Healthcare Experts versus Health Journalists

Appreciating the Distinction

By Dr. David Edward Marcinko; MBA


As the healthcare reform, and eMR controversy unfolds, I am struck by the more-than-linguistic distinction between the terms “healthcare expert” and “health journalist.”


Historical Perspectives

Historically, as a peer-reviewed writer, editor, medical expert witness and now electronic publisher for almost four decades, I always sought the journalist’s title. I think the longing began in my formative years when I read that after the French Revolution, Sir Edmund Burke, looked up at the Press Gallery of the House of Commons, and said, ‘”Yonder sits the Fourth Estate, and they are more important than them all.”


Expert versus Reporter

However, I no longer covet this title. Why? I’ve finally realized that it is far better to be a real subject-matter expert, than a journalist [read reporter]. The former creates news through knowledge, informed deeds and thought-leadership; while the later simply writes about various topics without same.



And so, in light of the eHR controversy, perhaps a word to the “wise” AMA, ADA, APMA, AOA and CCHIT leadership is sufficient; with apologies to Sir Edmund? Regardless of specialty, our guiding medical principles should always be; Omnia pro Aegroto [all for the patient].



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7 Responses

  1. Why report the news when one can make the news?


  2. Social networks – the fifth estate or the fifth column? Web 3.0 or anarchy?

    Dr. Marcinko noted that following the French Revolution, Sir Edmund Burke acknowledged before the House of Commons that freedom from oppression is protected by the press – which he called the fourth estate. That is only part of the story. Only a few years before, as a member of the Brutish Parliament during America’s revolution, Edmund Burke was one of the very few supporters of the colonists. “At the time, [Burke] insisted to his fellow legislators that if an entire citizenry was in revolt, it was the government that must be reformed.” (“Thomas Paine” by Craig Nelson, Viking press, 2006)

    Allscripts CEO, CCHIT board member, Obama advisor and generous donor Glen Tullman attracted my interest with a series of reckless comments he continues to offer to the press, which defy not only good PR advice, but common sense. Since I have always wanted to see a train wreck – from a safe distance, of course – I started following the press about Tullman.

    As recently as yesterday, Feb. 6, Tullman’s natural talent at squeezing off faux pas once again illustrated that a career in obscure bureaucracy has caused him to be insensitive to his market – that is, if his market is healthcare providers, who use his product, and not stock-holders who hold wishes Tullman can sell like you wouldn’t believe.

    In an article by Ken Terry posted on, Terry pointed out that Allscripts will obviously be a big winner in the $20 billion healthcare IT share of the economic stimulus (formerly called the bailout). The title of his article is “Healthcare Stocks Are Healthy–For Now.” Ominous? In the best of possible worlds … Yes.

    Terry points out that the incentives for physicians to acquire electronic health records will not be available until 2011, and that the legislation favors Allscripts. Terry describes Glen Tullman’s response: “But in the long run, the intensified government effort to spread health information technology should pay dividends to all players in the field, says Glen Tullman, CEO of Allscripts.”

    What about those of us who are not “playing” in the field? How many more Americans am I expected to hire in order to lower the costs of the care I provide? In my opinion, throwing money at Glen Tullman is an earthly stupid way to solve the nation’s unemployment problem.

    Enter empowerment and the Net.

    News reported in the fourth estate is often less important as the networked conversation it inspires in the fifth.

    Long ago, I discovered that from skip-reading comments which follow articles, I often find the most informative and timely stuff that can be found anywhere. That is how I came across Dr. Hayward Zwerling’s criticism of CCHIT, which is posted here on Medical Executive-Post.

    Boldface my word: Healthcare IT history will show that Zwerling’s comments are already significant in the upcoming realignment of priorities at CCHIT that everyone outside CCHIT knows is coming. Although Zwerling did not specifically blame CCHIT board member Glen Tullman for “player” problems with the defenseless dinosaur, he might as well have. Tullman is the biggest player blessed with game.

    This long, weaving introduction brings me to another comment, not unlike Zwerling’s, that I discovered following an interview of Glen Tullman.

    The day before Tullman reassured players in the field that there are dividends for everyone, on Feb. 5 he was featured in an interview on HIStalk, by Inga (no last name given).

    In the interview, Tullman complimented the efforts of CCHIT, smiled broadly for Allscripts-Misys share holders (MDRX.O) and downplayed the importance of patient privacy in eMRs. Nothing new.

    However, like Zwerling’s post, I once again found the best information in a response rather than the article. I copied below the comment by Evan Steele, CEO of SRSoft. Steele is the creator of SRS hybrid, the flagship product of SRSsoft. When I read Steele, I trust him more than Tullman. He seems to be talking to me and not shareholders.

    Since what I have written today is already long, perhaps Evan Steele’s comments following the HIStalk interview should also be posted separately as well. It demands networked readers, including those I lost a few minutes ago.

    Is this Web 3.0? No more than the Renaissance.

    D. Kellus Pruitt; DDS


    Evan Steele, CEO SRSsoft Says:

    Counterpoint to some misconceptions Mr. Tullman’s comments might cause both in Washington and with physicians around the country:

    The stimulus plan calls for $20 billion in HIT incentives. Before spending this exorbitant amount of money, a little reality check is in order to see if this money is a wise investment.

    EMR systems have been the topic of many studies with conflicting conclusions regarding savings to the healthcare system, quality of patient care and the efficacy of computer-generated documentation. But when landmark studies examine the impact of traditional EMR on physician practices, the clear, consistent conclusion is that traditional EMRs negatively impact physicians and their practices which inhibits meaningful adoption. There are four such landmark studies ­performed by respected, venerable institutions:

    * A recent National Research Council report states that: (i) EMRs cause inefficient workflows; (ii) clinicians spend more time entering data than using it; (iii) meaningful interoperability is almost non-existent; and (iv) benefits are significantly less than anticipated. This landmark study was produced by a committee of industry thought leaders from many of the most respected organizations in the world, including Harvard, MIT, Stanford, University of Pennsylvania , Brown, Google, and Intel. Committee members shadowed clinicians using traditional electronic medical records software at nationally recognized centers of medical care.

    * In an enlightening New England Journal of Medicine article, renowned physicians and Harvard professors maintain that EMR technology diverts the physician’s attention from the patient and creates chart notes in a way that is seriously flawed.

    * In 2008, the Congressional Budget Office released a study that was submitted as testimony before the House Ways and Means Committee. The study claims that “office-based physicians may see no benefits [from traditional EMRs] and may even suffer financial harm.”

    * A U.S. government-funded study by the MGMA reported a decrease in physician productivity of up to 15% usually lasting a year or more. The study concluded that it is “difficult to establish a business case for EHR adoption.”

    For more information on the studies cited, please see the links at the bottom of this posting.

    Where are the comparable, unbiased, physician-focused studies that validate the successes of traditional, EHR technology?

    Why is the voice of the physicians not more prominent in this debate? It is the physicians­ who must take all the risk, shut down their practices, sometimes for days, to learn to use traditional EMRs, and suffer drops in patient volumes and revenues over a protracted period of time.

    Additionally, with reduced productivity resulting from traditional EMR adoption, how will physicians meet the huge increase in demand for their services stemming from the aging baby boomer population and the anticipated addition of millions of newly insured patients under the new Administration’s long-term healthcare reform plan? Compounding this pending spike in demand for physician services is the ongoing shortage in the supply of doctors graduating from medical school, particularly primary care physicians interested in practicing in underserved areas. A “Perfect Storm” is brewing.

    If the government wants a massive uptake of electronic medical records, they should promote alternative systems such as hybrid EMRs that have been gaining so much traction with ambulatory medical practices. Hybrid EMRs bring about the benefits of traditional EMRs without the doctor having to use rigid, click-intensive, cumbersome and time consuming systems that, studies have shown, negatively impact physicians and their practices. Hybrid EMR creates a digital office where critical patient information can be accessed, searched and shared at Internet speed.

    Only when it is EASY for physicians to digitize their practices can there be a critical mass of portable data that will truly result in the quality of care, efficiencies and cost savings that the payers so desperately want.


    For more information on the studies cited, please use the following links:

    National Research Council report: and click the “Sign in to download PDF book and chapters” link.

    New England Journal of Medicine article: ( Caution: The New England Journal of Medicine is highly sensitive to the use and reproduction of their content. The link above brings you to a site where you have to download and install a small application on your computer to view a pre-paid copy of the article.

    Congressional Budget Office Report: (, see page 5).

    MGMA Report: Gans, David N. “Off to a slow start.” MGMA Connexion, 42. Oct. 2005. Available for MGMA members at


  3. Sovereignty,

    I find it strikingly interesting that Dr. Marcinko finds inspiration in Sir Edmund Burke. Here is another bit of history about Burke.

    Even though he was a member of the English Parliament, he vehemently opposed the blatant corruption surrounding the East India Company – a huge government-supported business venture that took advantage of unrepresented workers – whose rights were discarded for the good of the empire… sort of like CCHIT and the AHIC (now called the AHIC Successor Inc. for the time being).

    Calculated public/private cooperation enforced by the government maintained a few lucky English businessmen and bureaucrats in advantageous and unfair positions in parts of the world where they were neither invited nor wanted… sort of like the American Dental Association / Intelligent Dental Marketing partnership. But that’s a different colonial story from a smaller part of the world.

    Stakeholders in the East India Company were frequently granted special rights and privileges that included trade monopolies and exemptions from the Stark Amendment… Oh, sorry. Wrong century, wrong stakeholders.

    So if we started right now, how long will it take for healthcare providers to regain the rights that are re-gained with sovereignty? The Company remained a powerful force for another 100 years, in spite of Sir Edmund Burke’s objections.

    I think the rights we are granted are the rights we fight for. Sir Edmund Burke is dead.

    D. Kellus Pruitt


  4. Consumers needs both journalists and experts, but should understand the difference.

    Journalists should report the news, although in today’s society it appears to be more about the money than providing objective reporting. Experts need to continue providing their informed view points.

    However, as many know, there are usually experts on each side of a debate. Unless I am getting paid to report, I would much prefer to be a real subject matter expert as stated by Dr. Marcinko.

    Amaury Cifuentes; CFP


  5. Hi Amaury,

    Actually the seekers of absolute truth are known as philosophers.

    Defined as a wise person who is calm and rational; a philosopher is someone who lives a life of reason with equanimity and who follows a doctrine or a belief system that is accepted as authoritative by some group or school.

    So, as you alluded, what do we call those journalists who have a point-of-view [POV] to promote, for free or pay; online, in-print, or on TV, radio, or internet, etc?

    Why; they’re called columnists, of course. Cheers!



  6. Reginald and Amaury,

    A New Research Study on Health Bloggers

    As reported by the Association of Health Care Journalists [AHCJ], on January 12, 2009, a trio of researchers published a paper examining that peculiar class of people who may be loosely described as health bloggers.

    The results, published in the Journal of Medical Internet Research, found that “Medical blogs are frequently picked up by mainstream media; thus, blogs are an important vehicle to influence medical and health policy.”


    Ann Miller; RN, MHA
    [Managing Editor]


  7. ME-P,

    Did you know that the blog; PookieMD, explores the phenomenon of “health coach” to assist patients “clarify their health goals, and implement and sustain behaviors, lifestyles, and attitudes that are conducive to optimal health; guide people in their personal care and health-maintenance activities; and, assist people in reducing the negative impact made on their lives by chronic conditions such as cardiovascular disease, cancer, and diabetes?”

    This sounds suspiciously like what primary care is supposed to do, but can’t within the current paradigm of the 15-minute office visit.

    So, instead, people with no prior medical training are taking advantage, by signing up for courses over the internet and training to become a health coach. Some sites promise up to $121 an hour (“at least”), without having to leave home, and there are no worries about malpractice.

    But, weren’t nurses, para-professionals, websites and call-centers developed to fill this need? Just imagine what those with an actual medical degree can do as a health coach.

    It’s no wonder why so many physicians are leaving medicine, and finding cash-only alternative medical practices so appealing.



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