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.

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.”

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.