for truth to engage the media to ensure that decisions we make are based on the best possible information. If the public says no to new technologies having heard and understood the science, that is fine—indeed it’s called democracy. If they reject a new treatment because of an ill-informed debate dominated by non-experts then science has only itself to blame. One of the great pleasures of working at the Science Media Centre is watching scientists discover the joy of sharing their excitement about their research with science and health journalists looking for great stories. Scientists who steer clear of the media for fear of being misreported or mocked by colleagues for dumbing down also miss the amazing buzz of seeing their research reported to millions of people. Prof Sarah Bailey is one of the many scientists I have met who are anxious about engaging with the media. An eminent pharmacologist from Bath University, Sarah was the first to study the effects of the controversial anti-acne drug Roaccutane (isotretinoin), which was subject to law suits in the USA after anecdotal allegations of a link to depression and suicide in teenagers. Sarah understood the need to be transparent about her findings, which indicated some depression-like symptoms in mice. But because of the controversy she was reluctant to do media work for fear that a very preliminary study in mice would end up as front page news reported as proof that Roaccutane led to suicide. She also faced anxieties from colleagues about mentioning the use of animals in research at a time when the legacy of animal rights extremism in universities loomed large. Along with her university press office, the Science Media Centre reassured Sarah about the quality of our specialist health reporters, advised her to do a press briefing rather than a press release, urged her to emphasise the limitations of her study, and explained that detailing the animal side of the work was crucial to ensuring that this was not wrongly reported as immediately relevant to human beings. For Sarah, as with so many other scientists in a similar position, the results were revelatory. Far from realising
Academy of Medical Sciences
Comment
all her worst fears she found herself enjoying the media briefing immensely, loved doing back-to-back interviews in television studios, and was delighted to read her own science reported brilliantly throughout the mass media. Far from being deluged by emails from animal rights activists, she received emails and letters from patients thanking her for her research and accolades from senior colleagues delighted at the profile for the University. Much resource has been invested in new ways to inspire our young people to study science at school and in higher education, but sometimes the mass media side of this gets neglected. Results of surveys show that, although young people tend to rely on social media for their information, they also continue to pick up news, albeit on their smartphones. That the people best placed to understand, explain, and even find solutions for Fukushima, the horsemeat scandal, volcanic ash, swine flu, climate change, incurable diseases, and so on, are those who became scientists and engineers must surely show young people that these are the careers that can truly change the world. Fiona Fox Science Media Centre, London, UK fi[email protected] Fiona Fox is the Director of the Science Media Centre.
Engaging with health-care policy All physicians, whether they like it or not, necessarily become engaged in formulating health-care policy. This activity might be at a local level such as membership of a hospital Formulary Committee; sometimes at a www.thelancet.com
subregional or regional level such as membership of a Clinical Commissioning Group or a Clinical Senate; or possibly at a national or international level. There are opportunities for clinical academic trainees to get
Published Online February 26, 2014
7
Comment
For more on the National Medical Director’s Clinical Fellow Scheme see http://www. fmlm.ac.uk/clinical-fellowscheme
For more on Harkness Fellowships see http://www. commonwealthfund.org/ Fellowships/HarknessFellowships.aspx
8
involved with the development and implementation of health-care policy at most, and sometimes all, these levels. So how can academic or other trainees get involved? First, try to track the process of policy making in an area about which you are interested. Nowadays, in a spirit of transparency, many organisations (such as the National Institute for Health and Care Excellence [NICE], National Health Service [NHS] England, and Academic Health Science Networks) provide extensive information to the public during the course of their deliberations. Has the problem that needs to be solved, by formulating a new (or revised) policy, been clearly defined? What sources and forms of evidence are they using? If the meetings are available as a webcast, or open to the public, try to watch or even attend. Second, ask to attend, as an observer, a local policy or decision-making committee such as your local Formulary Committee. Watch what goes on, and learn from the experience. How do they take evidence (whether qualitative or quantitative) into account? How do they interpret the evidence? Do they make appropriate judgments about its nature and reliability? How does the chair interact with the members? How do the members interact with each other and the chair? Do some members have greater influence on decision making than others? If so, why? I myself learned much about making policy from observing how the chairs of decision-making bodies go about their responsibilities. I was fortunate, as a younger man, in observing two masters of the art (and it really is an art) of chairing forums where policy was being discussed and formulated. Lord John Walton was the dean of the medical school when I arrived in Newcastle as a new professor in 1972. He conducted meetings of the board of the faculty with consummate skill. This achievement was in large part because he studied the meeting papers beforehand with meticulous attention to detail; and he ensured that policies, formulated by the board, not only were desirable but also were practical and implementable. A few years later I was appointed to the Committee on the Safety of Medicines. This Committee no longer exists but, until the EU-wide system of drug regulation came into being (in the late 1990s) it effectively made the licensing decisions about both new and existing medicines. Its chair was Sir Eric Scowen who
had been professor of medicine at St Bartholomew’s Hospital Medical School. He, too, always had the evidence relating to a particular topic at his finger tips; but he handled dissent with wonderful humour. On one occasion we were discussing a re-formulated version of Vicks ointment—used to rub on the chest to ease coughs in children—when I questioned the evidence for its efficacy. Sir Eric looked at me and said “We have a long tradition, in this Committee, of allowing the public access to harmless products which they have enjoyed for many years. So, while you are looking out of the window and not paying attention, we are going to give it a licence”. Third, give serious thought to applying to join the Medical Director’s Clinical Fellows Scheme. This scheme was originally established by Sir Liam Donaldson, when he was Chief Medical Officer, but is now administered by the Faculty of Medical Leadership and Management. Successful applicants get 12 months of hands-on, realworld experience of making policy with organisations such as NHS England, the Royal College of Physicians, NICE, or the BMJ. Alternatively, consider applying for a Harkness Fellowship from the Commonwealth Fund in New York. Successful applicants spend up to 12 months in the USA conducting original research and working with leading US health policy experts. Finally, watch how decision makers explain their policies to the public on television or radio. From numerous encounters with journalists like John Humphreys and John Snow I have learned three lessons the hard way. First, prepare with the greatest care the message you want to convey, and make sure you deliver it. Second, think equally carefully about how you will respond to the obvious critical questions you will be asked. Finally, however inconvenient, go to the studio itself rather than agree to be interviewed down the line. Interviewers find it much easier to harass you when you are a remote interviewee than when you are making direct eye contact with them in their studios. Good luck. Michael D Rawlins Royal Society of Medicine, London, UK [email protected] Prof Michael D Rawlins is the President of the Royal Society of Medicine, and Fellow of the Academy of Medical Sciences.
www.thelancet.com
Academy of Medical Sciences
Comment
all her worst fears she found herself enjoying the media briefing immensely, loved doing back-to-back interviews in television studios, and was delighted to read her own science reported brilliantly throughout the mass media. Far from being deluged by emails from animal rights activists, she received emails and letters from patients thanking her for her research and accolades from senior colleagues delighted at the profile for the University. Much resource has been invested in new ways to inspire our young people to study science at school and in higher education, but sometimes the mass media side of this gets neglected. Results of surveys show that, although young people tend to rely on social media for their information, they also continue to pick up news, albeit on their smartphones. That the people best placed to understand, explain, and even find solutions for Fukushima, the horsemeat scandal, volcanic ash, swine flu, climate change, incurable diseases, and so on, are those who became scientists and engineers must surely show young people that these are the careers that can truly change the world. Fiona Fox Science Media Centre, London, UK fi[email protected] Fiona Fox is the Director of the Science Media Centre.
Engaging with health-care policy All physicians, whether they like it or not, necessarily become engaged in formulating health-care policy. This activity might be at a local level such as membership of a hospital Formulary Committee; sometimes at a www.thelancet.com
subregional or regional level such as membership of a Clinical Commissioning Group or a Clinical Senate; or possibly at a national or international level. There are opportunities for clinical academic trainees to get
Published Online February 26, 2014
7
Comment
For more on the National Medical Director’s Clinical Fellow Scheme see http://www. fmlm.ac.uk/clinical-fellowscheme
For more on Harkness Fellowships see http://www. commonwealthfund.org/ Fellowships/HarknessFellowships.aspx
8
involved with the development and implementation of health-care policy at most, and sometimes all, these levels. So how can academic or other trainees get involved? First, try to track the process of policy making in an area about which you are interested. Nowadays, in a spirit of transparency, many organisations (such as the National Institute for Health and Care Excellence [NICE], National Health Service [NHS] England, and Academic Health Science Networks) provide extensive information to the public during the course of their deliberations. Has the problem that needs to be solved, by formulating a new (or revised) policy, been clearly defined? What sources and forms of evidence are they using? If the meetings are available as a webcast, or open to the public, try to watch or even attend. Second, ask to attend, as an observer, a local policy or decision-making committee such as your local Formulary Committee. Watch what goes on, and learn from the experience. How do they take evidence (whether qualitative or quantitative) into account? How do they interpret the evidence? Do they make appropriate judgments about its nature and reliability? How does the chair interact with the members? How do the members interact with each other and the chair? Do some members have greater influence on decision making than others? If so, why? I myself learned much about making policy from observing how the chairs of decision-making bodies go about their responsibilities. I was fortunate, as a younger man, in observing two masters of the art (and it really is an art) of chairing forums where policy was being discussed and formulated. Lord John Walton was the dean of the medical school when I arrived in Newcastle as a new professor in 1972. He conducted meetings of the board of the faculty with consummate skill. This achievement was in large part because he studied the meeting papers beforehand with meticulous attention to detail; and he ensured that policies, formulated by the board, not only were desirable but also were practical and implementable. A few years later I was appointed to the Committee on the Safety of Medicines. This Committee no longer exists but, until the EU-wide system of drug regulation came into being (in the late 1990s) it effectively made the licensing decisions about both new and existing medicines. Its chair was Sir Eric Scowen who
had been professor of medicine at St Bartholomew’s Hospital Medical School. He, too, always had the evidence relating to a particular topic at his finger tips; but he handled dissent with wonderful humour. On one occasion we were discussing a re-formulated version of Vicks ointment—used to rub on the chest to ease coughs in children—when I questioned the evidence for its efficacy. Sir Eric looked at me and said “We have a long tradition, in this Committee, of allowing the public access to harmless products which they have enjoyed for many years. So, while you are looking out of the window and not paying attention, we are going to give it a licence”. Third, give serious thought to applying to join the Medical Director’s Clinical Fellows Scheme. This scheme was originally established by Sir Liam Donaldson, when he was Chief Medical Officer, but is now administered by the Faculty of Medical Leadership and Management. Successful applicants get 12 months of hands-on, realworld experience of making policy with organisations such as NHS England, the Royal College of Physicians, NICE, or the BMJ. Alternatively, consider applying for a Harkness Fellowship from the Commonwealth Fund in New York. Successful applicants spend up to 12 months in the USA conducting original research and working with leading US health policy experts. Finally, watch how decision makers explain their policies to the public on television or radio. From numerous encounters with journalists like John Humphreys and John Snow I have learned three lessons the hard way. First, prepare with the greatest care the message you want to convey, and make sure you deliver it. Second, think equally carefully about how you will respond to the obvious critical questions you will be asked. Finally, however inconvenient, go to the studio itself rather than agree to be interviewed down the line. Interviewers find it much easier to harass you when you are a remote interviewee than when you are making direct eye contact with them in their studios. Good luck. Michael D Rawlins Royal Society of Medicine, London, UK [email protected] Prof Michael D Rawlins is the President of the Royal Society of Medicine, and Fellow of the Academy of Medical Sciences.
www.thelancet.com
