Where does gatekeeping collide?

The process by which the countless events and messages competing for coverage are filtered so that only a few pass through to become news, and the people and routines that do the filtering. White's 1950 study The "Gate Keeper" followed a single wire editor he called Mr. Gates and showed how his personal judgements decided which stories reached readers, building on Kurt Lewin's earlier idea of a gate in a channel where a person decides what moves forward. Here the referent is the selection of public information in a newsroom, a social process of editorial choice, not a rule about who may see a doctor, a person who ferries technical know-how into a firm, or a stretch of DNA.[1]

Unit

One editorial decision to admit or reject an item for news

Recovery means

Not applicable

Measured by

Studied by tracking which incoming items are published versus spiked, and by content analysis of what routines and biases shape the choice

The arrangement, common in managed care and many national health systems, whereby a patient must first see a primary-care physician who authorises any onward access to specialists, tests, or hospital care. Forrest's 2003 review in the BMJ, Primary care gatekeeping and referrals, examined how far this filter actually controls use and cost and whether it improves or harms care. Here the referent is a formal rule about routing patients through a first point of contact, a feature of how a health system is organised, not the newsroom selection of stories, a person who channels technical information, or a gene that limits cell growth.[2]

Unit

One referral decision by a primary doctor to admit or withhold specialist care

Recovery means

Not applicable

Measured by

Assessed through referral rates, specialist and emergency use, costs, and health outcomes compared between systems with and without the requirement

A specific person in an organisation who keeps up with information outside the firm and passes it on to colleagues, acting as the link between an internal group and the wider technical world. Allen and Cohen's 1969 study Information Flow in Research and Development Laboratories found that a few well-connected staff, the technological gatekeepers, disproportionately carried outside knowledge into their labs. Here the referent is a boundary-spanning role held by an individual who moves know-how across an organisation's edge, not the newsroom filtering of stories, a health-system rule about seeing a specialist, or a stretch of DNA.[3]

Unit

One person occupying the boundary-spanning role, by their bridging ties

Recovery means

Not applicable

Measured by

Identified through communication and citation networks that mark who reads outside sources and is consulted by internal colleagues

A gene whose normal job is to hold back the growth of a specific tissue, so that losing both copies directly opens the way to a tumour in that tissue. Kinzler and Vogelstein's 1997 Nature commentary Gatekeepers and caretakers drew this class of gene apart from caretaker genes, which instead guard the integrity of DNA. Here the referent is a length of DNA that governs whether a cell divides or dies, a molecular control inside the body, not the newsroom selection of stories, a health-system referral rule, or a person who carries information into a firm.[4]

Unit

One gene locus whose loss of function releases growth of a tissue

Recovery means

Not applicable

Measured by

Established by genetics and molecular assays that link biallelic loss of the gene to tumour formation in a particular tissue