The perception of specialized journalists about the transformations of public communication of health and biomedicine in Spain in the last two decades was analysed. Twenty semi-structured interviews were performed. In the analysis, the metaphorical concept of "ecosystem" has been used. According to the interviewees, the main "environmental" changes have been technological (highlighting the expansion and diversity of online information and the impact of social networks). There is a multiplication and diversification of the "species" of information sources. Within this, specialized sources (researchers and health professionals) and civil associations (patients and consumers) have increased their visibility, but "opportunistic species" have also emerged, such as the promoters of fake-news and pseudotherapies. Despite recognizing that their work "environment" has worsened and perceiving the dependence on clickbait and network positioning as a threat, health journalists value their profession with satisfaction.
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