The Speed of Media in 2019

Well, it’s Friday afternoon in Virginia, and at this time last week, things were a little bumpy but no one saw the cascade of news events ahead. Without discussing the details of the events, let’s look at the interplay between the news media and the subjects of the news, and then the ecosystem around them. Why?

Because news has fundamentally accelerated. If there was a scandal with the governor of any kind 10 years ago, it might have “broken” online but most people would not be aware of it until it was in the morning paper, and that might have a pretty big reach but very few official comments would be filed. If it had been 20 years ago, it would have definitely waiting for the Saturday morning paper and maybe the nightly news, stretching into Monday as reporters and editors waited for confirmation during business hours. 50 years ago, who knows?

The fact is, by Monday of this week, we’d had reactions to reactions, and a deluge of responses that called for action. The news went from breaking Friday late in the day, to calls for resignation by 9 p.m. Saturday morning there was additional news that was confusing. A minority of people suggested waiting to see, but rather than thorough research and confirmed facts, rumors flew through cyberspace. The press conference was live streamed, and scheduled on a Saturday because responding was urgent. Reports from the press conference begat tweets immediately.

With news alerts to our phones, we glean just the barest information — what the headline said, and no more (and maybe not even that if we didn’t read it right.) Many more people get their news not from a primary source, but from a secondary or tertiary source. Part of this is that all the pinging of our phones happens while we are doing other things. Few people tune in for the live stream unless they are very interested, and fewer stay for the whole thing. Conversations online show these gaps in information as people check their news or absorb information at different rates — some people know that other news has hit, while a few are just learning about the first piece.

I am definitively not commenting on the content of Virginia’s week in the spotlight, but I need to say that observing it as a journalist has fascinating. Rather than beat reporters following up with their sources, like they do every day or week, I saw the descent of TV news crews to the Capitol or the front door of the Attorney General’s office. Totally reasonable, but a different style of news gathering all together — the press gaggle pounces on whoever emerges. The response of the subjects is also disheartening, in which they don’t seem to understand the context of the media, who represents the public’s interests. The intensity of the pressure seems to lead to some strange off-the-cuff choices which is not great communication because we don’t know what it really means when it’s done thoughtlessly.

So one week later, we’ve had two press conferences, multiple press release statements, a few press gaggle interviews and a ton of bizarre revelations, conjecture, reactions, positioning and tweets. Is this the new media age, where a week feels like a year? Are we better off for it?

Socal Mapping: Connect the Dots

I want to talk to you about social mapping. The longer I live in the same town, work in the same industry and volunteer — the more I see the invisible network of my social universe. That means that I know that Sam, who is on the library board with me, used to work at the college, so he’s a great person to ask for who to talk to there. He knows my friends, Peter, the health care lawyer and his fundraising wife, Kerry, who also go to my church. They know the former city councilwoman, Judy, who is on the board of the health clinic — she’s their neighbor! And she may know the mom of one of my son’s friends, Jack, who is also a writer and she’s a great person to refer me for developmental editing jobs (see the recommendation in my last post!) for college professors, who also know Sam! It means that I can’t give a lot of advice about where to find new clients because my biggest projects have always come from my social network.

But here’s some wisdom I can offer. When you want something, but don’t know how to get it, start making a map of people you know and see if anyone can get you the introduction or the advice to get you there. You may be surprised and who is a good connection, or who turns out to be a great connection! I often use online tool Coggle to map out concepts and it’s great for social mapping as well. I start with “mutual friends” on Facebook and then go to “mutual connections” on LinkedIn…it can be interested to see that you know a bunch of people from the same gym, sports team or that your kids go to school or play sports together. It’s a kind of networking — but really it’s just making visible your existing connections in your town.

Here’s an example: I am working on a fundraiser for a political campaign, and I want to know where the candidate and I overlap. So I make a social map. People we know in common, some are obvious, some are surprising! Then I look through my lists and see who I’m surprised that we don’t have in common, people who are active in politicals, who work in the same field or live in the same neighborhood — these are people where I can make an introduction, and that is potentially a very valuable introduction if it expands his network in a positive way. It could be for lots of reasons, social or business, but helping other people with their networks will help yours in the long run. (Have you read Inga Carboni’s book, by the way?)

Try it locally. Try it for your industry. It’s a great way to map out pathways to your goal.

This just in! Recommendation from Dr. Inga Carboni

Natalie was the developmental editor for my recently published book, Connect the Dots. My "final" draft was complete but I couldn't let it go. I kept revising and polishing. By the time I reached out to Natalie, I couldn't tell if the structure and narrative were perfect or needed a complete overhaul. Natalie was amazing. She gave me exactly the kind of high-level feedback I needed. She suggested cutting an entire chapter, tightening chapter summaries, reworking the flow of two chapters, and adding some graphics. She highlighted sections that worked really well and others that were too dense or abrupt. Natalie encouraged me to make the changes quickly and then send the book to my publisher. Natalie was right about everything! The publisher loved the book and, according to reviews, so do my readers. Natalie's competence, professionalism, and encouragement made all the difference. If you have a piece of writing that you want to take to the next level, I highly recommend you contact Natalie. 

Here’s the link for Dr. Carboni’s book.

Doc, Come Quick!

Besides reading about modern health care innovation, I love to read historical and fantasy fiction and watch historical dramas. One things I've noticed is this: health care skills have always been valued. I expect this will continue. 

Take the case of Claire Fraser, heroine of the Outlander series. She's a time travelling nurse who goes from World War II to 1743, and although she lands in hot water almost immediately, she is able to win the trust of her captors with her medical skills. Not only is she an amateur botanist, she knows about...germs! Which puts her ahead of her sudden contemporaries. She's got excellent diagnostic skills, having read and seen all manner of illness in her time. Ms. Fraser is experienced with sutures, tinctures and identifying whether a rash is a serious or fleeting illness. Her skills amaze others and she saves lives and wins the trust of many who help her find her way. (Of course, much of the delight of her skills for readers is that in 1743 everyone thinks she's a witch...but it's just modern medicine transported 200 years in the past!)  

Same with Doc Cochran, the only medical professional in Deadwood -- based on a true town in South Dakota. He's a grump Gus, and he should be because his patients are nearly all in bad shape. They've been injured in a mine, shot in a gunfight or are infected with a veneral disease. The show is all about this violent town's struggle for gold and independence, but Doc is able to disagree or raise a holler without any consequences...because everyone knows they soon may need his services. No matter how vicious relations get, the Doc is able to treat people, insist on better public conditions and even defy some of the more powerful people to do what he needs to do, because he has the medical skils that anyone may need imminently.  

I note these two characters, but there are many more, on apocalypse shows like The Walking Dead or CW's Hart of Dixie or BBC's Call the Midwife that make the same point. People will always be in need of health care, at some point. That makes these skills invaluable -- and I would like to note, we need to prioritize public first aid response training, professional health care education AND preventing burnout for our health care professionals, too. It's part of the human condition, and today we know that more than ever -- so we should be ensuring that we recognize this value. 

You Just Don't Listen!

I often advise clients that while they can just go ahead and do what they want, it's always good to talk to current and potential clients to find out what they want. If the business owner wants to listen to that and go in a different direction, that's his right to do that. But then, it's an informed decision. 

I get it -- some people feel strongly that you need to lead your customers, that they don't know what they way. And you don't want to try to be all things to all people -- also an important and overlooked concept, to inhabit your niche fully. But a lack of listening means that there isn't the "push and pull" process that needs to be there. 

One place I see this all the time is when scheduling times: opening / closing hours for businesses, the times they have classes, or town hall meetings for employees or recognition breakfasts. Is this a good time for people to attend? Do they mostly do their shopping in the morning and you should open earlier? Is lunchtime yoga actually practical? If you are trying to thank employees or customers, maybe you should make sure they can attend -- is it before or after work? If it's during work hours, can they actually attend? 

I see this often with doctors' offices -- they want standard opening and closing times, with a break for lunch. Is this helpful for patients? Would they rather have evening hours? Saturday morning appointments? And really, I think none of them want to you to close for lunch -- because most patients will be calling you on their own lunch breaks! To serve patients best, we need to ask -- what do you need? what do you prefer? what else could we be doing? This is where innovation can happen, as well as service recovery, where you address an issue that could potentially damage your reputation with a consumer. 

This is where surveys are fantastic. You can offer options, times, prices and a prioritization of needs. You can set out how you are doing it, how you are considering changing that and ask for feedback on any gaps. Don't forget focus groups, feedback events, check-in calls and celebratory events, as well as surveys. Listening offers information for you, but also conveys that you care about your customers!  

The More Things Change...

I found an old photocopy of a book I read in college for my journalism class called "Breaking the News" and I'd copied the section health care reform. 

Here are some quotes that could have been written today, rather than in 1998:

"...the market for medical care did not operate in the same way as markets for imported cars, or houses, or anything else...the health care market differed from other markets in that people don't even do the paying themselves, at least not at the time they get the care. I n a perfect market situation, the purchaser will have free choice among many alternatives, he will have full knowledge about the selections and he will have an incentive to economize. In the medical market the customer often has non of those things...the patient is often the object of this process rather than a participant in it."

Sounds the same, right? Despite attempts to make health care more transparent, people largely make their decisions based on "is this covered by my insurance?" or more commonly, "I hope this is covered by my insurance...I guess we'll find out."

"Businesses were in a panic about medical expenses, and so were any public officials responsible for a budget. The United States spent twice as large a share of its national income on medical care as the average for other developed nations. The money bought the world's most advanced and high-tech treatment for certain maladies but it also left the US with a higher infant-mortality rate and a lower life expectancy than in other advanced societies."

Panic, check. Highest infant-mortality rate, check. Lower life expectancy, check. And we are still spending WAY more than other countries on health care: OECD data shows the U.S. spent 17.1 percent of its GDP on health care in 2013, 50 percent more than France and almost double the United Kingdom's spending. 

"The strongest argument for single payer is, strangely, that it would be anti-bureaucratic. The great administrative nightmare in American medicine is the need to keep track of dozens of reimbursement forms from dozens of insurance companies, each with its own rules about payment rates and authorized courses of care."

Bureaucratic nightmare? Yep. Possibly we've gone further in our agreement that routing health care through employers is a difficult way to cover stay-at-home parents, entrepreneurs and small business owners. So, as we look at the future of American health care...what can we expect? Surely, change. But what kind? Time will tell. 

Why Regionalism Will ALWAYS Matter

I went to a economic summit in Virginia recently...and there was quite a buzz from the people sitting around me. It wasn't about the economic data. It was about the speaker, who admitted he was from California, repeatedly calling a city in western Virginia "Stawn-ten."

Well, we are very particular here in the Commonwealth about the way things are pronounced (also, about being a Commonwealth!) Especially our inherited English city names. It's "Stan-ten." (Yes, we know there's a U in it.) It flags you immediately as an outsider, (or an unprepared speaker.)

My point? No matter how globalized we get -- there are some local things that show you are part of the community, that you are familiar, that you took the time to get to know us. I doubt this will ever change. Like the recent holiday gifts: I got Malley's Chocolates from Cleveland, and my husband got Esther Price Chocolates from Dayton. Are these Ohio candies all that different? Probably not, but our childhood memories are, and that goes directly to the brand.

It's the same with any marketing -- it needs to take into account the uniqueness of the people who live in a regional, and respect it. There is no one size fits all, and I think it's human nature to want to distinguish ourselves. We want to know that we are not like everyone else, personally and as a community. It's why local breweries are doing so well, why farmers markets are popping up everywhere and artisan goods are getting a premium.

Hospitals, once stalwart icons of the community, would do well to remember their roots as well. The trend toward larger system franchises offers more access and more resources, but health care is deeply personal, and that should always be in the forefront.    

Here, Take This!

For months, I've been carrying around a stack of papers in my planner. It's about four pages, stapled. It's my son's occupational therapy evaluation report. 

I'm not carrying it around because I need it for any reason. I'm carrying it around because of a highly annoying, yet highly prevalent health care issue: electronic medical records.

My son's therapy office emailed me the report. Great. I've used that method to share it with the school nurse and teachers. But I called my pediatrician's office and asked them how I could share that with them, and they said they could not accept it via email. 

But I could fax it. Ha! (I haven't used a fax machine in years. In fact, my office doesn't have one.)  

More importantly, it makes no sense to take electronic information, print it on to paper and then send it over phone lines to be filed and transcribed electronically on the other end. But this is evidence of our "inherited architecture" problems in health care. We can't all get on the same page.

Some people adopted EMRs early, even designing their own customized portals. Problems with different systems (both health and IT ones) led to sharing problems. With the migration of most big health systems to EPIC, maybe this will be smoother. 

But...the issues I've had are with the little guys. The independent therapy practice is not going to go EPIC. Just like my OB practice just faxed all my paper records to the hospital and they PDF'd them but couldn't search them. All the paperwork for kids' health at schools is on paper back and forth between home and school, then put in the computer there. These little glitches mean that there are redundancies and  gaps. 

We are stuck in the era of bumpy roads with EMRs -- they should be making things go faster, smoother and more directly to the right places. But, sometimes it rains and we're stuck in the mud. I finally delivered the paperwork to the pediatrician on Friday. I held it in my hand the whole time so I wouldn't forget. I would have been so mad if I left without giving it to them. But I also would have been so happy to have sent it to them via email in April! 

Advice for Entrepreneurs: Believe You Can, Make a Plan, Be Aggressively Positive

I just found some notes from a great speech from Dr. Angeline Godwin, President of Patrick Henry Community College about teaching entrepreneurship (which is hard to do!)

Here's 5 questions to ask yourself, and a few comments from me on how I started down the road to Entrepreneurville:

1. The Bird in the Hand: What do you have right now? When I started my business, I had very few concrete things. Luckily, I wasn't selling goods, I was selling my brain, my time and my experience. I had to get a new computer, business cards and a website -- and get out there! I had connections but I need projects. I had some freelance clients, but they weren't steady. I did not have any previous business experience, but I'd worked mainly for small, growing companies which taught me a few things (mostly, what to avoid!)

2. The Affordable Loss: What are you willing to lose? I was in a very stressful work situation that required a lot of hours and freelancing seemed to be a great option. I wish I could have had a better, more stepped transition but unfortunately it didn't work out that way. So, I entered entrepreneurship by jumping into the great unknown and growing wings on the way down. Depending on what day it was, I was confident or disconsolate. Some of the uncertainty was balanced by less stress and more freedom -- but it's also incredibly hard to shake the feeling that you could ALWAYS be doing more.  

3. The Crazy Quilt: Who do you know? (who isn't like you...) I made lots of lists. People i knew locally, people from previous jobs in Cleveland, people I'd met at conferences and through work over the years. It's amazing how many people you collect -- and once I was focused on health care, it was interesting to see who I knew who might hire me that i had no work connection to. It's really a testament to ensuring you have a good all-around reputation. Many of my clients have come to me in unusual ways, through friends and colleagues and I appreciate that tremendously.

4. Lemon to Lemonade: What will you do when, not if, something goes wrong? I spent a lot of time worrying about things going wrong, even when they were going right. Being an entrepreneur will make you hyper-vigilant. It's important to have a Plan B and a Plan Z (as LinkedIn founder Reid Hoffman coined) as well as just plain faith in yourself. If you are good at what you do, if you are reliable and deliver as promised, if you can adapt to changing situations -- why can't you count on that in the future? 

5. Piloting the Plane: What do you control? Well, you can only control so much, and worrying will make you nuts. So, that's what insurance is for. I got some good advice in the beginning about setting aside half of every paycheck, and to get business insurance -- not just for liability, but for errors and omissions and other business issues that might be out of your control. You can create processes and set up policies as you learn, too, so you don't make the same mistakes twice. 

Entrepreneurship isn't for sissies. But it can be tremendously rewarding and the freedom can make you never want to work for anyone else again. I love what I do -- and I love that I have created my business to serve my clients in a way that works for them, too. Dr. Godwin also said "Be Aggressively Positive" and I think that's great advice. Believe you can do it. Make a plan to do it, and get to it! 

Food IS Social...We Should Admit that When Trying to Change

Right now I've got three streams of work projects where food is part of the conversation. Food allergies, obesity and oral health -- all of which relate to what you can eat, what you should eat and what you cannot eat. I think in the health care field, we tend to overlook how hard it is to change social food patterns. 

Here's an example -- in an article called Social Consequences of Food Allergy, Catharine Alvarez mentions a recent study in Pediatrics about Bullying of Kids with Food Allergy.  She mentions that she was surprised by people's resistance to accommodating her kids' food allergy restrictions.  What it seems to come down to is deep social mores that if you reject food that's offered to you, you are rejecting the person offering it. There is symbolic social function in shared meals, and the avoidance of sharing food, even because of a serious medical condition is not easily accepted. 

For obesity, there are similar issues. Control of one's diet, although necessary, can be difficult because the reality is that we don't eat in isolation. We eat with our families, we eat at work, we go to restaurants together, we share celebratory meals and meals at community events. It's never a solo event, and if it must be, it makes it difficult to sustain. The person unpacking their individual containers during the lunch hour is often seen as sad, while the people who join in the Friday lunch bunch are seen as good company. 

In a meeting with a speech pathologist this week, she mentioned how many of her patients have issues with swallowing -- and how being restricted to soft foods like applesauce and mashed potatoes is demoralizing for patients. They want to eat. They have favorite foods, comfort foods and they want to eat with their peers...whether they are 70 or 7. 

I don't think there's any question that health care professionals know that food matters, but we often look at the calories, the protein or the processing instead of the environment.  Food is social, and addressing who we eat with may be as important as what we eat in changing behaviors.  

Health (Brand) Journalism: What is it?

 

The Society for Healthcare Strategy, Marketing and Development (SHSMD), one of my favorite professional organizations, creates a great newsletter. This month, there's a piece by Cheryl Welch about brand journalism in health care. She offers a case study of brand journalism by Spectrum Health, a Michigan health system that deployed an internal reporting team to create content for their Health Beat digital news site. This is a fantastic example of how things have changed in media to where organizations need to "be their own publishers." A health system is a great ecosystem for illustrating this concept, because a lot happens in hospitals, doctor's offices and nursing homes every day. There are triumphs and setbacks. There are innovations and routines. But one of the challenges for public relations and marketing departments is that they don't hear about these stories until someone thinks to call them. 

Internal reporting, AKA brand journalism, applies the same concepts that we learned in journalism school to tell human interest stories, in this case within the health context. These stories are not outright cheerleading for health system, but interesting, balanced and realistic stories of the people who are inside it, for whatever reason. 

I see this as a major trend in marketing and PR and it can be done well. One of the reasons this is a great tactic is that as Welch says " traditional media is disintegrating, our consumers are more demanding and savvy and the tech landscape makes it downright cheap to reach large audiences."

One caveat, of course: if you are going to do it, do it well. Get a photographer. Create a style guide. Avoid astroturf (fake grass vs. real grass.) Take the time to do rounds and listen for the best stories. Have a plan for the brand voice to come through in the right. Hire people who know what they are doing. Get permissions. And then....go tell those stories!

Infertility....Has to Start with Fertility

My magazine editor asked me to write a story about infertility...maybe 900 words? And I said, "I just don't think it's possible to cover all the nuances in that amount." So, now it's a five part series! I thought I knew a lot about this, after moderating an online moms group for years, and seeing some of my best friends deal with miscarriages, blood disorders and long waits to finally get to announce their pregnancies. But after talking to many more people about this topic, I feel that it's still so much to absorb. First, people don't know many basics of fertility -- including the ages when fertility declines. I think this is a failure of our health education system that much of our information comes from celebrity magazines -- a number of people cited older actresses having babies as reassurance that they "had time." 

Here's the story, and I hope you'll keep following along! http://www.thehealthjournals.com/fertile-ground/

Words That Most People Don't Know...

I've heard people say that "medical school teaches you a new language" but that doctors don't learn how to translate that language well.

I attend a lot of meetings with physicians, and so I started putting words in my margins to look up. Things like "Baconian Induction" which to me, sounds like a cooking technique...but is actually part of the reasoning involved in scientific research, and "suboptimal hypertension control," which means your blood pressure is too high. 

This is one of the reasons why health literacy is so important -- not just assessing it, but teaching doctors to remember that most people don't know these precise terms. There are good reasons why medical terms are so precise -- Where is it? What's happening? How often? Is it getting worse? What's the cause?

But for patients, it makes things more confusing, as they are trying to listen to the doctor, read his or her physical cues, and determine just how bad it is. The more we learn about medicine, the more we need to remember that people working outside the field need simple, topline information.

  • What's is happening in my body?
  • What should I do next?
  • What will happen if I don't do that? 

Health literacy sounds simple, but as we often say in writing: "If you can't explain something simply, you don't understand it well enough." (attributed to Albert Einstein)

So I'm collecting words on a roll of paper in my office, to remind myself to keep it simple. 

 

Faxes, Paperwork and Our Tangled Mess of a Health Care System

Often, the best illustrations are personal. Here's the stats on my spring break health care administration for my sons:

1 ENT appointment                                 9 pages of paperwork

1 Occupational Therapy evaluation        4 pages of paperwork

3 dental appointments                           6 pages of paperwork

I filled it all out, with compliments from the front desk staff (I am a professional, after all.) But, I don't have great handwriting, and what are they going to do with it after I hand the clipboard back to them? They are going to type it in to their computers. Why can't I just type it into an online form? And, the dentist isn't new, it was just time for an update -- why couldn't they have read it to me and I confirm all the information, which hasn't changed one bit?

I know there's a lot of change in health care right now, but this is one of those process improvement issues that has long been adopted in other fields. In addition, the ENT's fax machine wasn't working so I went the pharmacy 3 times to pick up a medication that should have had a confirmed refill. Why is anyone faxing anything? 

I'm sure this has something to do with privacy laws, and security of information, and of course that's important. But I suspect a large part of it is that no one has pressed for this kind of improvement yet, they are too busy with other concerns. While I'm sympathetic to that, I feel it's more evidence for what Walter Cronkite said "It's neither healthy, nor caring, nor a system." A healthy system contains up-to-date health information, a caring system makes it easy for people to share their information and a system means there's an efficient process to do so. 

I'm optimistic about the requirement of electronic medical records, even though there's lots of grumbling about them. I think they can and will help patients and their care providers do better. First, let's get off the paper.  

Inoculate Yourself with Information

It all started with a conversation with my gynecologist....about Ebola. We talked late in 2014 in about how people we completely terrified about the Ebola outbreak and didn't seem to remember much about the basics of infectious disease. She said "Someone should write something about this for the general public." I agreed. Then I realized she meant me. 

So I wrote a story about this for the magazine I write for, The Health Journal, and then got an invitation to speak at The College of William and Mary about the topic. Unfortunately, we got snowed out that spring, and by the time I presented in the fall...no one seemed to care about Ebola. It didn't become an epidemic in the US.

But, luckily by that time, I was smart enough to add a virologist to my presentation, Dr. Kurt Williamson from William and Mary. He handled the virus and infection specifics, and I talked about how important it is to consume health information with a skeptical mind. It was a great chance to clarify some concepts for the general public, and for me, too! 

Entrepreneurship -- Hard to Spell, Hard to Do

I never thought I'd be an entrepreneur.

I still need to check my spelling on it -- there are a lot of e's!

Given that no one in my immediate family had ever started their own business, it was a little foreign to suddenly be able to just do it. Say I was starting a business, and do it. And, it's a little addicting. I am decisive, and there are a lot of decisions to be made. I'm a promoter, and that's always a plus, for me and my clients.

But it can be overwhelming just how many choices there are to made every day. That's why getting together with other entrepreneurs is great. They get it. We're all busy. We're all juggling priorities. I'm excited about going to a coworking meet up today, and I'm always excited to see small business owners at the Cobblers' Collective, the group that meets weekly at Work Nimbly.

Lots of places want to encourage entrepreneurship, but it can be like catching lightening in a bottle. We move fast, we want to get going and not wait for it to be discussed in committee. That means creative ideas come fast and furious, but it's hard to get us to go to 18 months of committee meetings.

It's an interesting, never boring life of entrepreneuring! 

The Art of Yellow Shoes

As a bona fide extrovert, I love going to conferences. But, apparently not everyone does. There's a psyching up that needs to happen. At the most recent conference I went to (#SHSMD2015), I found a brilliant marketing idea. I was in line for a drink with two gentleman, and I of course started talking to them about their names, my favorite topic. But then I noticed they were wearing yellow Oxford shoes. Both of them. 

Not only was this a great way to have an instant ice breaker with the thousand-plus attendees, it tied in to their booth in the exhibit hall, also full of bright yellow accents. The entire staff had yellow shoes: pumps, moccasins, sneakers. So, on brand, attention-getting and unique. A brilliant plan for standing out in a sea of competition. Nice work Lift 1428!

Infectious!

After giving a presentation this week on infectious diseases and deciphering health information, plus attending an excellent SHSMD session on the handling of the Ebola panic, I have a few thoughts. 

1. Even if all of us who work in the medical field think that people should know something, it's best to go back to the basics. Like the super-basic foundations of science -- for example, that a virus and a bacteria are different things but both can make us sick. Or, that one study does not science make!

2. Internal communication is ultra-important in a crisis. It's not enough to reassure the public. You must communicate to your staff, your board members, your volunteers and anyone working in your hospital. Because your credibility goes in the toilet when you say "We're prepared" but the reporter interviewing nurses on the loading dock hears "We've had no training on this."

3, Fear is a strong motivator, even if people know they shouldn't be afraid. They are, and they want to play it safe. I heard from someone who was thinking of firing her nanny because the nanny's mom was a nurse. It sounds like an overreaction now, but if you recall earlier this year, we were a nation on the edge of our seats as to whether we'd have an outbreak or not.

4. Communication takes time. It can be laborious when you want to be doing (let's go!!!) but it will save you time in the long run. Return people's calls (especially reporters!) even if you don't have anything new to share. Tell your employees what to expect. I agree with Doug Levy (formerly of Columbia University Health System) who said "Communication can't solve everything but it puts you in the best position to catch flaws in your plan." 

Infectious diseases are a tough topic, but one that we will continually revisit. They won't go away -- but we can educate and we can prepare. Oh, and we can communicate!