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What a dreadful newscast NBC put together on Tuesday! It led with such excessive coverage of a report on the safety of Hormone Replacement Therapy for menopausal women that HRT qualified as Story of the Day. It followed up with three reports on Campaign 2010: the network's own poll results on the generic ballot and a couple of incomprehensible features. For finishers, its Making a Difference offering was more propaganda than journalism. Meanwhile CBS led with a survey on the loyalty of Barack Obama's supporters while ABC chose the real estate foreclosure crisis. ABC did not even consider the HRT story, which NBC spent six minutes on, to be worth the assignment of a correspondent.

What on Earth did NBC see in the menopause story that was so newsworthy? Robert Bazell told us that the Women's Health Initiative released a follow-up to its 2002 research that found that HRT--the estrogen-progesterone combination--led to an increased incidence of breast cancer. At the time, HRT was "the most commonly prescribed medication for women 50 and older," Bazell reminded us, a routine practice that has been discontinued because of that research. The follow-up study found that the resulting tumors were not "small and not-so-life-threatening," as doctors had hoped at the time, but "more advanced and deadly."

Obviously that is not good news. But what are the public health consequences? Bazell did not tell us. How many women take HRT nowadays? What income and profits did Pfizer make then or does it make now from marketing HRT? How many extra breast cancer deaths occur each year? What is the cost to the healthcare budget of treating those extra tumors? Bazell did not tell us.

Instead, NBC anchor Brian Williams invited Dr Beth DuPree into the studio, the medical director of the breast health program at the Holy Redeemer Health System in Pennsylvania. What followed was almost four minutes of the most anodyne interviewing. Examples of Dr DuPree's pabulum include:

"I think we have to shift perspective and say individualize the care and make sure women talk to their doctors to know what their risk is."

"That is where we have to get back to having a very good doctor/patient relationship and discuss each symptom."

"You have to weigh those risks and benefits but at this point in time, I think it is something that we have to take a very, very good look at, from a medical perspective, to say, is this the right choice for this woman?"

"So should we be treating all those women with a medication or should we individualize the care and decide which women will benefit from it and which woman's risk is too high?"

"You have to individualize the care and make sure that you are treating that woman specifically and not just giving a medication to alleviate a symptom, so that that person no longer comes to your office with that same complaint."

My complaint is not that the health-&-medicine beat is an inappropriate one for the nightly newscasts. Of course healthcare should be covered. While NBC was airing this pabulum, CBS' Wyatt Andrews, for example, was filing an Investigation expose into infomercials that purport to sell health insurance to laid-off workers, coverage that turns out to be nothing more than a worthless discount card. Beware of the American Trade Association, he warned. Even Terry Moran's affecting first-person account of losing family members to dementia--part two of ABC's Taking on Alzheimer's series kicked off by in-house physician Richard Besser Monday--has its place in the nightly newscast palette.

No, my complaint is with this News You Can Use formula. It is a problem seen more often on the morning programs such as Today or Good Morning America. It has no business whatsoever on the nightly news. Actionable information directed at a tiny minority of the audience is a waste of time on a general interest newscast. Brian Williams should be addressing us as citizens, supplying information for participation in the public square. Individualized advice on whether or not we should take Hormone Replacement Therapy for our menopausal symptoms cannot be usefully dispensed by a journalist via television. Instead we need to know whether public policy concerning HRT, and its withdrawal from general use, was pursued properly, with full accountability.

CBS' in-house physician Jon LaPook did a superior job, in shorter time, than either correspondent Bazell or physician DuPree. CBS told us that 40m prescriptions for HRT are currently written annually. Presumably, on the basis of a monthly prescription, that means 3.3m women are taking the hormones at any one time. Dr LaPook told us that the increased risk of premature death from breast cancer as a result of taking HRT was "slight, a little over one extra death per year for every 10,000 women." Doing the math, that means that, nationwide, 333 women will die prematurely from breast cancer each year because they are taking HRT.

That is no big deal, certainly not worth more than a quarter of NBC Nightly News' entire newshole.

Andrew Tyndall 10/21/10 5:48:38 pm

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