Public Relations Strategy or Just Tell the Truth?

Most doctors want to see patients, not fight government. Doctors pay dues so that their medical associations will speak for them.

Is it even possible for a medical association to tell the truth about problems inside healthcare?

Can doctors speak about problems, without fear that the government will punish doctors for doing so?

Public Relations in Medicare

Everyone in our single payer system wrestles with what to say. Hospitals, associations, unions and patient groups must choose carefully what to say about:

  • Patients suffering on wait lists.
  • Provincial budgets that fall short.
  • System mismanagement.

One option is to only share good news, all the time. If you have something bad to say, do not say it publicly.

This is the most popular approach. Nothing panics hospital administrators more than hearing that one of their nurses or doctors has sent bad news to the media.

Single payer healthcare has no room for whistleblowers.

At the other extreme, some groups tell the truth to start a war. Some people love conflict. They want passion and courage. If we start a fire by being aggressive, so be it.

Passion and fire work to advance single issues, some of the time. And sometimes, we need courage to start a war. But fiery spirits often burn up opportunities to find solutions tomorrow.

Most groups look for ways to advance their cause while avoiding each extreme.

Advocacy Options

Doctors could consider building a separate group to speak for them. On its website, Working Families Ontario says that,

“Working Families was created by members of the labour movement with the goal of making voters aware of policies that threaten the well-being of working families in Ontario.”

Individual unions get to play nice with government and still say what they want through Working Families.

Other political groups develop different voices within the same association. For example, a spokesperson might say one thing, while their elected member says something else. Chaos creates opportunity sometimes.

Maybe doctors should rebrand themselves as health critics? They could focus on raising public awareness about problems in healthcare. They could be full time whistleblowers.

Machiavelli is Too Hard

Groups contort themselves as they try to figure out how to respond to public issues:

Do we attack incompetence? Do we ignore it? Is this problem too hot for us to talk about?

We try to be too tricky. We hope to achieve a particular end by saying things a certain way. We try to be strategic, political. We want influence and positioning.

Maybe we should think less about position and influence, and more about just telling the truth?

Maybe we should figure out how to tell the truth about problems in healthcare with kindness, balance and hope?

Voters know that healthcare is not perfect. Nothing ever is. Voters also know that people get upset about bad news.

Politicians will get upset if doctors raise concerns in public. Politicians might rankle if doctors criticize a new bill or provincial budget. But fear of upsetting politicians should not stop doctors from telling the truth.

Tell the Truth

Healthcare is in crisis, in Ontario. The polls say that the government faces a crisis too. This makes life very difficult for a medical association.

In the midst of crisis, we need people to tell the truth, gently. No one wins respect by saying that things are good when they are not.

And no one wins respect by being fiery and mean. They might win fear for a time, but not lasting respect.

Healthcare needs doctors to be bold and tell the truth. Patients need doctors to speak up about our system, too. After all, telling the truth is the only reason patients listen to doctors in the first place.

Photo Credit: A Few Good Men (1992)

14 thoughts on “Public Relations Strategy or Just Tell the Truth?”

  1. Consistently telling the truth would have to include the truth about issues within the ‘house of medicine” like inequitable earning capacity between disciplines, a situation which we created and which we need to address

    1. Good point, Dennis. There are a number of things that we can, and should, own.

    2. Only the market can determine the worth of a service.
      We need a competitive parallel system that allows choice for patients and doctors,would drive efficiencies,and set the value of sdisciplines services.

  2. We should never be afraid of criticizing or upsetting a politician. Until it falls outside the bounds of professionalism (the dreaded Hitler comparison) that are ultimately self-defeating, it’s all fair game. It’s politics, not high school debate club.

    I don’t think there’s any need for a separate body not bound by the bureaucratic restraint of playing nice with government. The problem isn’t even the lack of a polished, coherent message, but rather the lack of a receptive audience.

    Just this morning, The Current had a segment on the family doctor shortage in BC or Ontario. The talking points are the same we’ve been hearing for at least twenty years. No exaggeration – Michael Rachlis was one of the panelists, and he said the EXACT same thing to my first year medical school class: medical associations have all the power, need comprehensive primary care reform, etc.

    There are plenty of physician writers and bloggers out there with sizable audiences, providing pointed, thoughtful, insightful critiques. And that’s to say nothing of the Andre Picards of the world that have been commenting on the subject for decades. But if people in power listen only to themselves – does *anybody* outside the Liberal party and MOHLTC think Patients First is a good idea – we can message until we’re blue in the face.

    1. Really great comments, Frank!

      I groaned while reading what you heard on The Current. It makes me ill thinking about all the folks listening to the show, thinking that it’s a trusted source of information.

      I agree with your comments about criticizing politicians. Still, associations would never consider it. I was thinking more about criticizing long patient waits, adverse outcomes, waste, mismanagement, etc. We stay quiet because we think that we have greater power by sidling up to government…or we are just too scared of what might happen if we speak up.

      Thanks so much for taking time to share a comment!

      Cheers

      Shawn

  3. Truth telling is a revolutionary act, with those fearing to express it being fearful of the consequences of doing so.

    Silence is , in fact, an act of cowardice, our profession has been all too fearful to speak truth to power and to confront the government’s mendaceous propaganda with facts…the fact is that this system is dysfunctional and, on a global basis, our health care system is mediocre to inferior and deteriorating …the fact is that nothing about the policies to be imposed is evidence based; medical practitioners are expected to carry out evidence based medicine in a non evidence based health care system created by the political class and which has been turned by them into a sacred cow that has to be worshiped and cannot be touched.

    Someone has to tell the truth about our low grade health care system, politicians don’t do it, the health care bureaucracy don’t do it, the media doesn’t do it.

    We must stand up much as that little boy did in Hans Christian Anderson’s tale of the Emperor’s new clothes , in which confidence tricksters had convinced all that the magnificence of the Emperor’s clothing was invisible to the stupid, incompetent and those unfit for their positions.

    That little boy pointed out the truth, the Emperor was , in fact, absolutely naked.

    We must all stand up and point at the nakedness of our rather sad and deteriorating health care system.

    History reveals that the truth eventually wins out….if only we could live so long.

    1. Thanks for reminding me of that line, Andris:

      “…in a time of universal deceit, telling the truth is a revolutionary act.” George Orwell, 1984.

      Orwell’s comment seems a bit too negative, even for our difficult times. I only mention it because your opening line seems to nod to it.

      Well said: “Silence is, in fact, and act of cowardice…”

      The trick in all of this is to find a way to speak up without being nasty. Granted, we will get accused of being divisive and mean for speaking up, but at least we can try our best to be kind. We almost have to go overboard in our efforts to be kind and gentle…but still tell the truth.

      Thanks for sharing!

      Shawn

  4. Great article as always, Shawn, thank you. I think your idea to rebrand as health critics is a great one. We already do it as working physicians; why not make it more organized and directed, with a clear mandate that is separate from other organizations, and operates more like a kind of think-tank. Furthermore, I’d propose that this should be an arms-length subdivision of the OMA, that is branded as independent, but gets support and funding from our dues. Much like the short-lived Medical SWAT team that had a mandate to respond quickly and efficiently to all political disinformation in the media, it’s important IMO to have arms-length groups with focussed mandates that complement each other to advocate for positive change in the system.

    1. Thanks Mark!

      I tend to agree. Even if the OMA decides to courageously speak the truth, as much as possible, with gentleness, issues will pop up that are just too hot to handle. It would help to have an arms length group to say all the things that need to be said, without fear of reprisal.

      Sure appreciate you taking time to share a comment!

      Cheers

      Shawn

  5. I agree with Mark. We need a PR person that tracks the media and sends out our position on every issue that pops up . Also to be proactive and bring up the problems with suggested solutions. The public only hears criticism of what we do. Why not give the public the real deal about their healthcare system? How are hands are tied. How we are doing so much with so little. How we work so hard with so little support. It is a profession of sacrifice but there is a problem when so many feel burnt out. Let the public hear the real stories. And we need to speak loudly and with pictures!!!

  6. Congratulations on your win Prez Whatley and to Dr. Alam as well! All that hard work has paid off.

    We wish you well and are ready to serve as requested. This is a fine day for Ontario medicine.

    Canary

    A few words of warning from the inside the pink castle:

    “One sympathizes with the devotion of Dr. Whatley. A skilled sensitive MD. Central will eat him alive because he is trying to be reasonable. He MUST understand, at all times, central HATES, absolutely hates, the power and privilege MDs have, and has a sole mission to dismiss it, AT ALL COST. Each day begins with a chant – justice for all, destroy the doctors’ “privilege”.

    Within central, “social justice”, has replaced rationality. This is solely about power. Central will win. The backroom deals have been made. ”

    “Regretfully, one must advise them of the struggle. From the Prime Minister, through the Premier, through the various Ministries, the MDs are the “enemies” against social reform. The sociologists “believe” we are all equal, and thus, any issues are driven by systemic sociological bias. The biologists go, biology drives the issues, address, fairly inequity, but, in the end, some are biologically unable to deal with the current society.

    The new leaders need to quickly pick their camp. MDs treat disease as best they can, and will assure those resources become available, and try to even out inequities, or MDs own all the issues of society and are greedy. One wishes them well. Make a stand.”
    Mfo

    http://realist2.squarespace.com/journal/2017/2/7/resignation-of-the-oma-executive-what-now.html?lastPage=true#comment21735277

    2. Agree…Congrats to the new President.
      Best way to restore the trust of the profession is to ‘let your people’ and de-rand the doctors.We are the ONLY associated in the country with mandatory dues and the ONLY one without a PSA.
      Do the right thing…

      R Saplys

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