Why we should pay for news

Last weekend's column in the Kingston Whig-Standard.

The other week I got a message from someone who is looking forward to reading my weekly columns. She told me how glad she was to find out that they’re available free of charge on the newspaper’s website, so she wouldn’t have to pay to buy it. I was dumbstruck, to be honest. Much as I liked hearing from a reader who is looking forward to my writings, didn’t it occur to her that these columns don’t come cost neutral? That someone, somewhere would have to pay for them?

Newspapers, I’m telling no secret here, are dying left, right and centre, and not only smaller papers like the Whig-Standard are an endangered species, even bigger papers seem on their way out. Newsrooms across the nation have lost a large number of journalists to cost-cutting exercises. The working conditions of journalists – they were never great to begin with – are truly appalling. Job security in this industry is abysmal at the best of times. As a result, most newspapers aren’t what they once were in terms of quality. To create economies of scale larger publishers like Quebecor gobbled up smaller papers like the Whig, the London Free Press, and the list goes on. As a result we end up with local newspapers that are barely recognizable as local newspapers.

Why did this concentration of media ownership occur in the first place? Economies of scale had to be created, mostly because of the internet. The internet with its seemingly free provision of news content 24 hours a day discouraged many of us from renewing our newspaper subscriptions. Young people have grown up without a daily newspaper in their homes. They check quickly what the Huffington Post offers free of charge on-line, skip over to a celebrity gossip sites like TMZ, and that’s it for the day. No need then to pay for a local paper. In these outlets the difference between reporting and opinionating has become sufficiently blurred today as to have become a problem in its own right.

I do think this has very serious consequences for local democracy. Local newspapers are the only instrument really that permits us to keep our local councilors, as well as provincial and national politicians accountable. Full-time local journalists are needed to investigate and report what is happening in our community. We cannot just rely on volunteer bloggers to fill that gap. Talking back to Mayor Mark Gerretsen on his Facebook page isn’t quite the same either. So, there’s a first reason why you should subscribe to a local paper.

The same holds true for national broadsheets, too. The Globe and Mail is struggling badly and has been struggling financially for quite some time. It has asked journalists to take unpaid leave during the summer period last year to save money. The editor-in-chief was sacked  unceremoniously this week. The paper has recently introduced a paywall to ensure that people eventually pay for reading its content. The company also took a hit on the credibility front when it decided to keep on staff a columnist accused of repeatedly plagiarizing in her columns. It’s not quite clear to me who would want to pay for that. I’m not sure how that pay wall experiment will pan out, but good luck to them. The Guardian in the UK tried the opposite. It gives its news away free of charge through its website and hopes that eventually it’ll grow sufficiently to become a global media organization capable of relying entirely on advertising revenue from on-line ads. That’s a bit like trying to out-compete Google. Suffice it to say, at this point in time it doesn’t look as if this experiment is going to work out. The company also offers voluntary subscriptions. You pay a nominal fee and receive in return an advertising-free website.

On the other hand, there are thriving specialist news magazines. Unlike low-quality garden-variety magazines like Newsweek, Time or Reader’s Digest, highbrow international magazines like the Economist go economically from strength to strength. The lesson to me: there is a large number of people who are willing to pay for high-quality investigative journalism and analysis. Of course, the Globe and Mail isn’t the New York Times, and it certainly isn’t of Economist quality analysis. However, Canada needs a thriving national newspaper market. Why? For reasons similar to those I gave for the importance of local newspapers. Without the Globe and Mail and papers like the National Post, who would hold our politicians accountable? Who would be able to finance investigative journalism? Would we really want to depend entirely on what commercial news channels offer to us courtesy of their advertisers? How many investigative stories can W5 realistically put together in a year, compared to what the Globe and Mail continues to produce on a daily basis? We will be a much poorer country for it if those newspapers collapse because we are too cheap to pay for quality news.

What’s probably unimportant is whether a news organisation relies on print or operates entirely on-line. I love holding a newspaper when I read it, but that shows more how much of a romantic Luddite I am when it comes to this medium then the necessity of having print newspapers. I wonder why haven’t on-line newspapers long begun selling their different bits and pieces of news as subscription packages? What would be so bad about being able to subscribe to the Whig’s local content only?

And here ends this week’s sermon: if you are among those who read this column on the newspaper’s website free-of-charge, why don’t you subscribe today and so strengthen our democracy. It’s kind of a civic duty. You might not always agree with what you read, but it is important to have locally employed full-time journalists informing us about what’s going on in our fair city.

Udo Schuklenk holds various newspaper and magazine subscriptions, teaches ethics at Queen’s University and tweets @schuklenk

Hospitals are dangerous places

According to conservative estimates between 2-4% of hospital patients fall victim to doctors’ mistakes. In Germany every year between 340,000 and 680,000 patients are affected by such errors. At least 17,000 patients die in that country each year because of doctors’ errors. Compare that to the about 5,000 people who die in Germany in traffic accidents per year. No doubt, sub-optimal health care is a dangerous business. Equally, though, mistakes are all too human. They are obviously of greater consequence in some professions than in others.

W Five’s investigative team broadcasted last Saturday allegations about professional failings of a surgeon at Scarborough General Hospital. Some of these allegations seem to have been well-founded, because the surgeon in question is these days restricted in terms of the work he is able to perform at the hospital. The program makers went further. They demanded that patients should be able to access individual surgeons’ records of success and failure rates. After seeing the program and listening to truly heart-wrenching stories, anyone’s gut feeling would likely be that such disclosure is not unreasonable. After all, wouldn’t we all want to improve our odds if we had to undergo surgery? Surely, none of us would volunteer knowingly to be operated on by the worst-performing surgeon of any hospital department, or would we?

The ethical argument underpinning this demand is essentially that for any patient to give truly autonomous informed consent to any medical procedure she needs to know anything that is reasonably material to informed decision-making. One could argue that information about a given doctors’ failure rates is very much materially relevant to informed decision-making. Admittedly, a reasonable person likely would want to know. And yet, I remain skeptical about this solution. It seems, once we were to receive such information we would be sliding down a slippery slope that strips our health care professionals of much of the same rights to a kind of professional type of privacy that we take for granted for ourselves. Why not ask our doctors to also disclose any health problems they might have that might pose a risk to us during surgery? Do they suffer from infectious illnesses (we might not trust the efficacy of universal precautions)? Should we not test them prior to surgery and display that information on posters throughout the hospital and on the internet? Should we enforce psychological testing prior to surgery to ensure that no spousal dramas affect the on- the-job performance? Why not also have public report cards on the maintenance of the hospital equipment, cleanliness and so on and so forth? There does not seem to be a clear line that can be drawn in the sand on this issue, once we start going down the track proposed by W Five’s investigative journalists.

When we board a train, do we expect displays indicating how often the train driver erred during his career? Do we check when we board a transatlantic flight how old the plane is, or whether the pilot and captain have a history of heart problems?
Most of us don’t bother undertaking such detective work, and we don’t expect such information to be reasonably available to us. Nothing less, however is being proposed for doctors. When you think about planes and pilots (indeed, bus drivers!) many more lives are at stake, yet our inquisitive minds are at peace in the knowledge that regulatory agencies will ensure that the bus driver is well trained, and that the equipment she uses is in top condition. Government and statutory bodies like the Ontario College of Surgeons and Physicians look after the quality of our doctors and have checks and balances in place that ensure that individual professionals failing us are found out and properly dealt with. So it should be. This much the professions and our professionals owe us as society.
The real issue then should arguably not be to keep publicly track of individual performances, but to ensure that hospitals act fast when individual professionals’ performances are suboptimal. Scarborough General Hospital clearly failed on this count, if the information on the W Five program is to be trusted. It is also worth asking how we can ensure that the College of Surgeons and Physicians moves faster than it has in the case highlighted on W Five. It is a perennial problem of such bodies the world all over that many citizens and indeed, many professionals think that they are more concerned to cover up for colleagues under scrutiny then to keep the interests of individual patients, clients and society at large at heart. This constitutes a serious threat to the professions and the trust society has invested in them. It is government’s responsibility to ensure that institutions like the Ontario College of Surgeons and Physicians deliver on that front, and do so in a transparent manner.

The current demands for the public availability of individual doctors’ performance data are missing the point. Patients should not ever find themselves in a situation where such data would make a difference, because the offending professionals should be out of their jobs way before that information would be on display. That is the real regulatory issue.

What is it about 'being' a doctor?

I am not talking about people who are real doctors, ie people with a doctorate in some discipline or other, but about medical doctors (most of whom probably don't actually have a doctorate). - At a German university hospital a fraudster was found out not to be a medical doctor, only after she worked (successfully I might add) for four years at the hospital. The woman in question had no medical qualifications (she studied medicine but crashed thru various exams and never graduated). So she faked her graduation documents, applied for a post in the hospital and began to work. She also published a substantial number of scientific papers, quite a few of which received prizes for their excellence. In the end she was found out, suspended and is currently being prosecuted.

Nothing much in all of this is truly newsworthy, I guess. Over the years there's been a continuing trickle of fraudsters like this woman. Of course, we only ever learn about those fraudsters who have been found out, which makes one wonder how many non-medics work as medical doctors in our health care systems. It makes one also wonder what it is about medicine that drives folks to do such things. I mean, how often have you heard of someone pretending to be a philosopher who actually has no training in philosophy, or how often are lab technicians found out who actually have no training etc. I sometimes wonder whether it's to do with the quasi-religious side of medicine, its rituals and clothing (like: why should doctors have to wear a white coat? there is no particular scientific reason... it's really more like the colourful dresses priests tend to wear to distinguish themselves from the rest of us.- and how often do folks working in health care settings, who are not medics, aspire to (or actually do) wear a white coat, then there's white coat ceremonies etc etc). Medics usually respond with a vague nod toward 'tradition', and if that doesn't help with the grave responsibility for their patients' wellbeing (even life). This usually is also deployed to justify out-of-whack wage claims. The thing is, if responsibility for one's clients' lives was the relevant factor in determining one's legitimate claims in terms of salary, status etc, arguably the average bus driver carries in a day's work more responsibility than the average medic. So... what is it about the medical profession that makes it sufficiently desirable that people without such competencies lie and cheat to look like they're medical doctors?

Royal Bank of Scandalous (aka Scotland)

Regular readers of this blog will know that I made atrocious experiences with the Royal Bank of Scotland. For the record, the stuff-up the bank caused months ago during a stay in San Francisco has still not been rectified. Even my branch manageress thinks that the organisation's conduct has been shameful at best.

Having declared my personal conflict of interest, I should probably also mention that I continue to monitor this record profit making organisation for further evidence of truly scandalous conduct. And indeed, given half a chance, the Royal Bank of Scandalous (as a reader of this blog renamed the organisation) will almost certainly jump at it.

Well, here's what's happening. Just like other organisations, the company requires that its staff also buy its products. Any of its staff members caught not having a bank account with the Royal Bank of Scotland will be subject to disciplinary procedures. I don't understand why the company's staff would be so recalcitrant. Is it because they know better than most of us how crappy the bank's customer (dis-service) really is? May be they don't want to wait months to see an apology for bad service and some kind of compensation? After all, the bank pretty much instantly charges the living hell out of you if you overdraw your bank account. If they (by their own admission) mistakenly drain your account of money, they quite happily charge you (yes, you!) instantly. They then fail, months after having punished you for overdrawing an account that they accidentally drained, to compensate you or fix the mistake.

Of course, I shouldn't be unfair. There are plenty of other companies requiring their staff to buy their products. Rolls Royce for instance demands that its staff drive only Rolls Royce, and so do Bentley, Jaguar and Mercedes Benz. Come to think of it, thousands of Lufthansa staff were recently disciplined for flying other airlines. Worse, McDonald's staff seen with a Burger King burger in their hand will be shot on the spot by McDonald's Staff Monitoring Services. - OK, I guess you realise that I made these stories up. I also hope you get the point that I am trying to make. Take the opportunity to cancel your account with the RBS when you have a minute. As a bank it fails to provide decent customer services, and as an employer it undoubtedly sucks big time. Move on while you can.