Rick Wade, senior vice president for strategic communications at the American Hospital Association, says that the TV/hospital partnerships are an unwelcome result of fierce marketplace competition in health care. “There’s a lot of it going on,” says Wade. “It happens in major media markets where TV stations are starving and hospitals are under competitive pressure.” In response to cost-cutting by managed-care firms over the last decade, hospitals have glued themselves into large systems to fight back. Branding and marketing have become the weapons of choice. Ultimately the goal is to attract patients.

The hospitals don’t want just any patient, though—only those with good insurance to pay for the big-ticket procedures that bring in the big bucks. One result of the epidemic is that the health stories that dominate local TV news tend to push expensive specialties and procedures—like bariatric surgery for obesity, which can cost upwards of $20,000, or expensive gamma knife surgery for brain cancer, with a price tag of $10,000 or more. Stories about less profitable diagnoses, like AIDS or pneumonia, are rare, let alone pieces about care for the uninsured. The bland stories almost always discuss non-controversial topics, such as new technology, a hospital’s special services, or health and nutrition tips.

Worse, since TV news operations are finding that they can get this kind of health “news” supplied to them—and might even make money on the deal—they are tempted not to invest in a legitimate health reporter who would ask harder questions and look at the larger picture in health care. “I don’t feel we need a full-time health reporter,” says Regent Ducas, news director at KCTV in Kansas City, which had a lucrative partnership with the HCA hospital system until the end of 2006. When it lost the HCA partnership, KCTV moved quickly to look for a new one. Not all TV stations, of course, strike such deals. Sam Rosenwasser, president and general manager of WTSP-TV in St. Petersburg, Florida, says his station just hasn’t pursued one, but said he would “entertain anything if it makes sense.” It would make sense, he said, “as long as you let people know you have some partnership.” But too often the full nature of the arrangements is not disclosed, or inadequately disclosed, leaving the viewer without any understanding of what it means when the hospital gets involved in the content of news.

Good reporters are often afraid to talk on the record about the partnerships, but it’s clear that they don’t like them. “How are you as a journalist supposed to impart a sense of trust if the story is essentially directed and produced by a company not related to your news department?” asks one TV health reporter whose news director would not let her speak for attribution.

“I have to do these. I’m not given a choice,” said another reporter who asked for anonymity. “I kick, scream, and fight, and make them as journalistically ethical as possible. It makes me sick.”

The Cleveland Clinic started its news service nearly four years ago with a pilot sent to NBC affiliates that signed up and a handshake agreement with Fox News. The service acts as “a customer service arm for reporters,” says the Cleveland Clinic’s media relations specialist, Raquel Santiago.

At one end of the customer-service spectrum, NBC seems to use the Cleveland Clinic material as a kind of story-idea service. Helen Chickering, a medical reporter for NBC News Channel, which sends stories to NBC affiliates, says the network cannot use prepackaged Video News Releases, known as VNRs, in stories, but will make its own interview requests based on them. “The only way we can connect is with an interview request,” she says of the rules about dealing with VNR providers. One story in a special series called Modern Medical Miracles, which aired on NBC ’s Today at the end of November, demonstrates how the network uses the clinic’s material. In October, the Cleveland Clinic sent out a story called “Racing Hearts,” which showed how race-car drivers are testing a new heart-monitoring device, and featured a Cleveland Clinic doctor. Today then created its own story featuring the Cleveland Clinic doctor; the medical affairs director for the Champ Car World Series, an international car race; and NBC ’s chief medical editor, Dr. Nancy Snyderman, who called the device a “very cool breakthrough.” The segment discussed other kinds of heart devices and did note that the one tested on race-car drivers was not yet on the market.

Trudy Lieberman is a fellow at the Center for Advancing Health and a longtime contributing editor to the Columbia Journalism Review. She is the lead writer for The Second Opinion, CJR’s healthcare desk, which is part of our United States Project on the coverage of politics and policy. Follow her on Twitter @Trudy_Lieberman.