The quoted experts are likely physicians if you’re reading an article about healthcare or medicine. Chances are, if any nurses or physician assistants offer their views, it’s probably a story on hospital staffing or a topic specific to the nursing profession.

According to a recent study looking at the representation of nurses in the health news media, nurses were cited as sources in only 2% of articles. When quoted, nurses mainly discussed the profession, as they were primarily sought as resources for nursing issues. But for news stories that addressed health policy and the healthcare business, nurses were rarely, if ever, tapped as experts or used as a source. Overall, nurses or the non-MD professions were mentioned in 13% of the articles, while nurses were identified in 4% of photographs or other images accompanying the various news stories.

Nurses comprise the largest group of healthcare professionals but continue to be largely invisible in news stories. Here are some reasons why this is:

Nursing Remains a Profession Dominated by Women

About 90% of nurses are women, and even today, there continues to be a bias against using women as sources, especially when seeking out those in positions of authority in health care. In general, men were quoted almost twice as often as women in healthcare-related stories (66% vs. 34% of quotes), and this was particularly true in articles concerning healthcare management, healthcare business, health policy, and healthcare costs and finances.

Healthcare news stories are also more likely to be written by male journalists (52% vs. 42%), and men are generally the ones to write stories about healthcare policy, management, and the pharmaceutical industry. Female journalists are also slightly more likely to include female sources in their stories than men (39% vs. 32%). However, the use of women as sources has improved over the past two decades. In 1997, women were used as sources in 17% of stories, and that rate has risen to 26% in 2015.

Public Relations Staff at Universities and Medical Centers Generally Do Not Contact Nurses

When a journalist requests a source for a story, a physician is usually the source that is tapped. Some journalists said they didn’t get one even when they asked for a nurse. Nurses and nursing organizations have also not been as proactive as they could be in pitching nursing research and their clinical expertise to news organizations, and journalists report that they often don’t know how to find nurses to interview.

Journalists (and Others) Are Still Unclear About the Scope of Nursing

The scope and expertise of nurses go far beyond what has been traditionally depicted in movies and television, but interviews with journalists found a clear lack of understanding of the range of nursing roles. Journalists are also somewhat confused by the various credentials following a nurse’s name and the significance of the different educational backgrounds. Nurses’ level of expertise continues to be misunderstood, and journalists have said that they often have to justify using nurses as sources for their editors.

Nurses Are Not Media Savvy—Yet

Some of the onus falls on nurses. They must step up to the plate and put themselves in the spotlight. Journalists have said that it is rare that they will receive a press release from nursing associations or nursing journals about exciting new research or highlighting the work of a nurse researcher.

In addition, nurses need to be willing to speak with the press, and journalists also pointed out that individual nurses sometimes did not respond to interview requests promptly or wanted to remain anonymous. Reporters often work on deadlines and will use the first sources that get back to them.