Thursday, April 30, 2015

Part I: Does Kurt Eichenwald have (another) disclosure issue? Newsweek's Editor-In-Chief says "no" and Eichenwald blasted me for asking questions, but....

Via Seizures Hurt Memory, Ex-'Times' Reporter Says by David Folkenflik, NPR, October 19, 2007:
Investigative reporter Kurt Eichenwald was a star for years at The New York Times, and he won new acclaim in December 2005 with his front-page article exposing a sordid new online front in child pornography.

Eichenwald's reporting stemmed from his efforts to aid Justin Berry, who was both a victim and perpetrator of a Web pornography ring, and who was in league with several older men.

The ensuing story about Berry's world was a far cry from the coverage of corporate fraud that won Eichenwald journalism prizes and landed him on best-seller lists. He helped Berry get legal representation and arranged medical care, counseling and housing with some of the youth's relatives in Texas. Some media critics questioned the degree of Eichenwald's involvement in the life of the subject of his big story.

Eichenwald left the Times last fall for another job. Over the past seven months, during the prosecutions of two men involved in Berry's ring on related child-pornography charges, revelations have surfaced that have raised more profound questions about Eichenwald's own actions. Most notable was his failure to inform editors at the Times that he and his wife had made a series of payments worth at least $3,100 to Berry and his business partners.

Eichenwald said the payments were part of the effort he and his wife, Theresa, made to extract Berry from the child-porn business — and that he simply forgot to tell editors.

...In a story airing Friday on NPR's All Things Considered, Eichenwald reveals a secret that he had carefully guarded for more than two decades: His epilepsy had triggered so many and such severe seizures that, according to his neurologist, he suffers from "significant memory disruptions."


Via The Ugly Civil War in American Medicine by Eichenwald, published last month by Newsweek on March 10:
Are physicians in the United States getting dumber? That is what one of the most powerful medical boards is suggesting, according to its critics.
...On one side is the American Board of Internal Medicine (ABIM), which certifies that doctors have met nationally recognized standards, and has been advocating for more testing of physicians. On the other side are tens of thousands of internists, cardiologists, kidney specialists and the like who say the ABIM has forced them to do busywork that serves no purpose other than to fatten the board’s bloated coffers.

...The value to a doctor of being certified can scarcely be overstated. Many organizations will not hire uncertified doctors. And, without that stamp of approval, even doctors who open their own practices rarely receive permission from hospital boards to treat their patients in hospitals.
...So physicians shelled out money to the ABIM to take the tests, and then ponied up more cash to attend conferences and other programs for continuing medical education.
...But then ABIM decided that rather than just having doctors take one certification test, maybe they should take two. Or three. Or more...This was not cheap -- doctors spend thousands of dollars not only for the tests, but for review sessions, for time away from their practices.
...Then, something strange happened, doctors say. The tests started including questions about problems that had nothing to do with how doctors did their jobs.
...The result? According to the ABIM’S figures, the percentage of doctors passing the recertification test started dropping steadily. In 2010, some 88 percent of internists taking the maintenance of certification exams passed; by 2014, that had fallen to 80 percent.
In a next-day response to Eichenwald's article, ABIM chair David H. Johnson MD issued a media statement that included:
(The) author failed to disclose that his wife is an internist.
Next, via the March 25 Medscape Medical News :
Eichenwald disagrees that he had a conflict to disclose. "The argument is akin to saying that I can't write about politics because I voted," he said, adding, "Shouldn't being married to an internist make me pro-ABIM?" He asked that his wife not be identified.

Of all the criticisms of his article, Eichenwald said, the one that got under his skin was the one involving his wife and making her part of the story.

"It was despicable," he said, "[and] a sign of people who had nothing to say in response to the substance of the article.

"I don't react to bullies well. When they're bullying my family, I hit back."
So was Dr. Johnson's allegation relevant or simply bullying?

It seemed to me that determining  whether Eichenwald had an obligation to disclose any information about his wife -- Theresa F. Eichenwald MD, who practices in Dallas -- depended on whether or not she had a professional relationship with ABIM and, if so, did it present a concern?  

When I tried to find out, I didn't get very far.

I couldn't get answers from ABIM and when I asked Eichenwald, he threw a fit. 

First, here's a screenshot from Dr. Eichenwald's license look-up via the website of the Texas Medical Board:

2003's a long time ago, so I asked Gaby Laredo at the Texas Medical Board for the most recent date Dr. Eichenwald informed the board that she was certified by ABIM. She replied:
We do not verify if any physician is or is not specialty board certified. However, she last reported to the Board that she was certified in 2003.
Is Dr. Eichenwald still an ABIM diplomate?

No, according to this screen shot I took yesterday from ABIM's website:

So what years was she certified by ABIM? Per her husband's article, "The value to a doctor of being certified can scarcely be overstated," so why isn't she currently certified by ABIM? Did she choose not to re-certify with ABIM? Is she now certified by another board?

In an attempt to answer those questions, I sent multiple e-mail inquiries to Dr. Johnson (who claimed Eichenwald had a conflict of interest) and to Lorie Slass, ABIM's Senior Vice President of Communication.

I never received the information, so I sent an e-mail to Kurt Eichenwald in which I explained that for my blog I was reporting an item about his response to Dr. Johnson's allegation.

In my e-mail, I shared the information from the websites of the Texas Medical Board and ABIM, and submitted these questions:

1) What years was your wife certified by ABIM?

2) Is she still certified by ABIM? If not, is she currently certified by any other board(s) and if so which one(s)?

Here's his unedited March 31 reply:
Anyone obtuse enough to believe that my wife being a doctor is a story is not worth talking to and is merely someone too lazy to do actual reporting on real issues.

But I'll make the easy for you: My brother is a doctor, and so was my father. My mother was a nurse. My best friend is a doctor. My sister-in-law is a nurse. I have a doctor. I also like her very much. So I guess medicine is off the table.

And in the event I ever write about the judicial system: A friend of mine who saved my life is a judge. Law's out too, I guess.

My son is a wildlife biologist who studies the effects of climate change on species - so, guess that's out too. 

And on and on and on...

My point is - you're making a fool out off yourself. Find a conflict, not just a correlation. Every doctor who is contacting me is talking about how outrageous it is that ABIM dragged my wife into this. Those that don't end up being people who make money off of this system. That speaks for the wisdom of your piece.
In a same-day reply, I politely re-submitted my questions and also asked him to provide me with the name and contact information for his editor at Newsweek.

Here's his same-day response, also unedited:
I am not participating in a story written by someone who believes that dragging the reporter's wife into it is ethical. If my wife were, say, on the board of a competing credentialing organization, that would be a conflict. But - unless you are saying that the ABIM is in conflict with doctors - it is irrelevant and obscene, particularly since you don't even know if she played any role in it. She did not: My wife never knows what I am writing nor does she make any contribution to anything I write - ever. This is in the event of litigation to be sure she doesn't get dragged into it. The totality of her connection to this is that she receives journals in the mail and I saw a story about the ongoing dispute in Medical News (I think that is the name of the newspaper-isn magazine.) I did not discuss that with her and began researching the story and was shocked what I saw in ABIM's 990s and then started calling people involved in this dispute. She made no contribution and had no knowledge this was coming until it hit the internet. By your light, I can't research something already being *widely* reported (NEJM, Medical News, JAMA, etc) because my wife is a doctor? That's ridiculous. And show me once when a mass media journalist started dragged his family into a story simply because there was a correlation, rather than a causal connection.

But I can already tell...the fact that there is no connection and no rational explanation why this is a conflict ain't stopping this story. The illogic here is so obvious, and the fact that you are just operating off a series of false assumptions - one of which leads to such an obvious question you have never asked me, the answer to which undermines the entire thesis of your piece - that I recognize there is nothing that will give you pause. If I ever decide to reveal that answer -- which I will only do if ABIM manages to trick enough fools into continuing to drag my wife into this -- I will be sure to mention you never asked so people can all have a good laugh.

By the way...have you even LOOKED at the 990s? Have u even tried to understand why what's in there is a story that can't be ignored?
Given Eichenwald's 2007 admission that he suffers from "significant memory disruptions," a skeptic might question his recollections, but I simply chose to send him two courtesy follow-ups.

James Impoco (source)

I didn't receive a reply, so I phoned Newsweek and was connected to Editor-In-Chief James Impoco, to whom I explained that I was reporting about this for my blog.

He cordially offered to take a look, so I e-mailed him the above information, my complete correspondence with Mr. Eichenwald, and this request:
Would you please ask Mr. Eichenwald these questions and let me know his responses?

1) What years was your wife certified by ABIM?
2) Is she still certified by ABIM? If not, is she currently certified by any other board(s) and if so which one(s)?
He promptly replied, but instead of responding to my question, he provided this on the record statement:
We disagree with your concept of what constitutes a conflict in journalism. I urge you to read some of the voluminous handbooks that exist on journalistic ethics rules regarding the definitions of a conflict.
Contrary to his assumption, in reporting this story I've never expressed an opinion about any potential conflict. Since I have no expertise in journalism ethics, my opinion has no standing. I've simply attempted to obtain related facts based on Dr. Johnson's allegation.

David H. Johnson MD (source)

By the way, since Dr. Johnson threw the first stone, doesn't it behoove him to explain specifically why he thinks Mr. Eichenwald should have disclosed the information about his wife?

I'd also be curious to know Dr. Johnson's explanation why ABIM fails to provide the public with any information about diplomates other than whether or not they're currently certified.

Perhaps Mr. Eichenwald or another reporter will ask him.

Finally, in the interests of accurately representing Newsweek's position, I sent Mr. Impoco this follow-up :
Based on your statement, my understanding is that, re: the article in question, even if Dr. Eichenwald is currently an ABIM diplomate, Newsweek does not consider that to be information which should be disclosed to readers. If my understanding is incorrect, please clarify.
His reply:
Hi Peter. You are correct. Jim
Based on his suggestion that I consult journalism handbooks, I contacted the authors of three journalism ethics textbooks and asked for their opinions.

I'll be reporting their responses in Part II.

Part II: Three journalism ethics experts weigh in on Kurt Eichenwald's failure to disclose his wife's relationship to an organization he skewered in a Newsweek story, May 27, 2015.

This item has been slightly revised.

Thursday, April 9, 2015

Two days after my investigation request, the National Library of Medicine has replaced its "unconscious Heimlich" treatment recommendation

As I reported yesterday, on April 6 I filed a request with the directors of the National Institutes of Health (NIH) and the National Library of Medicine (NLM) to investigate this treatment recommendation which has been posted on the NLM's website since at least June 22, 2000:

I asked for an investigation because the "unconscious Heimlich" is reportedly not recommended by the American Heart Association or the American Red Cross, I'm unaware of any research that supports the treatment recommendation, and when I've asked A.D.A.M. Inc. -- the health care information company that supplied the information -- to provide me with citations to research that supports their treatment recommendation, I can't get an answer.

Yesterday the page was updated -- here's proof:

Here's what the page looks like now:

Among other unanswered questions, it's unclear on what basis the "unconscious Heimlich" treatment was ever recommended by the NIH/NLM.

Unless the agencies can produce legitimate evidence in the form of published research, it appears that for over 15 years they've been recommending an experimental medical treatment.

Wednesday, April 8, 2015

Has the National Library of Medicine been recommending an experimental medical treatment for at least 15 years? I've requested an investigation


The National Library of Medicine (NLM), on the campus of the National Institutes of Health in Bethesda, Maryland, has been a center of information innovation since its founding in 1836. The world’s largest biomedical library, NLM maintains and makes available a vast print collection and produces electronic information resources on a wide range of topics that are searched billions of times each year by millions of people around the globe. (source)

For at least 15 years, the NLM has recommended performing the Heimlich maneuver on unconscious choking victims based on information provided health information provider A.D.A.M. Inc.

A.D.A.M. was among the first group of companies to receive URAC accreditation for health information, and has maintained its accreditation since that time. The URAC accreditation seal indicates that A.D.A.M.'s consumer health products are in compliance with 49 rigorous standards of quality and accountability, verified in an independent audit by URAC ( URAC performs this audit every 2 years.

A.D.A.M.'s goal is to present evidence-based health information. Therefore, content in A.D.A.M. products is created by identifying the best available evidence from national guidelines, government agencies, and peer-reviewed literature, and then asking our writers and reviewers to create content based both on the quality of the evidence and its applicability to everyday practice.

The use of the Heimlich maneuver to revive unconscious choking victims is reportedly not recommended by the American Heart Association or the American Red Cross, and I'm unaware of any research in which the treatment has been tested, so in recent months I've attempted to learn the basis for the NLM's recommendation.

In years 2000, 2005, and 2007 the information was reviewed and approved by this series of physicians who presumably were hired by A.D.A.M.

When I recently asked Dr. Perez to provide me with supporting information, he replied:
To my knowledge, there is no definitive evidence for or against performing abdominal thrusts (on an) unconscious patient.
So on what evidence did he -- and the other doctors -- approve the treatment recommendation?

Isla Ogilvie PhD (source)

After receiving Dr. Perez's reply, I received a January 16 e-mail from Isla Ogilvie PhD, A.D.A.M.'s Strategic Content Director, informing me the information was being reviewed.

Since then, in several e-mails, I've asked her this question:
Did A.D.A.M. research the literature on the subject of "the Heimlich" for unconscious choking victims? If so, would you please send me citations to any relevant articles or studies?  
I haven't received a reply so a couple days ago I sent an investigation request letter with supporting documents to the directors of NLM and NIH. (Click here to download a copy.)

Via my letter:
1) This is to respectfully request that your offices review the following information and provide me with a determination whether or not the treatment recommendation meets the standards of your agencies.

2) If the treatment recommendation does not meet those standards, this is to respectfully request that your offices investigate how the information came to be published on the NLM website; the basis for A.D.A.M.'s recommendation of the treatment for at least 15 years; all details regarding URAC's review of the information; and that I be provided with the results of those findings.
I'm also looking into how much the NIH pays A.D.A.M. and will report the results.

Wednesday, April 1, 2015

BREAKING: UK tabloids report another "dog rescues choking master" story -- and an April Fool's Day invitation to media pranksters (UPDATE: I've nominated the lifesaving lab for an award)

Last April I blogged UK stupid press tricks? Three separate "dogs rescue their masters from choking" stories in the past four months about articles in the Daily Mirror, the Carmarthen Journal, and the Daily Star.

According to today's Daily Mirror and Daily Mail -- see the video above and the following screen shots -- the four-legged lifesaving spree continues!

source: Daily Mirror

source: Daily Mail

To my knowledge, the first recorded "dog rescues choking master" case was in 2007, when Debbie Parkhurst of Calvert, Maryland, claimed her pooch "Toby leapt up and down on her chest, dislodging the chunk of apple that had lodged in her throat."

The story was widely reported and even landed her and Toby an appearance on the Letterman show.


I have no reason to doubt the veracity of any of these stories. Plus they provide me with fun, bloggable material.

On the other hand, it's not so difficult to fake a choking rescue to gin up media attention.

For example, my father and country music star Luke Bryant apparently did.

Which leads me to this April Fool's Day challenge to merry pranksters out there.

Make up a story that your pet saved you from choking and get it reported by a mainstream news outlet.

Share the results with me and I'll likely blog it. (Click here for my contact info.)

So don't just stand there wagging your tail. Unleash your wits and see if any reporters roll over.


4/2/15 UPDATE:  As two eagle-eyed Sidebar readers (both of whom are journalists) wrote me, contrary to the headlines and text of the Mirror and Mail stories, Lexi the lab did not "Heimlich" his master.

The "Heimlich manoeuvre" (UK spelling) is an abdominal thrust -- a squeeze below the rib cage. Mr. Spencer's precocious pooch reportedly jumped on his back.

As it happens, Lexi's actions were in compliance with the first aid guidelines of St John Ambulance UK which, like the American Red Cross, recommends back blows as the first treatment response to a choking emergency.

One of the sharp-eyed readers also suggested that Lexi be presented with a lifesaving award, so I'm sending a nomination to St John Ambulance UK and will report the results.

Also on Lexi's behalf, yesterday I submitted corrections requests to the Mirror and the Mail. More about that later....