity, whether or not the information is in the public domain." When extracts from the medical records of Ian Brady found their way into a national newspaper, a House of Lords judgment in 2002 also stated: "The fact that Mr Brady had himself put similar material into the public domain did not detract from the need to prevent [hospital] staff from revealing patients' medical records."

Journalists' responsibilities

Journalists also have codes of professional conduct, including a duty to try to obtain both sides of a story. There are also limits to what can be reported in the press. Journalists are bound by the laws of libel and the codes of conduct set out by the Press Complaints Commission and Ofcom, the UK communications industry regulator. Both organisations place strict limits on what journalists are allowed to do in terms of approaching individuals in hospitals and similar institutions. In addition, if any criminal charges are brought then the matter becomes sub judice. Then the press, in theory, should publish only limited basic information as a case proceeds to trial.

Handling the media

So what's the best approach to take if you do receive that unexpected call from a journalist about a patient's case? The MDU's advice is as follows.

Try to stay calm. Avoid becoming angry or aggressive. You may say something you would not wish to see in print
Don't respond to a journalist's questions immediately. Take a note of the journalist's name, the organisation they work for, and their deadline and tell them you will call back
Contact your medical defence organisation. They will help you formulate an appropriate response, which can be made either by yourself or by one of their media team on your behalf. Your trust press office may also be able to help
Call the journalist back as soon as possible. If they are asking about a particular case it is unlikely you'll be able to say anything except that you can't comment because of your duty of confidentiality. But many journalists who are not health specialists will not realise this, so it is worth explaining it to them rather than just saying "no comment," which can seem evasive
Remember you are "on the record" from the moment a journalist contacts you. Everything you and other members of your team say can be quoted. Beware of off-the-cuff remarks or of confirming any details that could breach confidentiality
If a photographer or broadcaster tries to film you, do not attempt to cover your face or hide. Allow them to take a photograph or film you, and usually they will then leave you alone
If filming takes place outside the surgery ensure that patients cannot be identified and that the film crew are not obstructing patient access
Above all else, remain professional. Remember the journalist is doing his or her job, just as you are doing yours

BOSTON HERALD/REX

The gentlemen of the press

It's worth bearing in mind that in most cases where a patient actually carries out the threat of "going to the media," the media will not be interested. While the sensationalism of some newspapers might make it sound implausible, most journalists understand that medicine and the doctor-patient relationship are not simplistic black and white issues. But if you do receive a call from the media asking for a comment on patient care and you're unsure of how best to respond, contact your medical defence organisation for advice.

Example 2: Silent witness

A casualty doctor appeared as a witness of fact at an inquest into the death of a young girl. The doctor was involved in the case only peripherally , but was called by a local journalist asking her to elaborate on the evidence she had given. The journalist said he had been approached by the child’s parents, who had given the doctor permission to talk to him about the case. The doctor was advised by the MDU that even though the patient had died, her duty of confidentiality still applied. The MDU also pointed out that even if the family had given their agreement to talk about the case, and this would need to be sought from them in person, it was always possible that detailed information may cause them further distress. In any case, the doctor felt there was nothing she could add to the evidence she had already given. She was advised to explain this to the journalist and that she had no further comment to make.

The example cases are fictitious, but are based on cases from MDU files.

Dawn Boyall, media relations manager
Email: BoyallD@The-MDU.com

Matthew Lee, medicolegal adviser, Medical Defence Union, London

studentBMJ 2005;13:45-88 February ISSN 0966-6494

Media attention may put confidentiality at risk. GMC News, Spring 1997.
Ashworth Hospital Authority v MGN Ltd. House of Lords judgment reported in The Times 2002 July 1.