Trying to keep up with all of the investigations published by ProPublica, the respected and admired Pulitzer-Prize-winning online news site, is like trying to drink water out of a fire hose.
Click on "Major Projects" on its home page, and you get a list of projects that includes a five-part series on internships; a 20-part series on surveillance; a 67-part series (67!) on detention; and a nine-part series on drug prescribers. And that's just the projects that were updated with new stories since Monday–only four days ago!
I'm particularly interested in medicine and conflicts of interest, so one part of the prescribers series–on company payouts to top prescribers–caught my eye.
Expecting a seamless dissection of conflicts of interest, I was surprised do discover that after reading only the first few grafs, I had questions about the story:
- A brief editor's note just under the byline says, "This story was co-published with NPR." The story appears on the NPR website. I didn't do a word-by-word comparison, but seems to be the identical story. All three of the bylines are identified as ProPublica people–Charles Ornstein, Tracy Weber and Jennifer LaFleur. What does "co-published with NPR" mean? Did NPR have anything to do with this story? Did it contribute to the costs? Or did it just agree to reprint it? And if so, why?
- Four grafs at the top of the story report data from 2010, 2011 and 2012, and they say that the latest period for which Medicare data was available was 2011. I think I sorted this out, but I had to stop reading and construct a little chart in my head to understand what was being compared to what. It's a writing problem.
- The fifth graf says that at least 17 of the top 20 prescribers of the blood-pressure drug Bystolic in 2010 received $283,450 for speeches and more than $20,000 in meals from the drug's maker in 2012. It certainly sounds as though the manufacturer is engaging in questionable practices. But shouldn't the top prescribers be getting the money first, if this is a case of pay-to-prescribe? Or did the company, Forest Laboratories, monitor prescriptions in 2010 and pay off top prescribers two years later?
- Based on what we've read so far, you might expect that the very top prescribers are getting the most money, the next tier are getting a bit less, and those at the bottom of the top-20 list are getting the least. But that's not the case. The top prescriber wrote 2,525 prescriptions and received $3,750 in speaking fees, according to a chart accompanying ProPublica's article. The fourth-highest prescriber wrote only 965 prescriptions but received $51,250 in speaking fees. The top earner–with $85,750 in speaking fees–was the 19th-highest prescriber on the list, with 598 prescriptions. If Forest Laboratories is paying doctors to prescribe its drug, it is not doing a very good job of rewarding prescribers on the merits. The authors of the piece should have addressed this.
- ProPublica says the data on speaking fees was "made public by drug companies," but I was initially unclear on where it was made public. Where did ProPublica find it? I found the answer two clicks away, through a searchable database and to a sidebar that explained what ProPublica had done. This should have been explained better in the story. Readers shouldn't be required to launch an expedition to find the backup for the story.
The story goes on to disclose similar payments by other drug makers. It includes comments from some of the prescribers. It does not prove that doctors are being paid to prescribe, but it certainly suggests that there is a problem here. It's a nice piece of work.
It's not, however, an easy article to read. And while this was billed as a nine-part series on the investigations page, it actually consists of 14 stories. I'm sure I'd find them illuminating, and I'd like to read them. But I don't have the time.
And what about those other projects on detention and surveillance? They sound fascinating, too. I really should read them, and I should probably comment on them here. And what about the other investigations that were not updated this week? How many are there? Where should I start?
I'm glad ProPublica is using its fire hose to inform us about these important issues. But how can we keep up? Is there another way to organize this important journalism so we can absorb it?
I don't know the anwer to that. Asking or expecting ProPublica to do less is not the solution.
But I worry that much of this effort is pouring into stories that very few people will read. If we don't have time to read these critically important and valuable investigations, how can we possibly steal time to turn to the sports section, catch Channing Tatum and Jamie Foxx in White House Down, or take the kids for a swim?
-Paul Raeburn
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