Author
Prof. Mark Taubert, Consultant in Palliative Medicine amd Clinical Director, Velindre University NHS Trust, Cardiff, UK
Do you know how best to prepare if you are asked for an interview by the media? Get it right, and it can do wonders for the subject matter you are passionate about and/or your organisation. But get it wrong, and you can foster disinformation and/or damage reputation.
This blog can be read as a stand-alone article, and will also form part of a workshop, “Miscommunication with the Media”, at the 18th World Congress of the EAPC in Rotterdam, the Netherlands
TV/Radio/Podcasts:
Documentary programmes have become a mainstream televisual/radio and podcast phenomenon. They can be a valuable way to convey key messages to viewers, for instance on the importance of a variety of public health measures.
Looking at it in a positive light, there is genuine interest here and a willingness to show medicine/palliative care in all its dimensions. However, there are some pitfalls, or potential for miscommunication that are worth considering.
First steps:
First of all, you have a choice. You can say no. If you are uncomfortable or do not wish to talk to a journalist, then consider leaving it. Or offering them an email dialogue, where they can email you questions, and you can then respond in writing, in your own time with adequate reflection on the topic at hand.
And if you do feel you wish to engage with a tv/radio/podcast interview? Talk to your work line managers and also to your communications team (“comms”). They need to be fully aware and they tend to be very experienced in vetting any crews or individuals who may be approaching you with a programme pitch. They will also usually guide visitors through the paperwork, and help patients and families give informed consent. Don’t do anything without checking with the comms team! Be aware that there are some people around who will pose as reporters for reputable sources, but are in reality ‘doing their own investigation’, for instance conspiracy theory bloggers and vloggers, or ‘true-crime’ enthusiasts. They can be very deceptive! Do some homework and look up anyone who gets in contact with you.
Medical Council media guidance on consent to record versus consent to broadcast:
Look at the guidance for you, and for the TV/radio company. If you are approached in the UK, for instance, both the General Medical Council and BBC offer guiding principles on what should be considered. ([1]) ([2]) If you are doing a documentary that will involve patients, the BBC guidance, for instance, covers instances when patients die before giving written consent and what their policy allows in such instances. Journalists will usually adhere to the following key points, distinguishing between ‘consent to record’ and ‘consent to broadcast’:
– Patients’ right to privacy and confidentiality is usually paramount. To enable tv/radio crews to record in highly sensitive medical environments, they distinguish between consent to record (often verbal), and consent to broadcast (always in a form that is provable, often in writing). They would not normally broadcast any footage without clear, informed consent from patients and key medical or emergency staff featured.
– Key to filming in these circumstances is the principle that production teams consult with the medical personnel whose work they are following before making the initial decision to film a patient.
– It may be appropriate to seek consent to broadcast only after the patient’s treatment is complete and the decision has been taken to include their story in the television programme. It will be necessary to maintain close contact with the patient and their family in order to determine how and when to discuss consent to broadcast.
– Consent to broadcast should also cover you, if, as a healthcare professional you later decide that you do not wish a specific clip or soundbite to go out.
Trust: Talk to the producers early on and get a feel for whether you trust them. I always do this, and have on occasion not proceeded when I have had a gut instinct that warned me off. Talk to the producer about their approach to the topic, what they think the key messages might be. Ask what the title of the programme will be and if this has not been decided on, what draft title was used by the team for their pitch to their executive (there is always a pitch to ensure the finances are in place). If during filming, the production team wish to go in a different direction with the programme, they should let you know immediately. For instance, if your understanding is that the team are making a programme about Withdrawal of Treatment Ethics and wish to interview you, and then you are told later that the programme will be about assisted dying instead, then you will want to ensure that this new context does not subtly alter your words. Remember that the interviewer’s questions are not always broadcast.
Conduct: I would also consider taking the production team around your healthcare setting without cameras in the first instance, for example on a ward round, or a clinic, and introducing them to colleagues and patients. Observe these interactions. The one time I have had to ask someone to leave was when they got a camera out and started filming while I was briefly off the ward to take a phone call, and before we had even agreed to any filming taking place. Later they claimed it was to check the light levels, but I felt that trust had been breached and ended it there. On other occasions, I have had to ask production team members to consider their dress attire in the hospital, after patients commented on a lot of visible ‘bare skin’, i.e. not just ‘bare below the elbows’: one of the journalists was dressed very minimally.
Health and Safety: Before filming is about to start, it is good practice to pre-warn the people actually doing all the work in your hospital, that there will be lights, cameras and/or microphones and actions, and that this may disrupt normal flow. Let all the teams know, announce it with fliers, let comms do the usual to inform everyone. The production team is likely to have had a briefing on matters such as hand hygiene and policies to avoid spread of infection. Letting the fire officer know is a great idea, because the lighting equipment used by camera teams can sometimes trigger fire alarms. Let the production team know which areas to avoid, and cover any written or visual patient identifiables.
Read the contract: This may seem obvious to most readers, but in the excitement of the moment (‘I’m going to be on TV/radio!) some people have been known to sign the dotted line without scrutiny of the 26+ preceding pages of print. One contract I was asked to consider signing, had a standard clause that all the material filmed could be used into perpetuity, including for other (future) programme outputs. I was not comfortable with this, and asked for the clause to be changed so that it could only be used for the specific programme under discussion. Remember that the production crew may not be involved in the contractual arrangement, so find out who is, and involve your comms and possibly also your hospital’s legal team.
Money: I have never accepted any money for filming or broadcasts, and see it, if I agree to it and Comms team are happy, as part of the wider remit of my job. This has to be decided on an individual basis, and by your employer. The production company may wish to make a donation to a charitable cause, which aligns with the topic you are filming or the organisation you are working with.
Ethics: When a hospital opens its doors to a camera or recording crew, and journalists join patients in times of crisis to record physicians, nurses and allied healthcare practitioners at work and at home, which code of ethics should be followed? With the success of the medical documentary format starting as early as the 1980’s, newer programmes have now arrived that are really pushing boundaries. As early as 1995, the UK General Medical Council (GMC) issued guidance entitled ‘Filming patients for television programmes’, which emphasised the need for patient consent, and stated that healthcare professionals must ensure that the interests and well being of patients are preserved, and take precedence over the public interest in the making of a television or other programme…”. [3]
Journalism and medicine abide by different ethical principles, while being filmed in their interactions with patients, and healthcare professionals should be held to the usual confidentiality, consent, privacy, honesty, and autonomy principles on behalf of their patients. In my view, journalists should be held accountable to those same rules and principles as they cross into when coming into healthcare settings, and become active agents in the medical sphere. The ITV and BBC crews that came with us became ‘part of the firm’ and were careful not to transgress the rules that we had set out. If something comes up that seems doubtful ethically, discuss it against the ethical principles of Beauchamp and Childress [4] If anything, I was lucky to work with production teams that were more mindful to these rules than even healthcare staff sometimes are. This code should be discussed and agreed before any filming. Hospital teams should be wary of programme makers who wish to pander to lurid curiosity, or have little regard for a patient’s or relative’s vulnerability, for instance in the context of advanced illness, palliative care and grief.
Consent: some of the issues around consent are covered above, but be aware that the British Medical Association (BMA) in the UK highlights the need for a dual consent process. This means that there is consent to being filmed which is obtained at the time of first patient contact, and the consent for dissemination of the subsequent recording which is sought at a later stage.[5] And remember this consent not only relates to the individuals being filmed, but also pertains to radiological images that appear on camera, however briefly.
All of the above is general guidance that I have picked up from working with excellent Comms teams and with some great TV/radio production crews. Trust your instincts when you are approached, and be ready to step away if something doesn’t seem right. On the other hand, remember that you can make a real impact on the spread of key topics that are important to your area of expertise, and that this medium is still one that attracts huge audiences.
Things to ask yourself/revise before an interview or prior to agreeing to work with a media outlet:
- Understand why the journalist is doing the interview/report
- Consider your own goals/objectives in agreeing
- Steps to take to prepare for different types of media exposure (interviews, comments, blogs, podcasts, requests to write)
- Think of the awkward question(s) you may be asked. Learn techniques for dealing with awkward questions
- Read the small-print of any contracts
- Prepare for any type of media interview
- Memorise your key message(s)
- Gain background knowledge to help improve performance in proactive/reactive media interviews
- Practice in front of a mirror, or film yourself. Write down what you’d like to say.
- What will you be asked?
- Does it have to be a spoken interview? Could the interviewer email you there questions, leaving you time to write/edit/work on your answers before replying?
- What’s in it for you?
- Ask to see (for written content) what title they wil use for the article with your name in/on it, which images they wil be using alongside it (incl social media)
- Ask to see what copy-text they will be using for social media summaries of the article you are in/have written
- Off the record? Is there ever such a thing?
- Tone/speed of voice, and not just message.
- Awkward questions – the bridging technique watch it here
- Reactive Interviews and article requests: Key messages in a negative or crisis situation
- Importance of showing concern and that you care
A Media Training Workshop on difficult questions: Youtube link (ca 25 minutes)
[1] General Medical Council. Making and using visual and audio recordings of patients. 2011. [Cited 24 Jul 2014.] Available from URL: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/making-and-using-visual-and-audio-recordings-of-patients
[2] BBC editorial guidelines: medical emergencies. Available from URL: https://www.bbc.com/editorialguidelines/guidance/filming-in-medical-emergencies
[3] General Medical Council. GMC guidance on filming patients for television programmes. Audiovisual Media in Medicine 1995;18(4):171.
[4] Beauchamp TL, Childress JF Principles of Biomedical Ethics, 5th ed. Oxford, U.K.: Oxford University Press, 2008.
[5] British Medical Association. Taking and using visual and audio images of patients. London: BMA, 2018. https://www.bma.org.uk/advice/employment/ethics/confidentiality-and-health-records/visual-and-audio-recordings-of-patients