Since its launch in 2015, STAT News has published award-winning, in-depth, and independent reporting on health, medicine, and the pharmaceutical industry. Some recent digging by the media watchdog HealthNewsReview, though, turned up something less savory at STAT: two opinion articles that looked like the work of an ordinary patient and doctor, but were actually shaped by public relations firms working for pharmaceutical companies or their interests.
In one case, HNR reported, a PR company apparently authored an op-ed that was published under the name Robert Yapundich, a physician in North Carolina. The piece was headlined “How pharma sales reps help me be a more up-to-date-doctor,” but it was not disclosed that the piece had originated with a PR firm (Yapundich later admitted that he made edits, but that he did not write the piece), nor was it reported that Yapundich had received payments from pharmaceutical companies in the past.
In another case, Deborah Clark Dushane, a retired educator in Michigan, published an op-ed in STAT praising television drug commercials. The ads, she wrote, had led her to a drug that cured her chronic hepatitis-C. “Those commercials raised my awareness of the disease and gave me the courage to try again to beat it,” Dushane wrote.
But when HealthNewsReview called up Dushane, she admitted that a PR firm representing a pharmaceutical company had asked her to write the op-ed and submit it to STAT. The firm also reviewed and edited Dushane’s draft prior to submission. And while there is no evidence that the pharmaceutical company, Gilead Sciences, paid Dushane for her efforts, they did fly her out to California “to learn more about the company and its products,” according to a lengthy disclosure that STAT has since appended to her op-ed.
STAT retracted Yapundich’s piece and promptly changed its op-ed policy, requiring contributors to answer a list of questions about conflicts of interest and outside assistance. But given STAT’s stature as a top-flight journalism organization, the incident has raised larger questions about how easy it is for PR professionals to game opinion sections elsewhere. It also highlights a lack of clear industry standards on what amounts to ghostwriting, in which public relations professionals, acting on behalf of powerful interests, write what appear to be original articles and essays that are then published under the bylines of individuals.
Is that ever acceptable? And if so, how are readers made aware of what’s written by PR professionals in pursuit of an agenda, and what’s truly the product of an individual with something to say?
Certainly, the media landscape can be confusing for readers, even without hidden authorship and unclear incentives. While research on ghostwriting itself is sparse, there’s evidence that for many readers, it is increasingly difficult to differentiate between commercial communication and journalistic communication online. A 2016 Stanford University study, for example, found that middle school students struggled to distinguish between journalism and sponsored content on the homepage of Slate.com. Another recent study indicated that adults were frequently unable to distinguish between so-called native advertising — which is designed to look like an article — from actual editorial content.
Reasonable people might disagree on what exactly distinguishes an op-ed ghostwritten by representatives of a pharmaceutical company from an advertisement. But these larger confusions suggest that many readers may have little idea about where the opinion content they read comes from. When I brought this issue up with Patricia Parsons, a communications professional and former professor at Mount Saint Vincent University in Canada who has written about the practice and ethics of PR ghostwriting, she questioned whether there was clarity even with politicians. “These days, people will say, ‘Well everybody knows that politicians don’t write their own speeches.’ I’m not really sure that’s true anymore. I think there are an awful lot of people who don’t realize that politicians, for example, don’t write their own speeches.”
While it may be invisible to many readers, of course, it’s an open secret among journalists and opinion editors that politicians, CEOs, and other public figures often don’t write their own material — and it’s not just well-known figures who get help (or prompting) from public relations firms: Nonprofit leaders, local activists, think-tank fellows, and academics sometimes turn to ghostwriters and communication consultants, too. And PR firms frequently work directly with opinion editors, pitching and submitting op-eds on behalf of their clients.
The PR firm that ghostwrote Yapundich’s op-ed, Keybridge Communications, offers an “a la carte services menu” that describes the process to potential clients (the document was obtained and published last year on the left-leaning media watchdog site Fair.org): “First, we write a 500-800 word op-ed,” the menu explains. “Then we place it in one or more newspapers around the country. If we’re pitching to a national audience, we guarantee that we’ll reach at 50,000 readers.” The service costs $5,000, according to the document. For $2,500 per month, Keybridge will also write regular letters to the editor.
Some opinion sections do try to avoid ghostwritten material altogether. Michael Lemonick, the chief opinion editor at Scientific American, told Undark in an email that all contributors are required to sign a contract stating that “you represent and warrant that the Work was written solely by you.”
But for most opinion editors, the practice is acceptable, if not ideal. “Having a person write your op-ed, to me, is no different than having a speechwriter to write for a presidential candidate,” said Joanna Pearlstein, the deputy managing editor at Wired Magazine, who oversees their opinion section. “I don’t necessarily have an objection to that. I do want to know who’s behind the piece, and I like to have an idea of why they’re writing it.”
Elizabeth Souder, the assistant editorial page editor at The Dallas Morning News had similar thoughts. “I’ve found that a lot of other editors seem to be very adamant that the byline is the actual writer,” she said. “But I think that’s a little naive. I don’t think you can even assume that among even our best unpaid columnists. If you’re going to be publishing free content, you’re going to be publishing content marketing. And there are going to be other editors involved that you don’t know about. That’s reality.”
Perhaps so, but is this process entirely transparent to, and understood by, everyday readers? What made the cases at STAT unusual, after all, was that the writers did not appear to have any obvious institutional affiliations; they were just concerned individuals with something to say on topics of interest to them. It took some digging, on the part of HNR and others, to reveal that they weren’t always writing about their own experiences, and certainly not without the prompting and participation of multinational corporations.
It’s hard to tell how pervasive the practice is, but none of the eight opinion editors interviewed for this article said they thought it was widespread. Souder said the closest thing might be political groups that will ask a local citizen — say, a veteran — to put her name on a pre-written op-ed. “If that veteran really is a member of the group, really does care about that, well great.” Souder said. “But it’s hard to tell if that’s the case. And it feels slimy.”
David Haynes, the editorial page editor of the Milwaukee Journal Sentinel, also pointed to some politically motivated ghostwriting, but added that the commercially driven tactics used by pharmaceutical companies to target STAT seemed unusual. “I think for our news organization, that would be relatively uncommon,” he said.
At least one PR professional I queried regarding the Deborah Dushane op-ed seemed to agree. Michele Ewing, a longtime public relations professional who worked with clients in the health care sector, and who now teaches in the School of Journalism and Mass Communication at Kent State University, said it was the first time she’d seen something quite like it. She added that it seemed like “a clear violation” of the Public Relations Society of America’s code of ethics — as well as a questionable business tactic. “There are other ways to tell that patient’s story,” Ewing said. “You don’t need to do it through the op-ed page.”
Still, not all opinion editors agree that ghostwriting like this is necessarily a problem. “If it reflects her opinion, it doesn’t really matter if she wrote it or not,” said Ned Barnett, the editorial page editor of the News & Observer in Raleigh, North Carolina, after I sketched out for him the basic details of the Dushane case. D.J. Tice, the commentary editor at the Minneapolis Star Tribune, made a similar point: “The simple fact that some PR flak from the company helped them,” he told me, “does not seem so sinister to me, as long as it’s expressing their opinion or their view.”
Everyone would agree that deception is not okay. But where does that deception begin? Is it the moment that anyone claims authorship for a piece they did not write? Is it the moment when readers no longer understand that a ghostwriter may have been involved in producing an op-ed? Is it the moment when editors themselves aren’t sure whose opinion they’re publishing? And does it matter if the writer formulated the exact words of the opinion, as long as she’s willing to stand behind, and remain accountable for, the content?
Finding ethical and professional guidelines on the practice of op-ed ghostwriting is difficult. I brought this up with Haynes, who also serves as a co-chair of the opinion committee for the American Society of News Editors. “As for industry-wide standards, I’m not sure there really are, which is one thing that I think ASNE, through its opinion committee, probably ought to think about,” Haynes said. “It’s an issue that we’ve sort of informally raised as maybe a mini-project for our committee to take a look at and see.”
One thing that is clear: The issue isn’t going away. We are, after all, in a golden age of content marketing, in which companies and other organizations try to produce “content” that very intentionally masquerades as journalism, but which is little more than advertising. At the same time, newsrooms have fewer and fewer resources to vet contributors, even as the need to publish more material grows.
“Public relations firms have found that this content marketing approach is really effective, right?” Souder said. “They know how to write, and they can do it effectively, and they know what newsrooms want, and it’s free content.
“And,” she added, “newsrooms are struggling.”
Michael Schulson is an American freelance writer covering science, religion, technology, and ethics. His work has been published by Pacific Standard magazine, Aeon, New York magazine, and The Washington Post, among other outlets, and he writes the Matters of Fact and Tracker columns for Undark.