LIKE OTHER PROFESSIONAL and technical people, most physicians want nothing to do with the mass media. Some have seen their own research garbled by journalists; many have watched a colleague lose professional stature (and much-needed sleep) by becoming embroiled in a public controversy; nearly all have noted with scorn the errors, omissions, and misrepresentations in medical news and medical entertainment. A doctor seemingly has much to lose and little to gain by dabbling in the mass communication business.
Besides, reasons the typical physician, mass communication is as much a specialized field as medicine. It’s too bad that journalists and entertainers sometimes try to practice medicine, but that’s no reason for doctors to return the favor. The quality of medical content in the mass media, deplorable though it may sometimes be, is a matter for media professionals to deal with. Medical professionals wouldn’t know how and are better off not trying. (Note 1)
I want to dispute the foregoing chain of reasoning. I shall argue that it is both feasible and desirable for physicians – individually and collectively – to try to influence the medical content of the media.
Few people today deny that the mass media have an important influence on the attitudes and actions of their audience. The typical American visits a doctor several times a year. The same American reads a medical article in a newspaper or magazine several times a month; he or she watches a TV show featuring a medical problem several times a week, and may well encounter medical advertising several times a day. The impact of this constant exposure is profound. What medication do your patients use when they have a cold? How worried are they about cholesterol, and how has the worry affected their diet? Do they know the early signs of cancer? What are their views on megavitamins, on national health insurance, on partial mastectomy, on paramedical personnel, on malpractice suits, on “pulling the plug”? Inevitably the answers to these questions depend more on the content of the media than on the conduct of your practice.
Yet they affect your practice. The question we must answer is not whether the mass media significantly influence the medical attitudes and behavior of their audience, and thus the health of your patients and the future of medicine. We know they do. The question is what can doctors do about it. To answer this question, we must first look at the nature of media impact.
Media lmpact (Note 2)
People have thought about the effects of communication on attitudes and behavior at least since the time of Aristotle. And the special power of mass communication to change the way we think, feel, and behave has been a source of concern since the invention of the printing press. But the modern science of communication research emerged only in the 1930s. Its most important finding so far is a negative one: the mass media are very seldom able to convert their audience from one strongly held position to another.
Why? For one thing, the profit-oriented media rarely try. But there is a more fundamental explanation. The audience is an active participant in the communication process. We are not sponges who soak up everything the media throw at us; we choose our media diet, and we do so on the basis of our own goals, needs, and motivations. People use the media for fun, for passing the time, for information, for reassurance, sometimes even for guidance – but not, as a rule, for getting converted. When media content threatens our established viewpoints, we are free to avoid it, ignore it, misunderstand it, or forget it. We can even dispute it, seeking out competing media content or interpersonal support from our friends and colleagues.
These defenses are usually sufficient to insulate the audience from intentional media advocacy: from newspaper editorials or political advertising, for example. Of course advocacy in the media has a variety of effects on supporters and the uncommitted; we will turn to these effects shortly. But it is seldom powerful enough to convert one’s opponents. Patty Hearst did not become a revolutionary by reading S.L.A. pamphlets.
If this is true of intentional advocacy, it is all the more true of media news and entertainment, neither of which is even trying to convert the audience. It is especially important to acknowledge the inability of news to effect conversions, because so many campaigns of health-related persuasion rely on the principal component of news: raw information. Probably the most pernicious myth among amateur advocates is the stubborn, rationalistic conviction that new information leads to attitude change, which in turn leads to behavior change. Again and again, empirical studies have found very low intercorrelations among these three variables. Even when the audience is initially neutral, the causal links between information and attitude and between attitude and behavior are weak and unreliable. When the audience is predisposed against your position, these links are virtually nonexistent.
Confronted with a piece of information that conflicts with pre-existing attitudes, the audience usually ignores or distorts it, thus avoiding the conflict. And if this is impossible, the audience will usually manage to tolerate the inconsistency rather than change the established attitude. The new information is simply stored separately from the old attitude; behavior remains determined by the latter and unaffected by the former. In this sense we are all accomplished “still-thinkers,” capable of responding to discrepant information with the complacently anti-intellectual rejoinder, “I still think…”
Similarly, most people are quite capable of embracing attitudes that are inconsistent with their behavior without changing the behavior (consider attitudes and behavior with respect to smoking, for example). If forced to choose between the two – a difficult communication job in itself – we will abandon the attitude before the behavior; people are more committed to what they do than to what they think. For a new attitude to be easily translated into behavior, then, there must be no established behavior pattern to overcome. And the new attitude must have developed in a context that is real and immediate. But the abstraction of newsprint and the miniaturization of television are the antithesis of immediacy. The media “mediate” messages, creating a secondhand reality to which we respond as observers, not participants. (Note 3)
Anyone who wishes to influence people by means of mass communication, then, must first abandon the notion of rational conversion through information in the media. If the media affect people – and they do – it must be through meeting their needs and fulfilling their goals, through reinforcement, not through conversion. This is the fundamental law of communication: you reach people by offering them something they want. Consider the following examples of change through reinforcement.
1. Need manipulation
When a communication promises that a particular behavior will help satisfy a particular need, those in the audience who feel that need most strongly are likely to give the prescribed behavior a try. Much of modern advertising is predicated on this simple phenomenon. Does Ultra Brite really give you sex appeal? Most people don’t think so, but in a society preoccupied with sexual success there will always be plenty of us willing to ignore our own skepticism and try a tube or two.
Of course a message has greater credibility if the connection it postulates between need and behavior is genuine or at least conceivable. But the success of Ultra Brite establishes that this is not essential. It is the strength of the need, not its relevance to the recommended behavior, that determines its motivational power. Thus many successful drug advertisements go beyond the promise of “prompt relief” (which is relevant if not always true) to suggest more fanciful ties between the product and audience needs. Celebrity endorsements, for example, imply a tie to fame and success; scenes of tender nursing by one’s spouse imply a tie to love and nurturance.
Need manipulation raises serious ethical issues, of course, especially when there is no logical relation between the need and the behavior being urged. Nonetheless, it is a successful strategy that deserves the consideration of would-be advocates. (Note 4) And when the behavior you are trying to promote can genuinely fulfill a strong audience need, such as the need for good health, it would be foolish not to stress the relationship.
2. Salience manipulation
The mass media are very proficient at applying existing audience attitudes to new circumstances, suggesting a new behavior or a new evaluation of some event or issue without any change in attitude. This is a major function of news. News of the Watergate scandals, for example, didn’t make people any more opposed to political corruption than they already were, but it did focus that opposition on the behavior of Richard Nixon. Manipulating the salience of an existing attitude is a great deal easier than creating a new attitude.
In the fluoridation debate, for example, opponents of fluoridation have gained substantial ground in recent years by redefining the issue as “fluoride pollution.” Public disapproval of chemical pollutants in the water supply thus becomes a salient attitude in evaluating the fluoridation controversy. Similarly, medical information about the relation between diet and coronary disease probably doesn’t make many people more concerned about their hearts. But for those who are already concerned, it helps to focus their concern on dietary decisions.
In any hotly debated or strongly felt controversy, people look to the media for fresh arguments supporting their side. That’s why Republicans listen carefully to the words of Republican candidates, and why recent Pinto purchasers pay close attention to Pinto ads. Suppose most of the news about a local school bond issue happens to favor the supporters. Even if no opponents are converted by the news imbalance, the supporters will be much more likely to speak up in conversations with their friends and to vote on election day. Lacking this reinforcement, opponents of the bond issue are more likely to keep quiet and forget to vote.
Like most political disputes, the battle over national health insurance has been fought chiefly through rival efforts to provide ammunition to supporters. Few adults have changed their minds about “socialized medicine” in the past few decades, but many have been influenced by competing persuasion campaigns to become more (or less) active on behalf of their positions. If there is a trend toward more comprehensive health insurance programs in the country today, it is probably not because more people want them, but because people want them more.
Besides supplying ammunition to one’s supporters in public controversies, the media can also provide a sort of intrapsychic ammunition for more personal commitments. Suppose a patient has at last decided to follow his or her physician’s advice to lose weight, quit smoking, or exercise more regularly. The likelihood of that patient’s remaining on the prescribed regimen will depend very largely on the availability of reinforcement. Repeated messages that the new behavior is indeed healthful and that many people have adopted it successfully are invaluable in keeping the patient going. Such messages can be viewed as offering the patient ammunition favoring one side of an internal dialogue. The media are a very efficient vehicle for providing this ammunition.
4. Legitimation, agenda-setting, and modeling
Most people are uncomfortable doing and believing things for which they have no “good reason.” We therefore use the media to legitimate our actions and attitudes: to provide information that makes sense of our personal commitments and examples of high-status or sympathetic people who share those commitments. By legitimating our actions and attitudes, of course, the media in effect strengthen them. Many opponents of the war in Vietnam, for example, were exceedingly tentative about their opposition until media criticism of the war made it seem more acceptable.
Although the media can seldom tell us what to think, they constantly tell us what to think about. Any event given major play in the media becomes by definition a major event: something to think about, talk about, and reach an opinion about. Conversely, if the news media ignore an event, then it cannot be news in the minds of the audience. This agenda-setting function is not confined to news. When movies and TV shows began dealing with women’s liberation, for example, moviegoers and TV viewers had to begin dealing with it too.
Besides legitimating our commitments and suggesting new issues to think about, the media often provide us with sympathetic examples of people and behaviors we can feel good about copying. We imitate the posture and vocabulary of our media heroes, as well as their styles of dealing with people and situations. And not all of our media models are socially acceptable. In the early 1970s, scores of airplane hijackers learned from the media a new way to act out their hostility or their alienation. The media didn’t make them hostile or alienated, but through modeling the media did make them hijackers.
Legitimation, agenda-setting, and modeling are three distinct avenues of mass-media influence, but quite often they act in concert. Consider the issue of abortion. Media attention to abortion in recent years has put the topic on people’s agendas to think about; it is virtually a cultural imperative today to have some opinion about abortion. What had previously been a forbidden option became legitimate to consider and even to advocate. And on countless soap operas and prime-time entertainment programs, familiar and attractive characters – worthy of modeling – chose abortion right in the viewer’s livingroom. Even this triple blow failed to convert many proponents of the “right to life.” But it gave enormous support to those who were tentatively considering liberalized abortion laws as a policy preference or abortion itself as a personal choice.
5. Cultural norms
On topics about which people have no strongly developed attitudes in any direction, media content often determines and disseminates the cultural norms that will influence our behavior. How argumentative, how flirtatious, and how drunk can you be at a party and still remain within the bounds of good taste? When is an adolescent old enough to stay out all night? What is the proper attitude to hold toward Communist China, extramarital sex, and cheating on one’s income tax? How often should you wax your car? Principally in entertainment content, but also in news and advertising, the media suggest answers to these sorts of questions, helping to create and transmit national norms and a national culture.
“Doctor shows” have been a staple of television entertainment almost since its beginnings. One generation of patients and doctors grew up with Ben Casey and Dr. Kildare. Another generation is growing up with Marcus Welby and Joe Gannon. What sorts of norms about medicine are disseminated by these television physicians and their patients? No one has studied the question rigorously, but the following list probably isn’t too far off.
- Doctors are and should be heroic, glamorous figures who regularly – indeed, constantly – sacrifice their personal lives and personal relationships to the welfare of their patients. (Note 5)
- The best way – the only conclusive way – to deal with most serious illnesses is surgery.
- Doctors treat one patient at a time. They have the time, the inclination, and the right to become intimately involved in each patient’s private life and to mastermind every conceivable aspect of each patient’s medical problem.
- Doctors never argue with their patients or among each other about money; they don’t especially care if they get paid or not.
- Hospitals are places of high drama and constant personal interaction. Patients are not bored or fed unappetizing food; doctors and nurses are not harried, overworked, exhausted, or abrupt.
- Diagnosis is usually easy; treatment is usually experimental.
- Patients typically hide critical information from their doctors, revealing the key facts only after a highly emotional confrontation with the doctor, which immediately makes them feel much better.
- Seriously ill people usually look and behave just like healthy people, except occasionally when they gasp, keel over, and need immediate emergency treatment.
- Apart from high-risk (often experimental) surgery, the key to most medical treatment is sudden insight into one’s neurotic relation with one’s family and other intimates.
- Most medical decisions are fast, correct, and heroic; a few medical decisions are fast, incorrect, and virtually criminal; no medical decisions are slow, uncertain, or tentative.
A Proposed Agenda
We have discussed five areas of mass-media impact: need manipulation; salience manipulation; ammunition; legitimation, agenda-setting, and modeling; and cultural norms. We could easily discuss five more. But the important point here is that none of these areas of impact works by converting the audience from one viewpoint to another. They all work through some variety of reinforcement, through offering the audience something it wants.
Except for advertising, all of these media effects are accidental as far as the media are concerned. Reporters are kept busy just grinding out the news; entertainment producers are kept busy just grinding out the programs. Both work under strong professional norms against intentional manipulation of the audience. Conspiracy theorists notwithstanding, no one in the mass media is orchestrating their impact or trying to engineer this or that effect.
Who, then, is responsible for the content of the media? The media are. Journalists and scriptwriters are predominantly white, male, middle-class, urban, liberal people. Without especially trying to – often conscientiously trying not to – these people inevitably saturate the rest of the country with their particular sense of reality. Of course media professionals are constrained by a variety of external forces: government, advertisers, publishers and station managers, and so forth. But for the most part these constraints are embodied in the very structure of the communications industries. Working within that structure, media professionals seldom come up against a government regulation, an irate advertiser, or even a domineering owner. On a day-to-day level, the people who write medical news and medical TV shows write pretty much what they want.
But they have to get it from somewhere. The mass media, remember, are not trying to change reality; they are merely trying to depict it in a way that will attract and hold the interest of their audience. True, they must filter that reality through the values of the writer and the traditions, goals, and constraints of the medium. But what emerges from the “media filter” bears a distinct resemblance to what was fed into it in the first place. The media, in other words, write about the things they find out about.
It follows that if you want the media to write about something, you must make sure they find out about it. To get a particular fact, viewpoint, event, or issue into the media, you need only raise it in such a way that it becomes a part of the writer’s “reality.” In recent months the news has been filled with articles and features on the merits of keeping incurable patients alive indefinitely. Before the year is out we will undoubtedly see several TV entertainment shows on the same theme. “Pulling the plug” is by no means a new issue to physicians. Did reporters and scriptwriters suddenly resolve to explore its moral and medical implications? No. Karen Quinlan’s parents and the state of New Jersey made it a part of their “reality.”
The Quinlans and the New Jersey government had other goals than publicity in mind. But interest groups quite frequently raise issues in the mass media with no other purpose than to have the issues raised in the mass media. Reporters and scriptwriters seldom resent this as an intrusion on their independence. On the contrary, they are voracious for new and interesting content and are grateful to anyone who can provide usable grist for their mills.
This is especially true for news, which is more dependent than entertainment on a constant supply of new material. Journalists are in the business of reporting what happened. It would be absurd for them to resent a source for making something happen. The easiest way to gain access to the news, then, is to do or say something newsworthy. The media cover things because they are important, unusual, timely, local, interesting, amusing, violent, traditional, and so forth. To get them to cover your thing, simply endow it with several of these characteristics.
The craft of doing this effectively is, of course, public relations. Its most common tools are simple to master: the press release (content submitted by a source in the form of a usable news article) and the pseudoevent (an event that takes place principally so that the media will report that it took place, such as a press conference or a demonstration). There are more complicated weapons, but these two are fundamental. There are also simpler weapons. Few reporters will take offense when a physician – or any citizen – calls them with a good idea for an article.
In trying to influence entertainment content, the direct approach is usually the best. There are devious strategies that have sometimes worked well: cash prizes, for example, for the best TV show on this or that topic. But a number of health-related organizations have been just as successful simply by approaching various producers, suggesting new themes and story lines, and volunteering to review scripts in their areas of expertise. A few years ago the American Red Cross offered free blood-donor posters to the set designers of medical programs; you can still see one occasionally behind Dr. Welby as he confers with a patient in the hospital corridor.
I am not a physician. I do not know what sorts of medical content should be funneled into the mass media or what sorts should be squeezed out. The people who run the media don’t know either. For the most part they are too busy to care. If the mass media are to improve significantly as a vehicle for health education, individual physicians and organizations of physicians must play a more active role.
The following suggestions are necessarily general, but they describe the range of communication activities that physicians might productively undertake.
- Learn something about public relations. Many newspapers offer brief seminars from time to time on how to write a usable press release; most colleges offer courses on journalism, PR, and persuasion; the references at the end of this paper include a few good books on these subjects. Better yet, arrange for a workshop on medical public relations at a forthcoming regional convention.
- Volunteer your services to local publishers and station managers as an expert on the acceptability of medical advertising. Every mass medium tries to screen ads before it accepts them, but, except for the networks and the big metropolitan newspapers, they are sorely lacking in expert guidance. While you’re at it, let the local media know which public-service advertising campaigns on health-related topics you consider most valuable and urge them to use more than they do. And if the public-service campaign you’d most like to see run isn’t available, get some help from a local journalism department or from the media themselves and write it.
- Find out who the medical reporters are at local newspapers (broadcast stations won’t have a specialist) and get to know them. Try to establish the sort of relationship that enables you to offer advice on possible stories, approaches, and the like and enables them to seek your advice when they need it. Work toward a similar interchange between local editors and local medical groups.
- When reporters approach you for a story, try to be a good source. That means being accessible, accurate, and frank; it also means being willing to simplify your explanations to make them understandable and interesting to laypeople. Arrange for a local medical organization to supply the media with the names of experts in various fields who are willing to be called on a story.
- In dealing with the media, give serious consideration to the nature of media impact. Instead of expecting to change people’s behavior with technical information, try to offer the media content that reinforces the needs, attitudes, or behaviors of the audience in a way that seems likely to yield the desired effect. At the same time, however, bear in mind that the media themselves are not thinking in terms of impact.
- If you have medical information you badly want covered, try to embed it in a “newsworthy” format: a public speech by a noted celebrity, for example. Encourage local medical groups to play a more active role in public relations: engineering pseudoevents, mailing out press releases, taking stands on health-related issues of public policy, and volunteering information and expertise relevant to the stands others are taking.
- Remember that the media are very responsive to feedback from audiences, sources, and interest groups. When you encounter medical content in the media that you consider inaccurate, incomplete, or otherwise undesirable, let the writer or producer, reporter or editor know. Try to make your criticisms constructive rather than carping, though, and bear in mind that newspapers and TV shows are not technical journals. When you find something in the media that you consider exemplary, be free with your praise.
- Consider undertaking a formal content analysis of medical entertainment programming. A quantitative study of information, themes, and stereotypes in television’s doctor shows would be a useful project for any medical organization. The findings would provide a sound basis for proposing various changes to the writers and producers. Systematic monitoring of local medical news would be similarly valuable.
- When you watch television, try to think of ways in which important medical issues and information could be worked into the plots of local and national programs. If possible, establish regular contact between medical organizations and the producers of these programs, as a vehicle for appropriate suggestions. Even as an individual, make a habit of sending the producers news of suitable medical developments and proposals for possible story lines.
- Apart from news and entertainment, begin making use of radio talk shows, local television panel discussions, newspaper letters to the editor, and other sorts of media content that can help carry your message. Consider untraditional media as well: posters, pamphlets, and leaflets; matchbook covers and cereal boxes; comic books and restaurant placemats.
In sum, make it your business to know how the mass media influence the public on medical topics, and how physicians can influence the influence. And then, if you care, do something about it.
1 Of course some medical professionals do try. Public health communication is an established subdiscipline, responsible for extensive media campaigns on such topics as smoking, population control, alcoholism, and cancer detection. The substantial research literature in public health communication will not be discussed in this article, for several reasons. First, most health communication campaigns rely on public-service advertising, while I will be concentrating here on news and entertainment. Second, physicians in private practice seldom have an opportunity to participate in these nationally coordinated campaigns; I want to look at what the local practitioner can do. Third, and most important, the health communication literature is almost uniformly discouraging. Most campaigns have attempted to urge changes in deep-seated audience behaviors on the basis of semitechnical information alone; for reasons that will be outlined in this paper, their impact has seldom been cost-effective. There are important lessons to be learned from these campaigns – positive as well as negative ones – but they are not fundamental to the thrust of this discussion.
2 Most of the nonmedical content in this section is drawn from Sandman PM, Rubin DM, Sachsman DB: Media: An Introductory Analysis of American Mass Communications, 2nd ed., Englewood Cliffs, New Jersey, Prentice-Hall, 1976, pp. 12–21.
3 The nature of media news presentations helps lessen the likelihood that the audience will act on media-acquired information. The very format of the news is aimed at rewarding the reader, listener, or viewer for the mere act of reading, listening, or viewing. Reporters are taught to “round out” their stories, to work at creating the impression that all relevant questions have been asked and answered – that the job (reporter’s and audience’s) is done. In their effort to be objective, reporters seldom tell us what we should do with the information in the news, or even what we could do with it. The emphasis in news on the opinions and actions of “important” people encourages us to believe that citizen action is impossible and perhaps even inappropriate. Our job, we conclude, is to know what the issues are; dealing with them is someone else’s job.
4 An important byproduct of need-motivated behavior is the sense of psychological discomfort (“cognitive dissonance”) that most people feel when they are doing things for which they have an inadequate attitude base. This discomfort, in turn, prompts people to seek out information that can rationalize and justify the new behavior by building attitudes to support it. If no such information is available, the behavior remains unstable and must be constantly triggered by repetition of the need-association. This suggests a two-tiered approach to persuasion: First motivate the tentative behavior by tying it to audience needs, then cement it with relevant information.
5 Like many of the norms on the list, this one is double-edged. It’s nice to be admired, but the expectation is unrealistic, harmful if the patient swallows it and probably more harmful if the doctor swallows it.
This paper is an expanded version of Dr. Sandman’s remarks at a symposium entitled “The Missing Link in Health Services: Reaching the Public through the Media,” presented at the 57th Annual Session of the American College of Physicians, 5 through 8 April 1976, Philadelphia, Pennsylvania. Received 19 April 1976; revision accepted 18 June 1976.
The following bibliography is neither exhaustive nor definitive. In particular, it ignores entirely the extensive literature on public health communication. The most highly recommended sources are marked with an asterisk.
*BECK M: Public interest groups tap into entertainment TV. Access, 22
September 1975, pp. 8–11
Includes several medical examples of how to influence television entertainment.
BEUSSE RB, SHAW R: Maude’s abortion: spontaneous or induced?
America, 3 November 1973, pp. 327–329
Unsympathetic account of the Population Institute’s efforts to promote abortion.
BURKETT DW: Writing Science News for the Mass Media, 2nd ed. Houston, Gulf Publishing Co., 1973
Textbook for journalism students.
CANNELL CE, MACDONALD JC: The impact of health news on attitudes and behavior.
Journalism Q, 33:315–323, 1956
Old, but useful.
FESTINGER L: Behavioral support for opinion change. Public Opinion Q, 28:404–417, 1964
Good analysis of the relation between attitudes and behavior.
*FUNKHOUSER GR, MACCOBY N: Communicating specialized science information to a
lay audience. J Commun, 21:58–71, 1971
Impact of writing style on effectiveness.
HALBERSTAM MJ: An M.D. reviews Dr. Welby of TV. NY Times Magazine, 16
Jan 1972, pp. 12, 30–38
He likes it.
HASKINS J: Factual recall as a measure of advertising effectiveness. J Advertising
Res, 4:2–8, 1964
Intercorrelations among information, attitude, and behavior.
INSKO CA: Theories of Attitude Change, New York, Appleton-Century-Crofts, 1967
Excellent review of research.
*KARLINS M, ABELSON HI: Persuasion, 2nd ed. New York, Springer, 1970
Clear, practical and simplified.
KLAPPER JT: The Effects of Mass Communication, New York, The Free Press, 1960
Definitive as of the late 1950s.
*KLEIN T, DANZIG F: How To Be Heard, New York, Macmillan, 1974
Good introduction to access and media relations.
KRIEGHBAUM H: When Doctors Meet Reporters, New York, New York University Press, 1955
Ancient, but a great deal hasn’t changed.
*KRIEGHBAUM H: Science and the Mass Media, New York, New York University Press, 1967
Good overview of how science reporting works and why.
LAZARSFELD PF, MERTON RK: Mass communication, popular taste, and organized
social action, in Mass Communications, 2nd ed., edited by SCHRAMM W. Urbana, University of Illinois Press, 1960, pp. 492–512
Written in 1948, and still a top-notch summary of how communication affects society.
RENNIE D: What you can learn about health from TV. Today’s Health, January 1973, pp. 22–26
Very critical of doctor shows.
ROBINSON EJ: Analyzing the impact of science reporting. Journalism Q,37:306–3 13, 1960
Science information seldom affects audience behavior.
*SANDMAN PM: Mass environmental education: can the media do the job?, in Environmental Education, edited by SWAN JA, STAPP WB. New York, Halsted Press, 1974, pp. 207–247
Opinionated overview of how environmentalists ought to use the media; many possible parallels to medicine.
*SANDMAN PM, RUBIN DM, SACHSMAN DB: Media: An Introductory Analysis of American Mass Communications, 2nd ed. Englewood Cliffs, New Jersey, Prentice-Hall, 1976
Textbook survey of what the media do and why.
SCHRAMM W, ROBERTS DF (eds.): The Process and Effects of Mass Communication, 2nd ed. Urbana, University of Illinois Press, 1971
Good anthology of media impact studies.
Copyright © 1976 by Peter M. Sandman