For the past thirteen years the American Medical Association has hosted an annual Health Reporting Conference for physicians who also work as medical reporters, or aspire to. This year, with health care reform on the agenda of every newsroom in America, the conference, held in San Francisco, took on an extra dimension. And the very idea of having physicians report on health care topics came in for a check-up.

"Physicians . . . who see themselves as journalists first bring more to the medical story than a reporter," says Tom Linden, who moderated a health care reform panel at the April conference and who was a staff writer for the Los Angeles Times before he went to medical school. Now he hosts Physicians' Journal on Lifetime Medical Television. "We [physicians] have spent five, ten, fifteen years studying the field of medicine," Linden adds, "and the more you know about the subject the better you can report on it."

It's those physician-reporters who don't see themselves primarily as journalists, or who are not perceived that way by the public, who worry some news professionals.

Harry Fuller, news director of KPIX, the CBS affiliate in San Francisco, told a roomful of physician-reporters at theconference that, while "the M.D. label behind your name" adds weight and credibility, it suggests at the same time that you are an interested party, not an unbiased observer. For this reason, Fuller explained, he did not assign his medical reporter, Nancy Snyderman, M.D., a practicing physician (who is also the medical correspondent for ABC's Good Morning America), to stories that deal with doctors' income.

Larry J. Thompson, a founding editor of the health section of The Washington Post and, since January, a Washington correspondent for Whittle Communications' Medical News Network, says he was "horrified" and "outraged" when he heard Dean S. Edell, M.D., the medical reporter for KGO-TV in San Francisco and an anchor whose medical news programs are syndicated to about 100 U.S. and Canadian markets, tell his audience at a conference panel on medical ethics that "it's [President] Clinton against the doctors" and that the media are a tool at the doctors' disposal.

"He used his position of authority to proselytize shamelessly," Thompson says of Edell. Thompson says it took him a while to understand such behavior. He concluded that physicians -- including physician-reporters -- tend to live in the culture of physicians, and often fail to understand that as reporters they must try to see issues from other perspectives.

Instances of this kind of culture clash are likely to increase if the proliferation of medical shows on cable channels creates the demand for physician-reporters that some conference attendees expect.

Some physician-reporters seem immune to journalism's conflict-of-interest sensibility. For example, San Francisco stores display reading glasses with a photo and endorsement from KGO-TV's Edell. Local media exposure, of course, is also an effective way to help build a medical practice.

Physician-reporters, meanwhile, were being recruited by Healthvision, Inc., a Detroit-based medical communications company in Detorit, for its medical news program, Second Opinion. The TV show has aired on three NBC affiliate stations in Indiana, and company president Andrew Kokas has plans to go national. While Kokas accepts sponsorship from pharmaceutical manufacturers for his shows, he insists that the money comes with no strings -- save one: "The string attached is that if the company is actively involved in cancer drugs, they're not providing funding for us to go out and do stories on heart attacks."

The AMA's San Francisco conference itself, meanwhile, was supported by an educational grant from Pfizer U.S. Pharmaceuticals Group, while the National Association of Physician Broadcasters' awards banquet and annual meeting, held in conjunction with the conference, was financed by a grant from the NutraSweet Company. The awards dinner program also acknowledges support from the Agricultural Group of Monsanto Animal Sciences Division and the Pharmaceutical Manufacturers Association.

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