Toward the other end of the spectrum is Fox. As Cleveland Clinic’s Sharon Dennis sees it, “We act as a news bureau for Fox.” A CJR analysis shows just how true that is. We traced the use of eight stories the clinic sent out last fall and found that twenty-six stations—all Fox except three—used them almost verbatim. Dave Winstrom, the director of Fox News Edge, says Fox approves the scripts before the packages are sent to the stations, and adds that the stations may choose how to use them. “Some may use them verbatim, or cut them down, or not use them at all.” What’s sent to the stations, he says, is identified as being from the Cleveland Clinic, but “it’s up to them how they present the story.” (The piece about the virtual gym that ran in Austin did not tell viewers the source of the story.)

Marketing like that can produce a big return on a hospital’s investment. The Mayo Clinic, which started its own news service in 2000, sends its weekly Medical Edge stories to 130 TV stations in the U.S. and Canada. No other station in those markets can use Mayo’s Medical Edge offerings. Stations using the material must agree to say that the featured physician belongs to the Mayo Clinic and provide a link from the station Web site to Mayo’s.

How well does that work? CJR obtained a PowerPoint presentation given in 2004 to hospital marketers by the Mayo Clinic’s media relations manager, Lee Aase. It showed that brand preference for Mayo for serious medical conditions had increased 59 percent three years after the service began, and brought in new patients to boot. One story, called “Same-Day Teeth,” which told of a quicker way of doing lower-jaw dental implants, generated more than 175 calls, Aase’s report said. It resulted in twenty-three scheduled appointments and downstream revenue—money from patients who eventually had the procedure—estimated at $345,000. The presentation noted that 8.6 million people had seen the December 2001 Medical Edge stories. The value, said Mayo, was greater than ten times the cost of producing the shows.

Sharon O’Brien, the marketing director for University Health System in San Antonio, says she is moving away from paid advertising in favor of such media partnerships. “The hallmark of these packages is that they don’t look like paid advertising,” she says.

Marketing like this is so powerful, in fact, that some TV stations have found that they can charge serious money for “news.” Their sales departments aggressively pitch business proposals to health institutions, laid out in thick spiral binders that look like a prospectus, according to L. G. Blanchard, media relations manager for the University of Alabama Health System, who has seen many of them. Most hospital officials that CJR interviewed would not talk about their financial arrangements with TV stations, but the few who did offered a glimpse into how profitable the deals can be to those stations willing to charge for them.

Leni Kirkman, the executive director of corporate communications at University Health System in San Antonio, said her hospital paid about $90,000 in 2002 to KENS-TV for a year-long sponsorship that involved thirty-second promotions, prominent placement of the hospital’s logo—and a monthly feature called “Family First” that was narrated by the station’s news anchor but written by the hospital’s p.r. staff. Kirkman says the hospital has also had a deal with Univision, in which no money changed hands. In that partnership, she says, the hospital provides a tape with B-roll footage and interviews for a show called “A Su Salud (To Your Health),” which features the hospital’s experts and patients. “We get to have our experts interviewed, so we get the PR value.” But there’s a bonus: “When we want to them to cover something else,” Kirkman adds, “they are extremely receptive.”

Rob Dyer, a vice president for marketing and public relations at hca hospitals in Kansas City, said his organization paid KCTV $1.5 million over the three years of their partnership, which ended in December. That deal involved advertising spots, promotion on the station’s Web site, four Doctor on Call specials each year with the station’s morning anchor and hospital medical personnel.

In 2002, the Radio-Television News Directors Association ( RTNDA ) established voluntary guidelines for balancing business pressures and journalism values. One RTNDA standard says advertisers should have no influence over news content. Yet in many of these TV partnerships, hospital p.r. people decide the story and may even write or edit the script.

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.