You Can’t Always Get What You Want

· Competing narratives
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Knowing your audience and having a clear understanding of your key messages can take you a very long way. But too many organizations often fail to grasp the power of current events and how other narratives can alter your desired results.

We saw a perfect example of this last week when the Institute of Medicine (IOM) and National Academies released a report entitled “Transformation of Health System Needed to Improve Care and Reduce Costs.”  A reasonable concept, right? The very public debate over transforming our health system has created fertile media ground for any organization offering data or expertise.  The IOM and National Academies, certainly are qualified to enter the fray.

The first paragraph of their Sept. 6 press release read:

WASHINGTON — America’s health care system has become too complex and costly to continue business as usual, says a new report from the Institute of Medicine. Inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation’s economic stability and global competitiveness, the report says. However, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at lower cost, added the committee that wrote the report.

But if you look at the media coverage, how did IOM do in conveying its message? Two prominent headlines the day after give us some indication.

Health care system wastes $750 billion a year, report says,” was the headline accompanying an Associated Press story written by Ricardo Alonso-Zaldivar.

We spend $750 billion on unnecessary health care. Two charts explain why,” wrote Sarah Kliff in the Washington Post.

Rolling Stones lips logo

You can’t always get what you want, but if you try, sometimes you get what you need.

What happened? It’s enough to give a PR person their 19th Nervous Breakdown. It probably had something to do with the second paragraph of the press release, which in part read:

The committee calculated that about 30 percent of health spending in 2009 — roughly $750 billion — was wasted on unnecessary services, excessive administrative costs, fraud, and other problems.

Leading up to the IOM’s announcement, the Romney and Obama campaigns had been very loudly slugging it out over the Affordable Care Act’s $716 billion in proposed Medicare cuts. So it should come as no shock that AP’s Alonso-Zaldivar would write:

“How much is $750 billion? The one-year estimate of health care waste is equal to more than 10 years of Medicare cuts in Obama’s health care law. It’s more than the Pentagon budget. It’s more than enough to care for the uninsured.”

IOM walked into a “cross-fire hurricane.” Loud ideological and political discussions typically subsume very laudable intentions like: “Let’s have an intelligent discussion about healthcare facts and engage in solving this problem.”

It’s imperative that communicators, whether working for internal or external audiences, step back from their assignments and look around before proposing a strategy. You should have clear answers to questions like:

  • What is the greater world saying about our core subject matter?
  • What does that discussion tell us about how our audience will digest what we say?
  • Which elements of our announcement are likely going to be of the greatest interest?

Our modern society is overly susceptible to memes, easily falling into narrow dialogues that miss the big picture. For example, money is important; but how much more important is a human life? I found it interesting how the AP, Washington Post and LA Times stories completely passed over this sentence in the second graf of IOM’s press release:

Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state.

$750 billion dollars: Important to discuss. Needless suffering and 75,000 lives: Not so much.

I contacted IOM’s media relations department to ask about what their strategy had been, what they had expected the media’s response would be and how they felt their campaign went. A spokesperson declined to talk about it, saying this particular release was less than an optimal example of their work.

Now, I don’t want to infer that the release was a bust. The LA Times story quoted one of the report’s supporting organizations, The Robert Wood Johnson Foundation. Deeper in their articles, the LA Times and the Post covered potential solutions to reduce healthcare spending waste. If you try sometimes, you get what you need.

But could IOM have better maximized the 18 months of work put into this report? Possibly. I advise organizations to ask themselves three questions before finalizing plans for a significant announcement.

1)      Does competing noise give us reason to re-schedule our announcement?

2)      Can we accept and navigate discussions that go “off message?”

3)      Do we have resources to directly reach key stakeholders so we can better control the message?

No one ever could completely control any communication. And message control is increasingly being diluted with the growth of social media.

So sneak some Rolling Stones onto the iPods of your internal stakeholders, educate them about competing factors in their environment, and maybe schedule a Mick Jagger karaoke night. You’ll all feel better.

UPDATE: 9/12/2012 The New York Times published a piece today much more in line with the press release and report findings. The link is included here: http://www.nytimes.com/2012/09/12/health/policy/waste-and-promise-seen-in-us-health-care-system.html?smid=pl-share. The article mostly focused on the financial implications of waste, fraud, etc., though it did mention in the first graf that “policy experts and economists see a significant opportunity — a way to curb runaway health spending, to improve medical outcomes and even to put the economy on sounder footing.”

Also, money continued to take a prominent place above human loss. The reporter eventually got around to the following in grafs 8 & 9:

Along with the squandered money there is a human toll, the report said, as medical errors and inefficiencies mean that doctors fail to deliver the best and most timely care to patients.       

“If the care in every state were of the quality delivered by the highest-performing state, an estimated 75,000 fewer deaths would have occurred across the country in 2005,” the report said.

1 Comment

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  1. Trail Todd

    A one-word reply to this blog post: WOW!

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