Atul Gawande on why the New Yorker is way more rigorous than academic journals

The newly launched health news outlet Stat just published a fun and wide-ranging interview with Atul Gawande, the surgeon and famed New Yorker writer. The whole thing is worth reading.

But one interesting moment comes when Rick Berke, the site's executive editor, asks Gawande what the most important and overlooked story in health care is today. Gawande replies that it's simply "what it’s like to actually try to get health care."

Not only are more Americans accessing the system through Obamacare than ever before, but he also points out that their experience is likely to be different — after all, the focus of the Affordable Care Act is to deliver outcomes-based health care. That means doctors and hospitals aren't simply compensated for delivering "pills and procedures," he notes, but they're compensated for how well those medical interventions work and whether they positively impact people's health. Gawande calls this a "dramatic transformation" in American medicine, and one that reporters are missing now.

Separately, Gawande argued that the fact-checking process at the New Yorker is actually more rigorous than that for publishing in academic journals:

The editing process in journalism, I think, sometimes offers better protection for the quality of the ideas and writing than our peer review process. At The New Yorker, they will not only look to see if I have references and sources for everything I say, they will look up the references and call the sources. And they will also search themselves to make sure I haven’t cherry-picked the information. It’s a much more rigorous process than the one I go through with my scientific work.

Now, it's true the New Yorker is an absolute standout when it comes to fact-checking. Newspapers generally aren't fact-checked, and most magazines aren't either. But it's also true that individual studies can be hugely flawed — both by design and through errors in the peer review process. It's one reason why the safest bet when evaluating medical research is to look at larger reviews and meta-analyses — over time, that cumulative process of reexamination should weed out errors.

You can read more about that problem here. And be sure to check out Stat for other fantastic health coverage while you're at it.

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