Managing your media relations.

Four words can immediately cause severe diaphoresis in even the most seasoned health care executive:

"Mike Wallace is calling."

Palpitations, sweaty palms, and tension headaches can also be induced by a local call:

"Channel 4 wants to interview you about the AIDS-contaminated needles found near our dumpster yesterday."

Whatever the scenario, and the possibilities are legion, the critical facts are:

* Health care news coverage is at an alltime high and climbing.

* As a physician executive, you are a prime candidate for a media interview.

* How you handle that situation can profoundly affect your career and the future of your medical facility.

* A good working relationship with your local media can dramatically influence all of the above.

Recent surveys of radio and television news directors and newspaper editors throughout the nation indicate that health care coverege is now a high priority media topic, especially in television news. Of the nation's television news directors polled in one study, 61 percent rated stories about medical care and medical technology as "high" or "highest priority"' compared to 37 percent of the newspaper editors and 31 percent of the radio news directors. Sixty-seven percent of the responding news directors from all three media said they had increased health care news coverage in the past year.' Televisions sources forecast the greatest increase in future coverage of health and medical news. "There's no question that the consumer's growing interest in health care information is reflected in the increased assignments news directors are now giving their reporters in health-related topics," says Robert Kimmel, President of Audio/TV Features of New York City, a national producer and distributor of radio and TV news features. This is corroborated by other past surveys by NBC and the Associated Press.

Studies and surveys aside, a quick scan of radio and TV news programs shows that health care coverage is a hot topic. Evening news programs in many cities now have regular "Health and Well-Being" segments, as do many daytime talk shows. With 63 percent of Americans saying they get most of their news from television, this is clearly the medium that reaches the most people, has the greatest impact, and has the largest projected increase in health care news coverage.

Clearly then, physician executives are prime candidates for media interviews. Before the advent of a subspecialty of journalism known as "investigative reporting," reporters often got their stories from inhouse public relations representatives. In today's fast-paced, "eyewitness," exposeoriented journalism, the bigger stories most often come from a "primary source." Journalists want to talk to the executive directly responsible. As communications researchers Paul Fitzgerald, PhD, and Linda Embrey-Wahl, PhD, recommend, "Health care executives must get specialized training in communications skills, particularly as they relate to media interactions. This training could be provided through professional associations or by other means. Health care executives must learn about the media, in all its forms, to gain a better understanding of its operations, and then build bridges to improve relations...."

Knowing how to handle yourself with the media can be critically important. AI Campanis, the Los Angeles Dodgers' coach, had his 40-year career ended abruptly by 40 seconds of ill-chosen words during an on-camera interview on "Nightline." There have been countless other less visible victims. Media experiences can also be the fastest, most powerful way to enhance your public image and that of your group or facility. The media are one of the essential avenues through which business people communicate in this electronic age.

Improving Relations

One technique that often works to improve press relations is to invite members of the local press--producers, reporters, community services representatives--to a special open house or a luncheon meeting to brief them on what is new and newsworthy at your facility. Such a meeting not only puts you on a first-name basis with your local press but also is a good opportunity for you to learn subtleties about the individual members of your local press, such as their particular interests, their pecking orders, their past experiences in covering health care issues, and which of them seems especially approachable. One of our clients, a busy executive director of a large HMO, keeps a file of three-by-five cards with each television station's "call letters," phone number, names of reporters, and interesting bits of information about them. At a moment's notice, on the phone or in person, he can strike up a brief friendly conversation with the reporter he's dealing with before getting down to the business at hand.

One note of caution: If you decide to schedule a "Meet the Press Day," be sure you have something really newsworthy for the reporters. Also, be ready to answer questions they may have on other related health care topics. Try not to schedule your event the same day the city council meets or when some important person is due in town. A quick call to the newsroom can verify which days of the week are usually less frantic.

Educating reporters (without appearing to be patronizing) is an important factor in dealing with the press. Health care issues are very often complex. Clear, easy-to-read handout materials are valuable to reporters. )"enever possible, get those materials to them before they come to do the story and add a personal note that you'd be happy to answer any questions. Ideally, reporters would study the background materials for a particular story one or two days before, but all too often, due to the uncertain nature of news schedules, reporters have to read the background materials while racing to cover the event. Your information may help them arrive with many key points already understood.

It's very important to realize how strapped for time most journalists are. Their time is as precious as yours. Before they arrive to interview you, they may have covered two or three other stories; after they leave, they may cover several more. Try not to keep reporters waiting, because that can throw them off schedule for the rest of the day. If you get the reputation for being late or for requiring a lot of unnecessary time from the news team, they may, on a busy news day in the future, decide not to do a story you'd really like to have them cover. The Fitzgerald-Wahl survey cited earlier of news directors across the nation drew some interesting responses to the question of what they most disliked about health care executives. A whopping 20 percent of the news directors agreed that health care executives tend to be "too promotional," "too protective." A closely related complaint was that health care executives avoid discussing issues that are "interesting," i.e., patients, finances, and personnel. There is a tendency, say news directors polled, to want to talk only about "fluff," to try to push their product rather than face the issues. Another complaint was that health care executives ehher do not understand or chose to ignore the changes that have occured in the market place. And news directors very often echo the sentiments of their field reporters.

Another problem often cited by reporters and producers is the old bugaboo of using jargon, "doctor talk," "hospitalese." Although these other languages are entirely appropriate with colleagues, they are inappropriate with the press (or with patients) unless you take the time to explain what a particular medical term means. Remember, the press is thinking about what is comprehensible to viewers, listeners, or readers. As a medical reporter, I found that physicians I interviewed often did not even realize when they were using jargon. It may be interesting to note that in a study by three physicians at Yale University, such commonly used terms as "hypertension," "abdomen," and "stroke" were often misunderstood by patients. Nearly 50 percent of the patients studied thought "hypertension" meant "nervous, easily upset," and one out of four patients thought "orally" referred to how often one takes a medication. When you use jargon on TV or radio, you leave thousands befuddled. Television and radio audiences should be regarded as patients; they can make the same misinterpretations.

During the two years I hosted and wrote a weekly medical information program for a large clinic in southern California, I found that, while on camera, many of the guest physicians seemed to be talking to their physician peers in the viewing audience and not to the average viewer. They were often more concerned about how colleagues would judge their television interview than about how the lay audience would perceive them. This orientation promoted greater use of jargon and, overall, a more formal, "medical conference" style--deadly on a TV talk show. By means of a few media skills workshops and professional coaching, the physicians were able to alter their communications style and become more aware of when they were using jargon. Not only did our program win that year's national "ACE Award for Excellence," the cable TV industry's equivalent of an "Emmy," but many physicians reported that their communications with patients had significantly improved.

It's always to your advantage to appear helpful and cooperative when working with reporters and producers. Never give a reporter the feeling that you're trying to stonewall. There's no surer way to arouse the sniffer (and often the snarl) of any good news hound than to say "no comment." If you can't answer a question, explain why: "I'd like to answer your question, but because of the physician's ethical code, l have to keep my patient's medical records confidential." Or if you can respond, but don't have the information at your fingertips, or you need to check for accuracy, you can say, "I don't have that information right now, but I'll try to get it for you and call back." If you make that promise, be sure to keep it.

Don't try to endear yourself to a reporter by giving off-the-record information. Although many or most reporters will honor that confidentiality, some may not-especially if they deem the information to be of overriding importance to an informed public. You can place yourself in legal as well as professional and ethical jeopardy by such tactics. In addition, you never know what recording equipment is "live." I always warn participants in our "Risk Management with the Media" classes, "Assume all cameras and audiotape recorders are 'five'until they're packed up and carried out of the room."

Although a certain adversarial role must always be played by the press, as part of the American system of checks and balances, steps can be taken to develop a mutual professional respect. Planting the seeds for a good relationship with your local media can reap a bountiful harvest. Using the media skillfully can be your quickest way to garner support, community good will, patient education, and a broader patient base. At the very least, it can ease the bite of a predatory reporter or quiet the ominous buzz of the "paparazzi."

A quick review of some of the basic guidelines for improving media relations:

* Plant seeds of openness, trustworthiness. You're not perfect; neither is your medical facility. People understand that. Covering up makes you look doubly bad. Tell the truth whenever possible and legally advisable.

* Maintain a helpful stance. Offer printed information,films,videos, or your own time to reporters and field producers who are trying to understand the issues involved in a story. Call back with the answer to a reporter's earlier question; don't leave the reporter hanging. If you can't answer a question, explain why.

* Make an effort to be on time and accessible to reporters. This may mean juggling your schedule to fit theirs, but if presidents and heads of states can do it, so can you. By the way, having coffee, cookies, and sodas on hand maybe greatly appreciated by a hungry, weary news team, who often doesn't take time for lunch or coffee breaks.

* Speak plain English. Avoid jargon. Avoid using verbs in the passive voice. They don't play well in the media. For example, instead of "It is currently thought..." or "It has been found that...,' use the active voice and say, "We think that..." or "Researchers are finding that...."

* Practice being on camera with a camcorder, or consider taking a professional media skills workshop so you have the confidence and the comfort level plus the communications strategy needed to be effective during a media interview.

Knowing how to deal effectively with the media is an essential part of doing business today. It's becoming a basic management skill. Because of the voracious appetite of the U.S. public for health care information, the media will probably be on your doorstep--often. With the technology of the sattelite newsgathering vehicle (SNV), virtually a TV studio on wheels, you can be "live" on the national evening news in a matter of minutes. The potential is there for you to use, and it's one of the most powerful management tools you,ll ever wield. It's up to you to wield it with grace, tact, and skill. In the final analysis, positive media interactions and subsequent coverage help to develop a better informed public, more capable of making important choices affecting their own health care.