Josh Goldstein, Philadelphia Inquirer Reporter

by Rachel Resnick

The speaker at our 58th Annual Business Meeting and Reception was JoshGoldstein.  Mr. Goldstein is a health and science reporter at

Josh Goldstein

The Philadelphia Inquirer, covering health care quality, clinical care, and hospitals. He has developed computer databases that have enabled him to do sophisticated analyses of health care trends and quality of delivery.  He previously covered the business of health as a member of The Inquirer’s business department, writing extensively about Pennsylvania’s malpractice insurance crisis. He was part of an award-winning team that reported on the decline and bankruptcy of the Allegheny Health System, at the time the largest nonprofit health care bankruptcy in the country.  The topic of his presentation was how broader access and use of the internet has impacted and changed the use of health information.

Mr. Goldstein likened the changes in information access due to the proliferation of blogs to the changes in health information access due to all of the healthcare sites that now populate the World Wide Web.  But he lamented the lack of information literacy and health information literacy, stating that there was no “adult supervision,” no help for the average lay person at the point of information access to enable them to interpret the information that they find, and no added value such as is provided by information professionals like journalists and librarians.  He provided examples from his own life and from a newspaper article he was currently writing to illustrate his point.  He did stipulate that there are some sites that do provide such “supervision,” such as WebMD, HealthCentral.com, the Merck Manual online, and the Mayo Clinic.  But many lay people are unaware of the existence of these sites, and automatically start with “unsupervised” sites or search engines, like Google.

Mr. Goldstein also talked about the many medical journals he and his colleagues read every day in order to pick out those stories that they think will be helpful to the average person.  He mentioned the public accessibility of many journal articles after six months, but pointed out that accessibility did not necessarily indicate quality or meaningfulness or significance. He also lamented the problem of researchers and physicians who write about specific drug therapies or devices and who also have a financial interest in them; that these conflicts of interest are not always divulged, and that whistleblowers are sometimes punished for bringing these conflicts to light.  Because of this, many lay people are not aware of these conflicts; additionally, many do not recognize the significance of such conflicts because there often is no one to explain it to them.

Mr. Goldstein concluded his presentation by describing the different types of data that are available in order to provide information about healthcare quality among medical providers.  For example, data are available that indicate how many of various types of procedures are performed at area hospitals and whether the outcomes at those hospitals is above, at, or below the national average.  Comparison sites also provide information about the results of satisfaction surveys or cost research.  However, this “information transparency” doesn’t go far enough in helping the lay person interpret or infer quality; and often statistics don’t explain or account for the doctors who take the hardest cases, and who therefore might have worse overall mortality rates than other doctors.  The need for interpretation of data, of research results, of journal articles is still there, and information professionals such as journalists and librarians bring to the table the added value of their expertise in helping inform the public.