As “the Great Resignation” continues and more people in the U.S. quit their jobs—4.2 million in October alone—there are two professions in particular where employees are walking away for surprisingly similar reasons, and at record pace: health care and journalism.
Though these fields are not typically thought to have much in common, they share common purposes, goals, and practices. Both are what we call narrative professions that deal in information—gathering, synthesizing, and presenting it—ultimately for the purpose of enabling people to make the best decisions possible. Both are inherently social, requiring investigative listening and correspondence alongside reporting, checking, and considering facts. Their work depends on connections between professionals, the public, and reality built on trust and accuracy.
Most importantly, journalism and medicine serve higher purposes than simply providing products and services. At their best, they keep the public informed and healthy.
Yet, for these professions to be at their best, they must first and foremost maintain public trust. Unfortunately, many people do not trust medical expertise, nor do they trust journalists. Accordingly, they really do not trust journalism centered on medical expertise.
The result is a society that is unsettlingly ill-informed and unnecessarily ill. More than 800,000 people have died from the coronavirus in the U.S., and recent research has found that unvaccinated people are 11 times more likely to die from COVID-19 than those who are fully vaccinated. It’s no exaggeration to say that people are dying due to their distrust of either medicine, journalism, or both.
Doctors and journalists have noticed. Doctors who have left clinical care describe facing moral distress, stemming in part from their desire to serve a public that increasingly distrusts their guidance. Journalism is seeing a similar exodus of reporters, many of whom describe experiencing higher levels of stress, anxiety, and depression as they work to cover the news of the day in the face of widespread public distrust and harassment.
The distress that journalists and physicians feel is not only the result of their frayed relationship with the public, but their limited options when it comes to improving it. Whereas doctors used to own health systems, now they are “knowledge workers” with reduced power of organizational decision-making. Hospitals are increasingly privatized, and corporate entities now own nearly half of physician practices, making it next to impossible for community doctors to exist at all. Meanwhile, clinical time with patients has steadily decreased, and what little time remains is increasingly diverted away from the patients to electronic record keeping.
A similar phenomenon has played out in journalism. Newsrooms once run by people invested in the production of quality journalism now increasingly fall into the hands of hedge funds where they face short-sighted layoffs and buyouts. These cuts have been especially brutal for local news outlets, meaning many communities throughout the country do not have local journalists they can turn to for local coverage, eliminating a key bond between journalism and the public—as well as between neighbors within communities that lack the connective tissue that comes from knowing their own news.
In other words, journalists and doctors once had decision-making power in the structures and incentives that governed their work. Now those structures are primarily outside of their control, while new incentives lead to behavior that further chips away at public trust.
What’s important to understand about the narrative professions is that they depend on social and relational practices to ensure the accuracy of information and its interpretation. We call this relational accuracy: the phenomenon where quality information is not in the head of any one individual, but what emerges from the exchanges between the people within these relationships. Unfortunately, the structures that comprise health care and journalism have diminished the time necessary for relational accuracy to exist. Although each of these professions is public-centered, neither journalists nor doctors have the time and resources necessary to meaningfully think about and interact with the public.
As a result, doctors and journalists face two sources of acute frustration: 1) They have an antagonistic relationship with the people they seek to serve, and 2) while most want to improve that relationship, they simply don’t have the means to do so.
It’s not a lack of will, but a lack of resources and incentives for them to act on it.
Ending this crisis within both journalism and medicine begins with recognizing that the structures comprising our healthcare and information systems leave doctors and journalists ill-equipped to accurately recognize and represent the complexities of human health or of truth.
The next step is to imagine not only what news and medicine could look like were they operating in full service to their purpose, but the changes that would result. For instance, what if insurance architectures did not polarize patients and doctors by protecting each from the other, but rather recognized the relationship between them as a generator of knowledge and healing, and further protected it? What if—and we know this is ambitious!—more newsrooms were primarily audience- or even taxpayer- supported, so journalists had an economic incentive to create news from a place of partnership with the public? What if more states followed the leadership of the New Jersey governor, who, scaffolding off of the tax credits for employing local journalists included in the Build Back Better bill, recently signed off on a state budget that set aside $1 million for local news and information initiatives? What if Congress considered that a majority of Americans now support a single government program to provide health care coverage and made that a reality? These are just a few examples of the ways that information and health care structures can—and should— transform so that they prioritize common sense-making and common health over shareholder profit.
The Great Resignation within medicine and journalism, as well as the crises of misinformation and vaccine hesitancy among the public—these are the consequences of a society where trust in its most public-centered domains is increasingly absent.
Relational work is not only the stuff of medicine and journalism’s most rewarding moments. It is also the likeliest process by which journalists, doctors, and the public, will restore the agency and understanding necessary to create that trust, which is the bedrock to the knowledge and health of a flourishing society. Recognizing—rather than erasing—its fundamental role is the first step.