For the 106th episode of the Journalism History podcast, hosted by Ken Ward, researcher Ulf Jonas Bjork explains the criticism voiced in medical journals against reporters, advertisers and the newspaper industry in the late 1800s and early 1900s.
Ulf Jonas Bjork is a professor of journalism and public relations at Indiana University–Purdue University Indianapolis. He is the author of “Newspaper Medicine: Medical Journals Attack the Press, 1898-1909” in the Summer 2022 issue of Journalism History.
Featured image: Louis Dalrymple, “The Age of Drugs,” Puck, Oct. 10, 1900, Library of Congress Prints and Photographs Division.
Ulf Jonas Bjork: These medicines do nothing, yet newspaper publishers keep running them, and that really is a sign of corruption.
Ken Ward: Welcome to Journalism History, a podcast that rips out the pages of your history books to reexamine the stories you thought you knew and the ones you were never told.
Teri Finneman: I’m Teri Finneman, and I research media coverage of women in politics.
Nick Hirshon: And I’m Nick Hirshon, and I research the history of New York Sports.
Ken Ward: And I’m Ken Ward, and I research the journalism history of the Great Plains and Rocky Mountains.
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The COVID pandemic has given media researchers a lot to consider. There’s just so much to explore, from analyses of those early White House press conferences to ongoing efforts to persuade more people to get immunized, and naturally we historians are also looking to the past, looking at things like past pandemics to contextualize what we’ve seen in the media, and what we might see as the pandemic continues to evolve.
All of this throws into the spotlight the sometimes fraught relationship between the media and medical professionals. Both groups need one another. The media relies on newsworthy events for content, and medical professionals want to communicate with the media’s audiences. But even when both sides are doing their best work, they’re working to their own ends, sometimes with conflicting priorities. With me today is Ulf Jonas Bjork, professor of journalism and public relations at Indiana University—Purdue University Indianapolis.
He explains how the tension between these two groups rose to a boil in the late 1800s and early 1900s when medical journals began harshly criticizing the newspaper industry and their pages. Jonas, welcome to the show. Now, before we dig into your article, tell us how did you get into researching such an interesting and specific topic as this criticism of newspapers in medical journals?
Ulf Jonas Bjork: Well, I think it started when I was looking into — or I came across proceedings of social workers and public health officials from the early 1910s, where they were discussing quite specific tactics for using newspapers as a channel to the public, and at some point I decided to also look at medical journals to see whether this kind of discussion could be found there.
Instead, I found this rather virulent criticism of newspapers, and the further back I went — I looked back about 10, 15 years — it got even more intense, and that did intrigue me, I suppose, also in my own experience as a radio reporter. I personally on occasion would encounter members of the medical profession who were very, very skeptical about potential stories that I was covering. So I suppose that resonated somewhat with me as well.
Ken Ward: That’s really interesting, and maybe later on we should talk about that difference between those — sounds like two groups, social workers and — and folks in that sphere versus medical professionals, and both kind of in that public health space, but maybe with a different attitude towards newspapers. But that’s probably getting ahead of ourselves. Um, tell — tell me a little bit about medical journals, like what did these early medical journals look like here in the 1800s, and we —
— transition into the 1900s, and — and their growth throughout that area? What — what do these journals include, how did that get started?
Ulf Jonas Bjork: Well, obviously they were there to serve doctors, and you can find them really from the earliest days of the Republic. The period I’m looking at sees quite a rapid growth. I went back to publication directories in 1901, which is sort of in the middle perhaps of the period I’m looking at here. There were 121 of them. Four year later — four years later, they had — there were 183. So a substantial growth during the era I’m looking at here and they had a somewhat challenging purpose. They obviously served physicians in all works of life — or walks of life who were spread across the country.
They were also supposed to bring innovations, scientific discoveries, and sometimes they did find that, I think, difficult to balance, trying to find who their audience was. But clearly this was a growing field in the era I’m looking at here. I think one thing that was happening — the early medical journals tended to be for-profit enterprises. They were supported by advertising. They were often started by private individuals. In the era I’m looking at, you begin to see those not necessarily being replaced, but certainly being challenged or supplemented, whatever term you want to use, by a kind of medical journal I think we see today, which is associated with a medical society, typically on the state level, although the flag— flagship of course is the Journal of the American Medical Association, which has been around for a long time.
But these are then less profit driven, or not profit driven at all, and they tended to be quite skeptical. Editors of those state or medical society journals tended to be quite skeptical of these older for-profit journals, which are kind of fun to read because sometimes they almost read like penny press publishers. They boast about how much better they are than their competitors, and how they did not cheat by reading just abstracts of a conference, but actually sent a reporter or somebody at least who recorded what was going on. It was at the session, and therefore that you should read them because they had superior coverage of what went on.
Ken Ward: That’s interesting. How did they — you said they’re for-profit. How did they sustain themselves? Is it a subscription thing, ads? How do they make their money?
Ulf Jonas Bjork: They had a fair amount of advertising, which in itself was somewhat problematic.
This is something that the medical society journals stayed away from, to a large extent, and that was one of their criticisms, saying “Well, you’re taking advertising.” “Well, who are you taking it from?” “Well, obviously from drug manufacturers and others, medical equipment makers.” Can you really be professional if that is such a main source of revenue and sometimes you see exactly the same kind of appeal subscribers have found in small town newspapers saying, “Please pay your subscriptions. We are on the brink of ruin here, and we really need your financial support.”
Ken Ward: It’s interesting. So — so take us then to when this criticism starts in — in these medical journals. When does that criticism occur? What does it look like, and — and what did the medical profession look like at this point? You know, I’m pretty sure that the — the vision in my head of what a doctor might look like is not at all what a doctor actually looked like in this era. So what did the profession look like during this time?
Ulf Jonas Bjork: Oh, that’s a very good question. This starts in the 1890s. I looked before then. I’s fairly simple to do that. They have meticulous indexes at the end of each volume for each year, and I found nothing about newspapers or journalisms, say, in the late 1880s. But then it starts in the 1890s, and one reason I think has to do with the status of the medical profession, which was quite low in those days. Uh, I think one reason was that there were fewer doctors, and so people perhaps had to fend for themselves when it came to medicine, but it was also a matter of very low educational standards. It was pretty simple to start a medical college with very few credentials. Licensing laws were very lax, if they existed at all, on the state level.
And people, I think, generally mistrusted doctors. We’re of course talking about an era before antibiotics, really before a great deal of scientific background medicine has today. So it was quite easy, I think, to call yourself a doctor, say, in the 1890s, and I think the public sensed that, and there was a great deal of mistrust, and this was then often reflected in general interest newspapers and that is, I think, what drives this criticism, why it really takes hold in the 1890s and carries into the first decade of the 1900s.
Ken Ward: And so what is it that they were so critical of? Did — are — is medicine represented frequently in — in newspapers in this time, and if so, like what is it that these medical professionals are seeing in the popular press that — that fires them up so much?
Ulf Jonas Bjork: Well, it’s something that we perhaps as journalism historians associated with the muckraking era, and that is, of course, the abundance of patent medicines that you can find in newspapers from that time, and not just in yellow journalism newspapers, but really as I’ve found in small town papers as well. This was a main source of revenue. It’s been argued that this is really the first national brand advertising or patent medicines, and it goes back to the idea that you may not have access to a doctor, you may distrust a doctor, here are all these miracle medicines that promise to cure pretty much anything. I read through those, and sometimes I get associations to infomercials on late night TV today. They tend to promise all sorts of cures or what turned up during the pandemic here in terms of cures for COVID. You go back more than 100 years to late 1890s, and you’ll find these patent medicine ads everywhere.
And of course, they are problematic for doctors because they encroached on their professional field. Why go to a doctor if you can order some miraculous elixir that will cure whatever you have? Uh, and the criticism then spilled over, and they sort of said “Well, this is totally bogus in terms of medicine. These medicines do nothing, yet newspaper publishers keep running them” and that really is a sign of corruption, and if they opt to run these patent medicine ads, that taints the entire enterprise. Why should you trust what they report in the news when they are so venal that they actually take money from these patent medicine manufacturers? So that is really I think their primary target. It’s not the only one. They also very much distrusted the news itself.
I said earlier about how my experience with doctors several decades back was that they were quite skeptical of journalists and that is something you find all the time, that reporters were ignorant or uninformed, they couldn’t grasp the essence of medicine. On top of that, they were driven by sensationalism, so they tended to focus on miraculous breakthroughs, and doctors often said in their criticism “Well, that’s not how science work. It’s not a fantastic breakthrough. It may happen now and then, but it is not really what happens typically.” They would also do fantastical stories of miraculous cures, and all of that is a target of those who write for these medical journals.
Ken Ward: Yeah, there was an example in your article that I thought was really interesting. It dealt with — there was like a — an influenza outbreak in Boston in 1902 or something like that.
What was it that — like why — why would coverage of that be so problematic for a medical professional?
Ulf Jonas Bjork: Well, we’ve kind of seen — it’s strange, we talk about influenza more than 100 years ago, and we find ourselves in the same situation, and can relate much better than we could say 10 or 5 years ago. [Laughter] Uh, they often felt that either the newspapers downplayed it, but it was serious, or they sensationalized it and made it worse than it was. And I think behind that is a general sense among medical professionals that really the lay public and the lay public’s newspapers shouldn’t meddle with this. They just scare the public, or they somehow plant a false sense of security, and they really should stay away from reporting this, which is very odd of course. We cannot report — stay away from something that is a news story.
Ken Ward: [Laughs]
Ulf Jonas Bjork: But that tended to be the attitude here. “Do not deal with medicine. We are the professionals. It’s our field.”
Ken Ward: Well, and that brings up an interesting point. One thing I wondered as — as I read your article that I wanted to ask you about is how much of this — how much of that attitude that medical professionals were expressing through these — these medical journals, how much do you think that was specific to the medical profession, and how much of it is just professionals who feel like they know so much more about a topic, and therefore can pick out every little thing that’s — that’s, you know, poorly represented in a story, for instance. How much of this is unique to medical professionals, and how much of it is just professionalism at large?
Ulf Jonas Bjork: I think it’s a mixture of the — specifically — of course, the examples I cite here deal with medicine, but we also have, of course, medicine and law being two established professions, even if they had some issues back in the 1890s or around 1900.
And we sometimes talk about journalism as a profession, and we can argue whether it is a profession in the sense of medicine and law, or whether it isn’t, but certainly what comes through back then is, I think as you suggest, a skepticism of this group of reporters. They are not professional men. They don’t have an education. They don’t have a body of knowledge that is generally agreed on, and they’re not like doctors, or for that matter, lawyers. They’re not autonomous. They work for these huge newspaper enterprises, these corporations, and they have to do what they’re told. They don’t have the judgment to say, “This is not correct” or “This is not a story that we should publish.” They have to submit it to an editor. So they have no authority over what they create, in a sense.
Ken Ward: Gotcha. So how — how much of all of this is the press responsible for? You know, you talked about how beleaguered medical professionals felt because of sort of professional issues mostly. Did any of that public conception of — of medical professionals, sort of doctors being low on — on the — you know, being seen as less than other professionals or — or not having a great deal of credibility had — had coverage in the press been responsible for any of that or maybe did medical professionals perceive that to be the case? Was that part of their problem with the media as well?
Ulf Jonas Bjork: I think there were stories that are cited in the medical journals that claim that they are an attack on doctors. They bring up people who are shady, to use the term they actually used in these medical journals, and somehow present them as doctors.
And it’s a very complicated relationship because the standard at the time was that if you are a physician, you do not promote yourself. You really cannot advertise. And so one attack was — I think many of us have encountered this, the so-called reading notices that looked like news stories, but at the end as you read them, you realize that you actually just read an ad. There’s like a product at the very end of it. And often they said these reading notices, these are what quacks — to use the term they often use — use, and they promote themselves, and newspapers are complicit in doing this. So for the medical profession, it was also a matter of somehow drawing boundaries within the profession. Who is a doctor, who has the right to call him, for the most part —
a doctor at this time, and who are the people who are pretending to be doctors who are the quacks? Well, one way of finding out, some said, is if you advertise it. If you promote yourself, you are not a professional. You are not a doctor, as a doctor should behave.
Ken Ward: It raises an interesting question, or these medical professionals do, on a couple fronts, but it’s the same question, which to me is — so what is to be done about it, right? So we could take the case of the patent medicine advertising, and other types of advertising as well that we haven’t talked about, in newspapers, what was the solution that doctors or other medical professionals saw to that problem, the problem of patent medicines? Were newspapers just not supposed to take this type of advertising? Is that what they were really asking for, or pushing for? Uh, and I guess the conversation among themselves in these medical journals.
Ulf Jonas Bjork: No, I think it was pretty unanimous that patent medicines were harmful, they promised fake cures, and they should really go, and you find actually approving letters and articles in medical journals, because, of course, patent medicine’s become one of the targets of muckraking when that starts in the early 1900s, and that was very much approved, but the solution clearly was this — patent medicines ads have to go. They are doing a great deal of harm to the public and, of course, to the field of medicine to some extent.
Ken Ward: Sure.
Ulf Jonas Bjork: So that was one — one aspect. Toward the end of the time I’m looking at here, you begin to see more and more articles in medical journals recognizing that newspapers can be very useful … one investigative story somewhere in the Midwest exposed quacks in one —
— specific city, and had gone undercover, and had been promised all sorts of cures, which turned out to be fake, and this is something that medical journals heartily approved of, exposed these people who are not — who are fake doctors, if you will.
Ken Ward: Mm-hmm. So what — that brings up this other side. You know, what — the answer to these advertisements [is] just don’t have the advertising, what is the relationship between medicine and the popular press supposed to look like? If — if they’re concerned about all of these stories about newsworthy events, right — they’re “Oh, we — we don’t like this coverage of this flu outbreak” or something like that, like what — what should that relationship look like? What consensus did they come to in terms of their relationship with newspapers?
Ulf Jonas Bjork: Eventually they realized — someone said — the power of the press and, of course, this is kinda what I started talking a little bit about the public health movement, which begins to take off in the early 1900s —
— really, of course, is all about reaching the public with medical information, with medical advice, and more and more doctors began to realize, “Yeah, we may not like the press all that much. We may still think that reporters don’t understand medicine, but we need this channel to the public. We have to accommodate.” And they try various schemes. It’s very problematic still to be in a news story. One county medical society had a thing where if somebody who was a member appeared in a newspaper story, he would have to explain himself. “How did that happen? Did you do this to promote yourself, or did you just happen to be approached by a reporter?” Which you shouldn’t have — answer, but the other solution I have is to say, “Okay, we won’t do this on an individual basis, but our society will have a publicity bureau, or you can contact the society if you want medical information.”
So it’s a recognition of the power of the press, which changes from the idea that, “Oh, we should not deal with newspapers at all. We shouldn’t deal with reporters at all” to realizing that this is an extremely important communication channel, and we can’t ignore that if we want to educate the public about medicine. We have to put away whatever doubts we might have about the honesty or the knowledge of reporters, and even the motives of newspapers. But before that, patent medicines have to go.
Ken Ward: Sure. [Laughs] You note in your paper that all of this criticism in the medical journals kinda seems to taper off around 1910. Why was it that this fight kinda petered out? Was it this realization that you’re just now talk — or what you’re talking about here that there needed to be more interaction, and that led to a decrease in this criticism?
Ulf Jonas Bjork: Yeah, it’s — I think it’s certainly that. Uh, even — or as important is that the status of the medical profession is rising around that time. The American Medical Association, which had been around for a long time, but had been somewhat disorganized became much better at lobbying, particularly in Washington. State medical societies become much more organized in pushing state legislatures for better licensing laws. Educational standards are — we begin to see the establishment of medical schools that have an academic emphasis often connected to universities. The Indiana University School of Medicine was founded in 1903, and this happens all over the country. So this factor had been driving some of the criticism, the idea that we are under siege.
We are a beleaguered profession — I think begins to ease around this time because of all these changes, that now doctors are rising in public estimation. Their status is much more secure, and of course, you can also say that this is when the era of new journalism, or yellow journalism, or whatever you want to call it, begins to ebb as well. We have — and we have muckraking, of course, which shows that journalism can take up social causes and be more responsible. So I think it’s a number of things that come together around 1910.
Ken Ward: Hmm. Can we see any vestiges of this fight here in the present? You know, is there — are we still feeling the impact of this battle early on? Did it have a lasting impact on — on this relationship between the medical profession and the press?
Ulf Jonas Bjork: I think some of the skepticism that doctors have toward journalism survives.
As I said, I encountered it in my career early on. Uh, we have, of course, the drive of health communication, the idea that it’s very important to reach the public. So I think the idea that you use media channels to get medical information out is very important. I think we — so an example of that, during the pandemic, press conferences and so on from health officials, I think perhaps that there has been an attempt — part of the media or the press, whatever you want to call it, to actually gain some expertise. Medicine becomes a beat where you have to have a certain background, and — and understanding and I think, of course, in many ways, of course, journalism, not always perhaps, is more responsible than it was in the 1890s.
Ken Ward: Sure.
Ulf Jonas Bjork: We have stricter standards of objectivity, and factuality, or whatever you want to call it, that perhaps didn’t exist in the same extent when we go back 130 years.
Ken Ward: Sure. Well, our time is running short, but I do want to ask you one last question, and it’s a question that we ask all of our guests on the show, and that is why does journalism history matter?
Ulf Jonas Bjork: I put that in my syllabus whenever I teach our journalism history course and it matters, I tell my students and, of course, believe myself because it does show us where came from, that where we are today is a product of what happened in the past. I just had a discussion with a friend, and he talked about the founding fathers and the First Amendment, and we came in on the sideline saying, well, yes, clearly they believed in freedom of expression, but it was also a practical —
— aspect to this, that they needed a way to reach voters in this huge Republic in order to be able to govern and to conduct elections, and therefore it is not somehow the First Amendment just being handed down. It is a product of its time, and I always also say, “You think we are partisan now, you should have seen the early years or decades of the Republic.”
Ken Ward: [Laughs]
Ulf Jonas Bjork: Not even George Washington escaped severe criticism. So understanding that, I think, is crucial. Even if, as I often hear — why have journalism history at all? Reporters, well, you understand your field, and you understand where the standards came from, and — and conventions, and all that sort of thing, and for that you have to look back at the past.
Ken Ward: Absolutely. Well, Jonas, that’s all the time that we have for today, but thank you very much for being on the show.
I enjoyed our conversation.
Ulf Jonas Bjork: Thank you.
Ken Ward: Well, that’s it for this episode. Thank you for tuning in, and be sure to subscribe to our podcast. You can also follow us on Twitter @JHistoryJournal, that’s all one word. Until next time, I’m your host, Ken Ward, signing off with the words of Edward R. Murrow “Good night and good luck.”