Patient Narratives: How To Get Them Right Even When Your Subjects Don't

Update: read a correction on this post here.

Recently, Henry Stern of the long-running InsureBlog took a Columbus (Oh.) Business First story to task for incorrectly portraying one woman's problems under health reform.

Stern asks why the woman doesn't understand some basic insurance issues, but that's asking too much of many people who are often misinformed about the details of their medical treatment or insurance status. It's really the reporter's job – not the subject's – to figure out whether his or her subject's story is accurate. In this post, I'll offer some tips for doing just that.

Here's an excerpt from Stern's post:

Let's start with this little doozy:

"The Delaware County resident understood when a surgery for her son's lifelong digestive condition caused her premiums to shoot up by $700 a month."

Um, no, it didn't: by law, carriers can't single out individual insureds for rate increases, expensive surgeries notwithstanding. Perhaps Ms Hokes misunderstood how insurance works, and honestly believed that she (and/or her) son had been singled out for a rate hike.

Unfortunately, that doesn't fly, either: Ms Hokes knew (or should have known) darn well what the relevant laws are, since she herself is an independent insurance agent and she's co-chair (or perhaps immediate past co-chair) of the Ohio Association of Health Underwriters' Political Action Committee, something Carrie Ghose should have pointed out. So Ms. Hoke's no amateur.

Henry rightly points out that a professional insurance agent should know a bit more about health insurance than the average "patient on the street." But I've seen highly educated medical professionals get details of their own medical conditions or health insurance wrong, never mind a confused senior trying to comprehend the Medicare prescription drug benefit. Our health care system is just too complicated.

Anyone covering health care for a general audience knows you need "real people" in your stories. It's often the most time-consuming part of the health beat, finding that perfect person to vividly illustrate whatever subject you're covering.

On more occasions than I care to remember, I spent considerable time interviewing a "real person" for a story, only to find upon detailed questioning that their circumstances didn't apply to what I was writing about. This is particularly true in policy-oriented stories about health insurance, health reform or entitlement programs like Medicaid or Medicare.  

I hope you can learn from my mistakes with these suggestions for making sure you understand your subjects' "fine print" - even when they don't.

1. Make sure you understand your issue inside out before going on a "real person" hunt. This is an obvious suggestion, but it can get overlooked in the deadline rush.

2. Pre-interview your subjects. Before spending too much time on in-person interviews, photography, audio or video, chat informally with your subject to make sure their situation is relevant to what you're covering.

3. Get documents whenever possible. You may notice things your subjects do not.

4. Ask your subject to refer you to others in the same situation. Better to have backup subjects in case your first one doesn't work out.

5. Glean as much information as you can from the person (doctor? Insurance agent?) who refers you to a subject. Ideally, you'll know your subjectss situations almost better than they do before you meet them.

6. Don't take anything at face value. This doesn't mean not being a compassionate interviewer. This means asking a lot of "how do you know that?" questions.

Do you have other good tips? Share them in the comments below.