Another standard says that a news operation’s online product should clearly separate commercial and editorial content. But such clarity is often lacking. For example, WIS-TV in Columbia, South Carolina, featured one of its former reporters in a Web story as she had her risk for heart disease assessed by a local hospital heart center; the story blended so smoothly on the site with the hospital’s ads it was difficult to tell the difference.

For the most part, TV stations and hospitals see little wrong with their partnerships. Hospital p.r. officials often believe it is simply another way to inform consumers about health care. Chad Dillard, a former hospital marketing vice president for Good Samaritan Hospital in Baltimore, said he didn’t think the partnerships crossed the line. “I never honestly thought it was anything more than getting a good story out to the consumer.” For his part, Regent Ducas of Kansas City’s KCTV concedes that his station’s Doctor on Call programs are not news, but are more like “a Billy Graham special.” But, says Barbara Cochran, the president of the RTNDA: “If your viewers and listeners start to think your news content is for sale, you’ll lose credibility and the value that advertisers want will be damaged.”

TV anchors and health reporters lend credibility to stories resulting from partnerships. In Seattle, the popular KING-TV anchor Jean Enersen starred in a package on lung cancer that ran last October and was promoted as a “ KING 5 Cancer Free Washington Special.” Although the program reported on patients in lung cancer support groups and smokers trying to kick the habit, it was also unquestionably a plug for the work of three hospitals that formed the Seattle Cancer Care Alliance, which partners with KING. Enersen has hosted eight hour-long shows on cancer over the last two years, as well as shorter “health link” pieces that run during the primetime news once a week. Sometimes anchors also appear in commercials for the hospitals, giving the ads the patina of news. Wayne Dawson, a news anchor at Cleveland’s Fox station wjw, for example, does spots promoting MetroHealth’s help line. The spots run during WJW’s news and entertainment programming, earmarked as commercials.

In its 2003 annual report, Meredith Corporation, which owns fourteen TV stations, noted, “Now everyone at each station, including news anchors and other on-air personalities, is playing a role in generating advertising revenues or supporting sales operations.” Thus it was only natural that Meredith’s station in Kansas City, KCTV, would agree that, as part of its deal with hca, one of the station’s anchors would host the Doctor on Call specials that featured hca doctors and nurses answering viewer questions. HCA’s Dyer says the station wanted a representative to host the shows and “we didn’t mind that.”

The larger problem with TV-hospital partnerships is that in many of them the hospitals effectively co-opt the station’s journalistic duties. How much control the hospitals get varies from partnership to partnership, but they often select the topics, choose the patients and doctors, and sometimes write or edit the script. Shawnee Mission Medical Center just outside Kansas City, Kansas, for example, has a sponsorship deal with an ABC affiliate, KMBC, owned by Hearst-Arygle, to air stories called HealthWatch for Women, which airs every Wednesday and Sunday, featuring only the health system’s medical experts. Shannon Cates, a hospital media relations specialist, says the stories, which discuss such subjects as osteoperosis, progesterone, and bladder control, are “definitely” news. “I develop the story ideas and arrange for the physicians and patients to speak on the air,” she says. “Channel 9 comes to do the interview for the segment. It’s like any other news story they would do.” The partnership goes deeper. “Working on a regular basis we’ve come to trust each other. They feel comfortable with me developing story ideas, and I trust them to put the story together that represents the hospital well.”

Thomas McCormally, a public information officer at rival Children’s Mercy Hospitals, based in Kansas City, Missouri, says this about the women’s health stories: “As a consumer you wouldn’t know they are advertising.”

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.