Month: January 2020
Resistance Is Futile
I thought you might want to see this story from NPR .
Resistance Is Futile
www.npr.org/2019/12/31/792730157/resistance-is-futile
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PBS Newshoour: Local newsrooms across the country are closing. Here’s why that matters
Local newsrooms across the country are closing. Here’s why that matters
Jan 1, 2020 6:35 PM EST
Click the link below for the complete video.
https://www.pbs.org/newshour/show/local-newsrooms-across-the-country-are-closing-heres-why-that-matters
Across the country, local newspapers are printing fewer pages, less frequently — and sometimes collapsing entirely. Recent studies paint a grim picture of the decline in local newspapers and the impact it has on American politics. Jeffrey Brown reports and talks to Chuck Plunkett, formerly of the Denver Post, and the GroundTruth Project’s Charles Sennott about the crisis of lost local news.
Read the Full Transcript
· Nick Schifrin:
Across the country, there are deserts of news. Local newspapers print fewer pages less frequently, and, in some cases, collapse entirely.
Recent studies paint a grim picture of the decline in local newspapers and the impact that is having on our politics.
Jeffrey Brown has our look.
A recent report by PEN America was titled “Losing the News: The Decimation of Local News and the Search for Solutions.”
And the evidence comes in newsroom jobs lost and papers shut down. According to the report, at least 200 counties in the U.S. have no newspaper at all.
The Internet, of course, helped change the economics of the news business, as advertising migrated online, and the Internet offers new ways for all of us to get news. But what’s happening and what’s been lost at the local level?
For that, I’m joined by Chuck Plunkett. He’s a former editorial page editor for The Denver Post. In 2018, he protested layoffs of the newsroom staff after the paper was taken over by a hedge fund. He’s now director of the News Corps at the University of Colorado Boulder, a media program for student journalists.
And Charles Sennott, a veteran journalist and now founder and CEO of The GroundTruth Project, a nonprofit media organization that founded Report for America, which helps train and place reporters in local newsrooms.
And welcome to both of you.
Charlie Sennott, help us define the problem and its causes. How do you describe — in broad terms, how do you describe the current situation?
· Charles Sennott:
I think the crisis in journalism in America has become a real crisis for our democracy.
So, as you pointed out, there are newsrooms across the country that are seeing their staffs decimated. We are seeing communities where their news organizations have just closed up and gone away. There are 2,000 newspapers that have completely shut down, 2,000 communities without a newspaper anymore; 1,300 no longer have any local news coverage at all, no one watching the store, from small towns to medium-sized cities.
When we lose 30,000 reporting jobs, as we have in the last 10 years, what we lose is an ability for us to have a shared set of facts on a local level, and for us to have a civic debate on a local level. And I think we’re really seeing a fraying of communities as a result.
· Jeffrey Brown:
So, Chuck Plunkett, you have — you have seen this up close, put it in specific, even personal terms. What’s not getting covered? What are we missing?
· Chuck Plunkett:
I mean, here in Denver, it’s a perfect example. And it’s happened across the country.
When I started at The Post in 2003, there were nearly 300 journalists. And now there are 70. And that means there are fewer reporters covering the city hall, covering the statehouse, covering the important beats like cops and business.
Studies have shown that, when there are fewer reporters in communities, that corruption inevitably starts to grow, taxes start to go up, voter participation starts to drop.
· Jeffrey Brown:
I mentioned, of course, the changing business model. And you both have watched that.
So, in the interim, in some of the solutions — Charlie, you’re addressing one of them as part of this nonprofit movement. Tell us what you — tell us about your project.
· Charles Sennott:
Sure.
So, what we’re trying to say is, we need to have a movement to confront this challenge to local reporting in America. So we started Report for America as a real service project to say, this is a call to service for a new generation of journalists to come forward and serve these local communities.
As Chuck pointed out, there’s greet needs to cover education, to cover health issues, to cover rural areas where no one is really having their story told.
So what we are trying to do is create a kind of a Teach for America or City Year for journalism and to deploy young journalists in the host newsroom. Those host newsrooms will now take in 250 Report for America corps members, as we call them.
And we’re really trying to put boots on the ground, so that we can say the best way to confront this crisis is going to be with real human beings doing real reporting and answering that need.
· Jeffrey Brown:
Chuck, if the economics don’t work so well anymore, the way they traditionally did for your industry, is it only projects like that, nonprofit, experimental, relatively small, even if trying to — even if having an impact in?
· Chuck Plunkett:
Every little bit helps, Jeff.
But I fear that we need something much bigger than that, that for years and years and years, before the rise of the Internet and things like Craigslist and Facebook, the rule of thumb was that traditional newspapers got 80 percent of their revenue from pricey print ads and classifieds and things like that.
And so now, when ads shift to online and people can go to Craigslist, that revenue just evaporates. So, The Denver Post, that had top level editors and top level reporters and investigative reporters and photojournalists, and the whole ballpark, suddenly, you find them in a situation where they need a lot more money to be able to pay the bills.
And trying to go this subscription model or the nonprofit model, the different courageous experiments that you’re seeing out there, isn’t really getting the job done.
I came around to the idea that a public funding option to help subsidize, to help backfill some of that 80 percent of the revenue that has been lost is going to be critically important to keeping our democracy alive and healthy.
And we need our watchdogs. We need the people who are journalistically trained to get out there. You need a source that you can go to that’s reliable, that speaks for the community, that’s been trusted and is considered one of the most plugged-in members of the community, like a Denver Post.
· Jeffrey Brown:
We’re talking economics, of course, but we’re also in a time where journalism, journalists are — these are contested areas. Facts and truth are contested.
And you’re both now working with young people. You’re working with what you hope is a new generation of journalists.
Charlie, what do you say to people coming into this?
· Charles Sennott:
What we say to young people is, look, you can go into a community, and you can be of service to that community, and you can change things.
Right now, too many communities have no one watching the store. There’s great journalism that can be done to go out into these communities and uncover really important stories that matter to the community.
So, Jeff, you and I came of an age when journalism had a big future to it, and you could get into these jobs. We want to restore the pipeline for a new generation of journalists to come forward. And we really want to urge them to apply.
You go to ReportforAmerica.org and apply for these positions.
· Jeffrey Brown:
Chuck, you’re working at a university now, so you’re with young people. What are they coming to you for, and what are you saying to them?
· Chuck Plunkett:
Our students have a lot of passion. They look at the world that they live in, and they fear that it’s chaotic, and that it’s full of tricksters.
And a lot of — as much as the Internet gives us wonderful information and tools to use, it also brings a lot of mischievous activity. And they look at the state of the country, and they see that there’s a lot of disconnect and a lot of anger.
And they have a real passion for wanting to do something about it and get involved and be able to develop the skills that it takes to go far beyond the kind of citizen journalism that’s needed.
· Jeffrey Brown:
Chuck Plunkett and Charles Sennott, thank you both very much, and happy new year.
· Chuck Plunkett:
Happy new year to you.
· Charles Sennott:
Thank you. Happy new year.
PBS NewsHour from Jan 01, 2020
NYTimes: In a Homecoming Video Meant to Unite Campus, Almost Everyone Was White
Some hard truths about how segregationist attitudes in Wisconsin manifest themselves at the University of Wisconsin-Madison.
In a Homecoming Video Meant to Unite Campus, Almost Everyone Was White nyti.ms/35f2iRi
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NYTimes: Doctors, Nurses and the Paperwork Crisis That Could Unite Them
Doctors, Nurses and the Paperwork Crisis That Could Unite Them nyti.ms/39rkxXh
Opinion
Doctors, Nurses and the Paperwork Crisis That Could Unite Them
They don’t always get along. But they are both under siege by the bureaucracy of a failing health care system.
By Theresa Brown and
Ms. Brown is a clinical faculty member at the University of Pittsburgh School of Nursing. Dr. Bergman is a professor of medicine at New York University.
Broken, wasteful, inhuman, expensive, deadly. The problems with the American health care system, or non-system, are neither subtle nor unrecognized — especially by those of us doctors and nurses who actually provide the care. And yet we all too often feel the most helpless, seeing how much of the problem is driven by drug companies and hospital networks.
Too often, each profession sees the other as fighting separate battles, and sometimes against each other. Doctors blame nurses, and vice versa, for the failings of a system that punishes us all, and our patients.
Instead, the two of us are suggesting that nurses and doctors try something unusual. Let’s put our differences aside and work together to achieve real change, starting with a pernicious problem that drives so much of our mutual discontent: electronic health records.
The current system is pushing both doctors and nurses to the breaking point. Enough doctors in the United States commit suicide every year to fill two large medical school classes. A 2019 MedScape report found that 44 percent of physicians feel “burned out,” driving many to alcoholism and depression, or to leave the profession entirely.
Nurse suicides are not systematically measured and reported, but a 2017 study in England found a suicide rate among nurses that was 23 percent above the national average. Half of all nurses are considering leaving the profession, according to a 2017 study by RNnetwork.
Clinicians are notoriously overworked, but ask anyone on a hospital staff, and he or she will tell you that workloads have become heavier the last several years thanks almost entirely to the arrival of electronic health records — detailed reports about a patient’s medical history and care. Originally intended as a work-saving tool, the records have gone in the opposite direction, taking time away from patient care in the name of electronic box-checking.
A new report from the National Academy of Medicine says that on average nurses and doctors spend 50 percent of their work day treating the screen, not the patient, and that “increased documentation time” associated with electronic health records can lead to burnout. Burnout is also tied to finishing documentation at home, a necessity for many physicians, and for nurses who provide home care.
The use of electronic health records increased significantly with the 2009 passage of the Health Information Technology for Economic and Clinical Health Act, which offered financial incentives for hospitals to adopt them. Such records promised efficiency and better teamwork, but as they increasingly serve the needs of America’s corporate, profit-motivated health care, those promises remain mostly unfulfilled.
Insurance companies and hospitals demand ever more data to make decisions about payments and billing, so clinicians have to provide much more information about each patient at each interaction. Mounting regulatory requirements that get built into these records are described as insuring patient safety, but are ultimately tied to compensation, which means money. And in a system rife with legal risks, there is a strong incentive to overdocument everything.
This is why nurses and physicians must come together. We must acknowledge the harm done by these ever-increasing documentation requirements, without losing the core benefits of electronic record keeping.
One inspiration comes from a surprising place. Electronic health records are almost universally disliked, with one telling exception, those used by clinicians at the Department of Veterans Affairs. The reason: Billing concerns don’t shape the records at government-run V.A. hospitals. They document only what’s necessary to deliver better care.
Why can’t the rest of the health care system do the same? For example, some hospitals already have a periodic review of their electronic health records, paring items that do not relate directly to patients; more hospitals could do the same, and all could do it more aggressively. Another: A group of coders at Intermountain Healthcare in Utah is working on a more radical solution, called “activity-based design,” which updates records by voice, and offers helpful care algorithms to clinicians as they interact with patients.
Part of the reason for inaction is that not enough clinicians are making it loud and clear that change is necessary. Doing so requires a unified voice across our professions — and unfortunately, right now, doctors and nurses are anything but unified.
Physicians earn much more money than nurses and have much higher status in the medical hierarchy, which can lead to resentment from nurses when that higher status is abused. The gendered history of both professions also contributes to a view of nurses as fundamentally subordinate to physicians.
Most important, the experience of nurses is often invisible to doctors, even though they typically work alongside them. There are examples of respectful working friendships on the front lines, but the legacy of hierarchy persists, and keeps us from focusing on our common struggles.
Doctors would be wise to let nurses take the lead. For years, nurses have organized to improve hospital working conditions, in particular fighting for better staffing levels. The Service Employees International Union and National Nurses United represent nurses all over the United States, and in general are good at getting their demands met.
Doctors, on the other hand, have no similar organizations, no national unions and little experience in activism on workplace issues. Maybe it’s the myth of the single, heroic doctor that keeps them from recognizing the strength in collective efforts. Or maybe they believe their high status will protect them from the worst of the profit-focused excesses in American health care.
If so, those beliefs are collapsing, as most physicians are becoming painfully aware that no one will be spared, and that bureaucratic nightmares like electronic health records have impaired their ability to do their jobs well, much less enjoy them.
The millions of us, nurses and doctors, who directly attend to patients want the best for them, and yet are prevented from caring by profiteering and gross inefficiency. We need to restore caring to health care. For nurses, doctors, and even patients who take on this fight, the life you save may indeed be your own.
Theresa Brown is a clinical faculty member at the University of Pittsburgh School of Nursing and the author of “The Shift: One Nurse, Twelve Hours, Four Patients’ Lives.” Stephen Bergman is a professor of medicine at New York University and the author, most recently, under the pen name Samuel Shem, of the novel “Man’s 4th Best Hospital.”
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