The Wall Street Journal columnist and leukemia survivor helps patients advocate for themselves
By Andy Koopmans
The Wall Street Journal recently ran a review of two new books by journalists with personal cancer experience: Clifton Leaf’s “The Truth in Small Doses” and George Johnson’s “The Cancer Chronicles.” The review was written by Laura Landro, a WSJ journalist who for more than the past decade has been writing a column for the paper, “The Informed Patient,” on the medical and health industries.
“The idea of the column is to give you what you need to know about what is happening in the health care system to get the best care and protect yourself from harm,” she said in an interview with “Petri Dish.”
Landro is uniquely qualified to write the column, not only as an experienced journalist and researcher but also as a cancer survivor. In 1991, when she was 37 years old and covering Hollywood and entertainment for WSJ, she was diagnosed with chronic myeloid leukemia and spent the next year in treatment, including receiving a life-saving bone-marrow transplant at Fred Hutchinson Cancer Research Center. Despite two recurrences, Landro’s leukemia went into remission, where it remains today.
Landro drew on the experience to write a number of essays and a book, “Survivor: Taking Control of Your Fight Against Cancer.” Later, she traded her Hollywood beat for her column, in which she helps her readers navigate the often-overwhelming abundance of information available to patients so that they can be best prepared to engage with their situation and advocate for themselves.
She considers self-education and self-advocacy extremely important in dealing with illness, particularly cancer: “It’s your life, and it’s up to you to save it,” she wrote in the introduction to her book.
Attaining the proper knowledge to get through cancer is not easy, she admits. “One of the greatest problems facing a cancer patient is trying to understand the medical research. I’ve been writing about and trying to understand cancer for 22 years and it’s still pretty mind boggling.”
One advantage new cancer patients have now that she didn’t when she was diagnosed was the Internet. “When I went through cancer treatment and even when I wrote my book, it was like the Dark Ages as far as the Internet is concerned. I was able to access a lot of the information because there was electronic retrieval I had through my newspaper, like Lexus/Nexus, but medical studies didn’t just pop up in a Google search and certainly you couldn’t go onto trusted sites like the NIH or Medline,” she said. “Patients are much better off now as far as information goes. They are much more likely to be active in their own care and more likely to participate and be compliant with treatment. In that way the information revolution has been a good thing.”
However, she noted that combing through the abundance of information to find reliable data is not easy. “It’s kind of a double-edged sword. All the information is available but it can be very difficult to sort through for the lay person and to make decisions based on that information for your specific situation,” she said. “And there’s so much outdated information, conflicting information, outright misinformation and pure snake oil out there, and sadly people will cling to it.”
Landro said that in addition to the information revolution, in recent years there has been a growing movement by patients and families to get the health industry to focus on and improve patient experience and treatment satisfaction, including giving patients more involvement in their care.
“You no longer have a barrier where the patient is helpless and not participating,” she said. “Patient- and family-centered care has taken root. Families can visit more and they can be present during consultation or procedures.”
Patient-satisfaction surveys have also become common since Medicare last year starting basing reimbursement in part on customer-satisfaction reports, Landro noted. “Hospitals are even using social media now to reach out to people and ask them, ‘How are we doing? Did the doctors and nurses communicate well and answer your questions?’ It’s not just ‘how do I feel about the food?’ or ‘was the area clean or was it noisy?’ but whether doctors and nurses communicated, whether discharge instructions were correct and whether the patient got the information they needed.”
Although she is a patient advocate, Landro said that she respects and sympathizes with doctors as well. “I have a unique view. I have enormous respect for modern medicine and research because I am a product of modern medicine,” she said. “Doctors have a very important job to do—they figure out what has to be done to treat the patient and get the patient to do what they think has to be done. If you’re a cancer doctor, you now have to talk to patients about alternative treatments. I don’t envy them their situation. It used to be you could say, ‘This needs to be done, this is what you do.’ Now you have to explain more. Sometimes patients come in with a thick paper stack of information downloaded off the Internet that you have to explain. You have to be prepared for that as a doctor,” she said.
Landro said that she is well aware of the less positive stories about medicine, but she tries to approach them constructively rather than spreading concern and fear. “I know there’s a lot of negative, terrible stories about fraud and malpractice and errors and all that, but when I write, what I’m looking for in the story is what is being done to fix the problems. Whether it’s misdiagnosis or medical error or patient safety — I don’t want to write a story that just makes people afraid. I want to write about how people are working to fix that or improve that. I want to write about what you need to know as a patient so problems won’t happen to you,” she said.