When they discover the center of the universe, a lot of people will be disappointed to discover they are not in it.
– Bernard Bailey
No organization functions in a vacuum. Neither does the world revolve around any single organization. No matter how noble the cause, how admirable the work, how worthy the protagonists, there will always be detractors, critics, and sceptics. Health-related organizations, perhaps more than any others, and particularly some health professionals, often suffer from the mistaken idea that because of the human service aspect of the work they do, they somehow have a right to the higher moral ground. This is a dangerous assumption for healthcare managers. What is needed more than ever before is careful consideration of how health-related organizations and their managers appear to the public.
The need for strategic communication in the management of health-care activities has grown out of a need for organizations to communicate their messages expertly to a variety of constituents whose goodwill is important. This goes far beyond trying to persuade publics to your point of view, as we have discussed throughout this book. The behaviour of these constituents both directly and indirectly affects the organization’s ability to continue pursuing its noble cause, its admirable work, and its overall service to society. And the need for this approach to strategic communication will only intensify, rather than diminish, in the future.
To examine the future of communication within healthcare management we need to broaden our view. Examining the role of health-related organizations within a social context provides us with an expansive canvas upon which to paint a vision of the future. Change is inevitable; therefore, a serviceable starting point is a look at what is likely to be transformed on this canvas. However, some issues are not likely to change a great deal, and these are just as important. Finally, we will look at how the individual healthcare manager can keep his or her communication strategic.
There are some things that will change and some things that will remain the same. Let’s begin by examining some of the things that will undoubtedly change.
Probably one of the most important factors affecting how healthcare organizations must reconsider how they communicate is the aging population. No one needs the government statistics about the aging baby boomers to recognize that the population is getting older. This situation is particularly acute for healthcare organizations, since health problems increase with age. The communication strategies and approaches of both organizations and individuals will have to change.
First, the age of your employees is edging ever upward: Workers aged fifty-five and older are the fastest growing segment of the workforce, with the median age of the Canadian workforce having finally reached over forty in 2006.1 In the United States, 48 per cent of the members of the total workforce, representing some sixty-nine million Americans, are over age forty.2 In a society that is still in the grips of a youth obsession – baby boomers trying fruitlessly to hang on to their youthful bodies and skills – it is easy to figure out that the way organizations communicate with the employees will have to change. The situation in health care is especially acute, since the workforce through much of the last century was typically younger than in many other industries. Aging employees want information about different things than do younger employees, and healthcare managers have to provide that information in a way that avoids any sense of discrimination.
Clearly, the most important aging group that healthcare organizations need to communicate with is their current and potential patients and clients. Marketers know that the words we choose to communicate our messages are all-important in gaining the attention of the target. We can learn from them. To begin with, it seems that there is no one acceptable term to describe this group. Senior citizen is outdated and offensive to some. Senior is just as bad. Old is discriminatory. Elderly conjures up physical frailty. The term mature seems to bridge the gap between insulting and nondescriptive.
Once the labelling is out of the way, you will face other communication considerations. One important consideration for more mature audiences is the challenge of finding the right medium to reach them. Hospitals, health-service organizations, and long-term care facilities need to assess the usefulness of the materials they produce and the way these materials and messages are distributed to aging audiences. Here are some questions that may provide useful information in an evaluation of these materials.
1. Is the content applicable to an aging clientele?
2. Is the visual layout considerate to people with declining vision?
3. Is the material distributed in places that are likely to be frequented by aging clients? Or, perhaps, do you use direct mail (which is considered to be useful for this group)?
4. To what extent will Web-based communication vehicles be embraced by the mature public in your own sphere of influence?
Another factor that alters communication from healthcare facilities is changing public opinion. Since your organization’s image is a reflection of public opinion, how it changes is key to understanding how the external world thinks about you. Public opinion has always been mercurial, but changing demographics of the North American population are likely to magnify this fluctuation. Keeping communication current with public opinion is going to be a challenge for every manager in the healthcare industry.
Each passing day it seems, your audiences have more easily accessible information about health and health care. This proliferation of health-related information is a double-edged sword. On one hand, it does indeed serve to empower many consumers with enough information to somewhat balance that lopsided relationship that patients have traditionally had with healthcare providers. It truly makes them a part of the decision-making process about their own health status and healthcare decisions. On the other hand, however, a frighteningly large portion of the population has difficulty sifting through all of this available information. They have no frame of reference for determining what is truly useful to them and what is completely inaccurate.
Never before have we had so much genuinely valuable healthcare information so easily accessible. But, thanks in large part to online sources, never before have had we had access to so much spurious rubbish, either. Healthcare organizations have an increasingly important role to play as credible sources of information. Indeed, it may even be the case that they have a duty to assist consumers in this search for useful information. This might make the basis for a terrific community relations strategy.
Another consequence of this increase in information is that attitudes toward healthcare decision making are changing. Even fifty years ago most decisions about health care were happily left to health professionals, mostly doctors. They knew best and paternalism was rampant. Now, however, public attitudes about who should be making these decisions and how they should be implemented are changing.
Communication implications for healthcare organizations are many. Are your employees knowledgeable about patients’ rights? Do they have enough materials available to aid them in assisting patients? Are your employees aware of management’s perspective on patient decision making? Do your patients/clients know their rights? Is your community familiar with your philosophy? These are just a few of the questions you have to be able to answer.
Finally, communication technology changes almost daily and is likely to continue to change. Financial concerns notwithstanding, health-related organizations cannot afford to lag behind in communication technology. As a manager, it is important that you first recognize that access to the latest in communication technology is a strategic advantage. Second, you must be comfortable with the use of these technologies. When voicemail was first introduced into our workplaces, there were those who refused to embrace it or even learn how to use it. Then came electronic mail and few of us realized the extent to which it would revolutionize how we communicate. These two examples are only the beginning. Your own knowledge and comfort will enable you to ensure that others within your organization understand that these communication technologies are not only a nice addition to your organization’s abilities, but may be crucial for their continued success.
These changes are already happening, and, in fact, may be better identified as trends. The bottom line is that the context of communication is continuing to change, and healthcare managers need to recognize these changes and adapt their strategies to them.
Even amidst all this change, however, some very crucial issues will remain the same – the most important of which is the requirement for organizations of all kinds to recognize their social responsibility. Despite the fact that health-related organizations, by virtue of their very missions, consider their core work to be fulfilling a social responsibility, we need to examine the issue through a broader lens.
All organizations in society continue to exist only if they fulfil a societal need, only if they are serving a useful public interest. While at their core, health-related organizations seem to serve a vital public need, there must always be the public perception that the organization in question is doing so in a socially responsible way. In general, this implies that the organization fulfils its mission within the letter and spirit of the law at all times, has a code of ethics that guides its decision making, and that its activities reflect respect for human dignity and consideration for its larger community – in short, the organization is a good citizen. These actions are more powerful communication tools than any words that might come from your organization.
From time to time, it might be a useful exercise for health-related organizations to perform a social audit. This is a tool that you design to identify and assess your “social and environmental impacts, communicate internally and externally [your] performance, and make continual improvements in such areas as community and customer relations, employment practices, human rights issues, environmental responsibility, and ethical behavior.”3 This definition implies that communication is at the heart of a social audit. The results may help your organization to formulate directions for not only future communication priorities, but for operational priorities as well. Again, public perception of your organization’s activities is at the heart of the matter.
Although the broader context of your communication activities and those of your organization continue to change and develop, there are some things that managers need to do to keep their communication strategic. Here are a few ideas.
1. Ensure that you treat all audiences as special. We have talked previously about the issue that one size definitely does not fit all. Careful consideration must be given to determining the informational needs, desires, and habits of a variety of constituencies for your organization. Indeed, your own communication practices should always consider this: in everything from composing e-mail messages to making public presentations.
2. Enhance opportunities for two-way communication both internally and externally. As attitudes about shared decision making and participation continue to change, it is more important than ever for you to consider how much feedback you invite and what you do with it. This needs to be true two-way communication, not lip service to asking for feedback and then ignoring it. Strive to enhance your communications with employees, clients, medical staff, board members, and the community at every opportunity to truly engage with them – not just listen, nod, and ignore..
3. Keep up with new advances in media technology. This may require you to take a course. Even if you are at the highest level in your organization, don’t rely on others to take up the slack here. As we have discussed all along, communication is a requirement of everyone, and you, as a manager, need to have more than a passing acquaintance with the new technologies. Right now: Do you know how to use Twitter? Do you use it strategically? Do you have a social media policy in place? Do you know how to search blogs online? These are some very simple media technology questions that no health-care manager should answer “no” to at this point.
4. Practise and hone your communication skills. Your own personal skills – writing, presenting, giving media interviews – all need to be assessed and updated continually. Make use of your public relations staff if you have one available. Look for workshops and seminars. Attend communication sessions at health management conferences. Read.
5. Keep an open mind to enhance creativity in healthcare communication encounters. This is necessary on both a personal level and on an organizational level. An old way of approaching a communication challenge may be just that – old. Always be open to new ideas and strategies.
In summary, respect the power of communication. It has outcomes that are both planned and unplanned, and you must be aware of these at all times. You should never be caught off guard by any consequence of your communications with anyone, at any level, in any situation.
The power of communication is the very reason that ethical considerations are paramount. Primum non nocere: First, do no harm. Anyone who has worked in the healthcare industry, even for a short time, is familiar with the first commandment of ethics – to do good and to do no harm. And communication can indeed be harmful if not approached with a consideration of its ethical underpinnings.
The primary ethical consideration in healthcare communication, as in all other brands of public communication, is the responsibility to be honest in all undertakings. Religious traditions throughout the world, despite their wide differences, all exhort us to be honest. Indeed, integrity in organizational behaviour is crucial to maintaining positive relationships with all of your important constituencies. Honesty is one crucial part of integrity, which implies doing the right thing even when no one is watching.
Fairness is also important in healthcare communication. Treating all your audiences as if they are important ensures that your communication efforts reflect your respect for them. Fairness implies that all those constituencies will be considered when planning a communication effort and that you will deal with them honestly in all encounters.
For the healthcare manager personally, behavioural guidelines can enhance the ethical stance of your communication. It seems fitting that we should end our discussion of how communication for healthcare managers goes beyond persuasion with a note about ordinary politeness. It is truly amazing what good manners, which by their very nature imply respect for others, can do in communication encounters. Can you answer “yes” to all of the following questions?
• Do you always say “thank you” to those who assist you even when it is part of their job?
• Do you always say “please”?
• Do you never reprimand a subordinate in front of others?
• Is your temper always well controlled?
• Is your language always appropriate and free of vulgarities?
• Do you completely avoid sexist remarks and/or ethnic slurs?
• Do you always refer to others with the degree of formality you expect for yourself?4
You need to be able to honestly answer “yes” to all of these as a basis for integrity and credibility in your communication efforts. Guidelines for your behaviour have the last word.
• Focus on your own work and not on that of others unless you have specific responsibility for their work.
• Be conscientious and honest at all times. This will become a part of your reputation.
• Be cautious about self-disclosure. Employees and peers do not need to know everything about you.
• Give credit where credit is due. Ensure that those you supervise receive credit for their work rather than taking it for yourself.
• Take responsibility for your own actions. Don’t pass the buck.
• Subscribe to a code of ordinary politeness.
It is impossible to manage without communicating. The notion that managers in healthcare organizations could begin their careers without formal instruction in communication – both personal and strategic – is beyond comprehension. What healthcare managers in the twenty-first century need to know, however, is that communication goes far beyond persuasion; and skilful communication is essential to successful achievement of your organization’s mission.