This is testimony that I gave at the first meeting of the FDA Risk Communication Advisory meeting, February 2008. The committee is made up of outside people and they exhibited considerable interest, asking several questions.
The testimony was posted on the AHCJ webpage and picked up in full by the subscription website FDA.com in the days after it was given.
My name is Kathryn Foxhall. I’m a freelance reporter. I write for publications including Medscape, Drug Topics, Contemporary Pediatrics and the American Journal of Public Health. I’ve covered the Washington health scene as a reporter/editor for specialized publications for over 30 years. Among other positions I was editor of The Nation’s Health, the newspaper of the American Public Health Association for 14 years.
The way it used to be
Not too long ago a host of reporters reported on federal agencies in standard reporting fashion. We talked to people in the agencies. We got to know staff members. We developed source people. We called people and got 2-minute educations that vastly improved our stories. A very quick interview often turned a story from an empty shell, or something that might be misleading, to a solid piece that meant a great deal to readers.
Some specialized newsletter reporters regularly walked a beat in the halls of agencies, in the time-honored manner of local reporters.
Communication with agencies was almost constant for some specialized reporters.
And the process was absolutely vibrant. We got story ideas faster than we could scribble them down. We got a good understanding of what was happening. The experts in the agencies were like our graduate schools.
Nobody ever quantified or even studied those communications. Usually they were just a routine part of a staff member’s day.
Then, about 12-14 years ago agencies began instituting a control mechanism:
Staff members in some agencies are strictly, emphatically forbidden from speaking to any press or media reporter, unless the reporter makes application with the public relations office and is tracked by that office. FDA is one of the worst agencies in the use of this control.
What happens now
This permission-to-speak system is simply the most horrible thing I have seen happen to governmental process in my time in Washington. It is severe censorship and very effective censorship. Agencies track, monitor, control and chill our conversations with staff.
We are prohibited from talking without government monitors overseeing every word. If this “government monitor” system sounds something from North Korea or China, I think it should.
This permission-to-speak mandate has probably killed over 90 percent of the communication that previously took place and should take place now.
It goes like this. A reporter who wants talk to a staff person – whether it’s for 5 minutes or 2 hours – must call the public relations office. An assistant in that office tells the reporter someone will call back. The reporter waits. The public relations officer calls back, maybe in two hours, maybe a day, maybe not ever.
When the public relations officers get back, they want to know what the questions are, when your deadline is, etc. Then they often try to answer the questions themselves, without allowing you to talk to the source person. Sometimes they just say you can’t talk to the person, because of reasons like the agency doesn’t answer questions like that.
If the process goes forward, the public relations officer says he or she will get back to you, again, and then hangs up. What happens in the meantime, we don’t know. Does someone else have to bless the conversation? Is there some process where insiders decide whether the communication is a good thing?
The public relations officer then gets back in two hours, three days, or never. There is no set time.
I have sat at my desk all afternoon while a physician expert sat at his desk, after he had already told me he would love to talk to me about technical medical provisions of a Federal Register notice. But our permission-to-speak never came.
If the reporter gets permission-to-speak, many times the public relations officer mandates that he or she will listen in on the conversation. So the officer goes away, again, to set up a time when all three parties can be on the phone.
And, increasingly, the public relations officers –those people whose job it is to make the organization look good—listen in on every word.
I don’t see how this can be seen as anything but a cynical attempt to control reporting. It’s burdensome to the point of all but killing the process. The education, the source building, the casual conversations that led to great stories, they are all eliminated now.
Usually, reporters don’t call because they can’t hold a story that long and they can’t devote the absurd amount of effort to the application process, for a short discussion.
But it doesn’t take a reporter to understand this. What business or other endeavor could survive a mandate of a multi-day, permission-to-speak application with a third party for for every 5-minute conversation? What would that do to anybody’s work?
The burden of the process, by itself, is severe censorship. But that is not the worst of it.
The chill of the fact of the public relations officials tracking and/or listening in on every conversation is nearly universal and it is devastating. The communication a reporter has with a staff member is nearly always very different –less fluid, less informative– from what it is if we can ever get people away from the monitors.
Most Communication Is Benign
Ironically, the permission-to-speak system is also very counter-productive for public relations.
The great majority of the communication that has now ceased was benign, useful, and non adversarial from the agencies’ own point of view. It was exactly the kind of information an agency wants to get to the public, including specialized publics like health professions.
Reporters, having to work very quickly, wanted to know: Does this rule apply to this population? What does this term mean in the context of this Federal Register notice? Can you give me any further background specific for my pediatricians? Is this the same program that came out last year or is it different? Can you tell me what this is about, in English?
Countless times agency staff members turned a story into something much more meaningful, by just talking to me for a short time.
However, Viva the Adversarial Press
On the other hand, there is a critical need for those conversations that some agency officials --or the political administrations -- are not comfortable with.
And, frankly, a number of reporters think it’s those conversations that these rules were meant to control.
Uncensored, untracked conversations are necessary to prevent us all from being fed malarkey.
Remember, among other factors, the agencies will always want to look good and they will always be working for a political administration.
In addition to “untracked” conversations, “off-the-record” conversations are often absolutely indispensable to preventing the press and the public from being treated like stooges. If the current permission-to-speak rules had been in effect and adhered to in the early 1970s Watergate could not have been reported.
This is not a theoretical proposition for reporters, at all.
For example: Before the permission-to-speak system, one day I was on the phone with an agency staffer--an expert, the head of a program--for 30 minutes. The interview was not great but I had gotten my obligatory quotes and I was about to hang up. Then, just on a chance, I said, “Dr. XYZ, is there something you could tell me if your name weren’t attached to it?” At that point Dr. XYZ exploded with information. It was as if a klieg light had come on in a totally dark cave.
And everything he told me was “public information.” And it was confirmable. But not in a hundred years would a reporter or members of Congress have understood it without the help of an insider.
But that kind of guidance can be inconvenient or “not on-message” for the agency or the administration. Staffers have a keen sense of what the public message is and what they shouldn’t talk about when the agency is listening.
When I finally got off the phone with Dr. XYZ, I was shaken at the thought of the story I would have written had I not gone off the record. It would have been sterilized to the point of deception. And I was shaken at the question of whether my profession is worthy of any public trust at all. Is what I spew out so misleading that it’s worse than nothing at all? Does it just serve to lull the public into thinking that the official story has been confirmed and there’s no need to question further?
But this is not just about an occasional event, or uncovering dramatic scandals. It’s a constant, ongoing situation. Everyday, the conversations are more telling, vastly more educational when they happen away from the agency censorship process.
Something happened a couple years back that illustrated to me how much trouble we are in. An agency held a major media event to announce an initiative. But there was no initiative because there was nothing new, no new funding or new activity. This most certainly had to do with politics.
The media covered the event and gave it major play. No reporter understood the inside workings to question things that should have been obvious. No reporter could call staff without being tracked by the agency. And of the numerous staff people who understood the situation, no one tipped off a reporter, because they are forbidden to talk to us off the record and because staff people and reporters don’t know each other any more.
That story went unquestioned in the mainstream media.
The important thing to notice here is how confident agencies seem to be that they can just put out a story, control the information and nobody will talk to each other, even though dozens of people know better. The press is flying blind and full advantage is taken of that.
Dangerous to let people communicate?
Officials say you can’t allow just anybody to talk to the press. That’s dangerous. That’s not the official story.
It’s against most reporters’ standards and motivations to just talk to somebody or other and not confirm facts, not look elsewhere, not find out if they really have a story. Most of us are scared of looking like idiots when a better reporter gets the story straight.
Nevertheless, in an uncensored environment, bad things will happen. Some irresponsible reporters will talk to irresponsible staff members and irresponsible stories will come out.
Free speech, like democracy itself, is one of the messiest things ever thought of. The only reason we ever allow it, is that censorship is thousands of times worse.
Rather than allowing only a few insiders to understand what is going on, free press and free news gathering are the only chance the system has to correct itself.
FDA News Recently
Many of the news stories about FDA recently have not been good. The reports often are about part of the agency not working well, so that the public is endangered, or that the agency does not have the resources to work properly.
Having been around Washington for so long, there are a couple of things I know. For most stories like that, there were a number of staffers who understood the problem for years. And, some of those staffers would have laid out a map of the situation for a reporter, if they could have talked without the monitors listening. And from there, the reporter could have gotten a fair, balanced story by talking to a number of other people.
In this country, reporting is a major part of accountability for the whole system. And that’s been killed in these agencies.
And agencies are getting bolder about using this blockage. Recently an FDA public relations officer told me, “I decide if you can talk to him.” (I never got to talk to him.)
This committee’s charge is to look at FDA’s communication to the public. If the agency controls who the press can talk to and what the press is allowed to know, it’s keeping the public out.
The agency can spit out advisories, web materials, press releases and all kinds of materials. But if the press can’t freely make calls and be there to have “unofficialized” conversations, then the trust in the information, whether it’s about risk or about the agency itself, must be very limited