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David Jarrard

In Change Management, High Stakes, J|Insights, Strategic Positioning

Durable Optimism and the Importance of Healthcare Boards Taking Informed Risks

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Change is hard and, these days, it’s compounding. Big disruptions layered with small pivots have led to a tough environment where “one more thing” is a burden, not an exciting opportunity.

In this environment, healthcare executives and hospital board members are challenged with walking a fine line – guiding their organizations through disruption while acknowledging the uncertainty, making decisions when the path forward is foggy, and processing their own exhaustion, too.

Jarrard Inc. CEO David Jarrard and McDermott Will & Emery partner Michael Peregrine – both of whom have a deep interest in helping healthcare executives and boards navigate change – sat down to talk about the situation. They first acknowledge the challenge, then provide some historical context, then offer a few ideas for getting through it all.

Here’s an overview of the conversation. Listen to the whole thing or read the transcript below.

The Challenges:

It’s natural to wonder about the point of making long-term plans when we’re experiencing constant upheaval and uncertainty, when change has worn us down, when so much is out of our control.

In healthcare this is borne out as we see increasing responsibility – and opportunity – arrive at the door of provider organizations. And, some of the forces that have been serving as accelerants of change over the past few years have grown to be more disruptive. These factors are like the lighter fluid that started a campfire in a dry forest.

The Risk:

The tendency is to focus on and do what is doable. We tend to act on what’s right in front of us. And, while that is right and necessary in a crisis, it is not sustainable long-term. Spending too much time in the short-term leads to susceptibility to competition and disruption.

The Solutions:

Read the Transcript

David Shifrin: Michael and David. So, a lot of change disruption happening these days, and it’s happening in ways that put pressure on us and on health care leaders, both personally, as well as professionally.

I guess just a few things to note, to run down the list; although this definitely isn’t comprehensive, we’ve got the Dobbs decision, which is just one of a number of significant Supreme Court decisions this term. We’ve got the great resignation and kind of the workforce reshuffling, we’re facing down the prospects of massive inflation, which continues, as well as a potential recession. We’ve got the ongoing epidemic of gun violence. We at Jarrard just put out some resources to help healthcare providers be involved in that conversation. There’s the political divide; there’s lack of trust that we’re seeing. And then, Michael, you even mentioned the shakeup in college sports recently, with schools moving between conferences as something to flag. So, there’s so much, it’s exhausting.

And so, I’ll just kick us off here and then let you both converse with each other and bounce ideas back and forth but to start with, just talk about where that overwhelming collection of change is leading us and how people are processing it, or maybe failing to process it.

[00:01:54] Michael Peregrine: I think that’s right. You mentioned the change in college football. I think that put the capstone on it for me in terms of, it’s not that people and leaders are afraid of change, per se. I think they’re, to use your word, exhausted by this pace and the profound nature of the change. Too much, too fast change to traditions on which people counted on as normality in their lives, as predictable in their lives.

And one by two by three they’re being taken away from folks. So, I think, and David, I’m interested in your view. I think it’s a question of losing faith in the ability to control events. I know that I was particularly shaken in this environment of violence. The Abe assassination was one that I put down on my list because, again, I always thought we could count on living in a global society where we were civilized nations. These things don’t happen. And that’s really,

I guess the question, David Jarrard, I have is, I’m wondering if our leaders are saying that “when will this stop?” These things that we, these guard rails of society, these guard rails of organizations, seem to be eroding. And if we can’t count on them, and David Shifrin, going to your point, what’s the use of trying? What’s the use of planning? What’s the use of looking forward? You know, we talk about the three-year strategic plan being superseded by the five-year strategic plan, being superseded by the never-ending or ongoing strategic plan. Why even engage in strategic planning, if we’re just getting pummeled on a daily basis with things that we’ve counted on being obliterated? David, what’s your take?

[00:03:43] David Jarrard: Yeah. And in that environment, it’s the latest change that gets the greatest attention because it’s the latest change. It’s right in front of you. And everyday can begin to feel like a fire drill because you’re, as a leadership group, as a board, and even as a staff member.

I’m thinking of, of course, our hospital health system client, you run from event to event. It’s like having moved from a surgery suite, where everything is well planned and coordinated. And a good surgery, runs like a ballet. You know exactly what you’re doing, how you’re doing it to the ER, where you don’t know what’s going to come in the door next and you are running and gunning. You’re looking for supplies and trying to take care of people and keep folks alive and make it through the shift. It’s a whole different environment and way of thinking, and ER nurses and ER physicians, they have a different mindset than that orthopedic surgeon who’s been around for 30 years and knows exactly what they’re doing and how to do it.

It’s, and to your point, it’s not just the change. It’s the culmination of a whole series of changes. And it’s that sense of a lack of control where you can, you can begin to think, “what’s next? Why even act?” And I’ll add one more that we’re really paying attention to. It’s the decline of trust in organizations, in institutions. And healthcare systems continue to be very trusted organizations. And so, as other organizations become less trusted, more responsibility seems to land at the doorstep of our hospitals and health systems.

[00:05:09] Michael Peregrine: Yeah, from a leadership perspective, what troubles me is the concern that leaders for both executives and directors to pull back from engaging more fully in issues.

This is something that you, as you and I have talked, that Mitt Romney recently wrote about in the Atlantic. A concern that it’s easier to take the easiest, most simple solution to complex problems even though you have a fair likelihood of believing that it’s the wrong solution. But it’s easy, it’s quick and it’s available. Whether it’s denying that a problem exists or taking a shortcut. It’s this loss of a willingness to engage. Because again, we can’t count on traditional traditions. We can’t count on traditional guard rails to hold up. So, we’re playing short term ball. We’re making short-term decisions. We’re allocating capital on a short-term basis. We’re not planning for the future. So, when we come out of the current combination of crises that our clients are going through, will we be prepared for the next phase? Will we have prepared strategically? Will we be more susceptible to disruption and competition and regulation?

You just worry about this wearing down on our executives and our board members and it being just, when have we really hit the last straw? You’ve talked about it.

[00:06:32] David Jarrard: I agree. We, particularly, our leadership teams in healthcare systems are used to a strong sense of agency. Like driving forward and shaping the delivery of care and having some control over what happens next. And so, we are all built, particularly in healthcare, but other industries too, to do what’s doable. What can I do today that’s actually going to make a change and make a difference?

And Michael, I think you’re exactly right. Things have become so chaotic beyond our vision. That we act on those things that are right in front of us. So, we become tree people instead of forest people when we act. Which can be helpful short term; it can maybe be great in a pandemic, great in a global crisis, but not in a long-term event. It’s not a long-term solution to the crisis. That doesn’t seem to end.

[00:07:18] Michael Peregrine: And also, David, I’m concerned that if this is affecting our colleagues in the boardroom and in the C-suite, it’s got to be affecting the workforce as well. What do you say?

[00:07:28] David Jarrard: Oh, for sure. You know, our hospitals and health systems, they are not immune. they’re not an island. I mean, all the things that we experience in our communities are happening in the halls of our facilities as well. And we see it play out like position by position, job by job, in our hospitals.

And you see that in nurse staffing issues. You see it in labor activity. You see it in consumers being more and more reluctant to go spend that money, to receive the care that they should receive that would be helpful to them that will forgo longer-term health care costs. But, because they can’t see the future, they don’t know if they’re going to continue to have a job. They don’t know if they can live with continual 9% inflation that erodes their wages. They’re not seeking the care or may not seek that care in the future. Which has this cyclical effect, it reduces the revenue hospitals receive, which reduces their ability to pay nurses at a wage that is in competition with Chick-fil-A, for goodness sake. And so, it begins to build on itself into a significant issue.

[00:08:27] Michael Peregrine: And I guess the one thing that I worry about, particularly with respect to the board, is it’s trying to be a true partner in management and help lead the organization through all these very difficult times. Including the extraordinary economic issues that they’re having right now. Will board members be up to making the commitment to invest? And looking towards the future, in being an effective partner again if they are concerned that those things they knew and counted on are no longer reliable? And will there be another shoe to drop in terms of one of these change curveballs?

I particularly am concerned that what we see in the polls is about a lack of trust in democratic principles. At some point, is there a line that we’re crossing where our leaders will look to themselves saying, “after this, I know there’s really only one thing I can trust and it’s my judgment. It might not be the judgment of my collective group. My fellow executives, my colleagues on the board. I’m going to go with my gut because I know that’s not changing even though everything else around me is changing.” And that’s just antithetical to effective governance. And it is not what our industry needs at this time. And again, I’m sure you’re seeing this as well with the people you deal with in crisis management and communications.

[00:09:44] David Jarrard: That’s such a good point. Because we as a board, although the last, 20 or 24 months through the pandemic have been a very challenging time, we’ve been able to talk about the pandemic as an accelerant of change. What the pandemic has really done has made things that were already changing, just move faster.

So, telehealth, telemedicine, all the elements that are part of that new evolution of healthcare, are just occurring faster. And in some cases, that was a good thing. This strange environment gave us permission to move in the direction we wanted to go anyway. In the last year though, it’s felt like the changes have not been accelerants of change. They’ve been almost purely disruptive. And it’s impossible to anticipate. And so, the result is the bets are bigger. The risks feel higher. Because, as you say, no one has a model to predict this one outlier after another. There’s not necessarily math you can run. There’s not an analysis you can do that will give you a margin of error. So, you have to lean more on, and I love the way you say, you have to lean on your gut. What you believe to be true. And that seems to make ultimately the real job, the ultimate job of a board.

[00:10:51] Michael Peregrine: What worries me too, and has to be corrected, is the concern that the foundational principles, the core understandings of the industry, that our volunteer directors, or even our compensated directors came on board. And there were those principles or those operating guidelines, those basic understandings about the healthcare industry that they were weaned on, that they came to understand. The foundational principles and the understandings and the stipulations that underscore the strategic plan. Again, if we lose confidence in these types of factors because of the Powerful rapidity of change, we’re again, operating on an “I’m taking it one day at a time” basis. And that can be catastrophic for an organization’s future. And we, and that to me, that shift from a focus on the long-term vision to the “I just have to get through tomorrow” vision, that’s what we have to protect against.

[00:11:49] David Jarrard: And I know you work with so many boards, and I know how seriously they take the idea that they are trustees. That they are entrusted with this extraordinary organization, you know, often times hundreds of millions of dollars or multi-billion dollars of revenues and thousands of jobs. I know that weighs heavily. And so, they take seriously the ability to plan for the future and invest in the future two years, five years, 10 years out. I’m curious, as they are thinking today, how are they beyond their gut thinking about the future, sort of, envisioning about what the future is going to bring so they can plan for it?

[00:12:24] Michael Peregrine: It’s got to be a frustration again, because they contribute to a strategic vision in a variety of perspectives. They’re making bets on certain developments. And again, if they find out that they’re really unable, that change is coming too fast and too strong, their willingness to take informed risks, David, I think we’ll be limited. And that is, I keep coming back, that will be the greatest harm of this. And this is why, this kind of a miasma has to be stopped before it gets much traction.

And I was thinking about something. I saw a blip in the paper the other day. We just passed the 43rd anniversary, and I’m sure you have this on your calendar, of Jimmy Carter’s malaise speech. There’s been a lot of anniversaries this summer, with Sarbanes, with Watergate. But I thought to myself, wait a minute, as someone who waited in line for hours at the gas station during that period of time, and remembering a speech, I thought, there’s a little bit of similarity there. You had back then, as I recall, this overarching sense of an inability as a country to control our own destiny. We were no longer in charge of events, and to a certain extent, I’d be interested in your view, that seems to be where we’re headed right now with this change fatigue. We can’t stop these things from occurring. Things that we relied on are no longer reliable. We cannot control events. Do you see that as relevant at all?

[00:13:56] David Jarrard: I do say it’s very relevant. And I do remember that speech and I do remember the heckling he got afterwards. I have two thoughts about that. And the kind of communications that leaders are and could be delivering today. When I think about Carter’s comments, he wasn’t wrong to call out that this was an issue; that there’s a concern. And recognizing how the voters at the time, at least how he felt the voters at the time were feeling and thinking. I think it’s right for a leader to see the folks that they are asking to follow them. Is that recognition? I think that’s really important, and I think that’s what he was attempting to do.

But the other element of that message was there’s a problem, and I don’t know what to do about it. I’m not sure, I feel helpless, just like you. And that was, that’s the disconnect right there, that that can’t be the message leadership delivers. So, it’s great to recognize it. It’s great to call it out. It’s great to show appreciation for it and sort of shared empathy. But then, as a leader, therefore here’s what we’re going to do. Here’s how we’re going to tackle this problem. Not that I have the answers, but I know how we’re going to get into it together. I think that’s an important element for leaders today.

[00:15:07] Michael Peregrine: I agree with you. And as I thought about it, and again, I know that half of our clients have no idea what we’re talking about. But I think part of the problem, again, Carter did have his finger on the pulse. There was a crisis of American competence, and communication was what failed him. The communication of his vision failed him and ultimately failed his presidency.

And as I recall, David, this is germane to the subject of, how do we address this in the context of our clients? Somehow, he allowed the conversation on his message to shift from “we need to work together for the common good and make some self-sacrifice” to “Mr. President, you’re criticizing our way of life. You’re making moral judgments on our consumerism. You’re suggesting that we’re overly reliant on materialism and you’re blaming us for the problem.” And that, I think, as inaccurate as it was, took over the dialogue. I come back to your expertise in response to change fatigue as it may be creeping in with an organization just seems to me, not just what the message is, but how it’s delivered.

[00:16:19] David Jarrard: Yes, very much. And some of that message has to be action. So, it’s the recognition that there’s this issue. It’s acknowledging that there’s a challenge with creating a vision in such a cloudy environment. How do we see past the fog into the future? So therefore, and here’s the key, it’s always the, so therefore what? So therefore, we’re not going to cross arms and go into our boardroom and worry about the future. So therefore, we’re going to create teams. We’re going to involve you. We’re going to create a dialogue. We’re going to construct this and reconstruct it together. So even if the answer is, we’re not sure about the future, it’ll be an answer we all came to together.

So just the action of pulling people together in concert can be hugely energizing. Because then you’ve set the organization up for whatever direction you need to change. And because we will need to change, but you’ve set them up to acknowledge their own consensus building in that work. And that’s the right place for leadership right now.

[00:17:15] Michael Peregrine: Not to be Pollyannish, but I think that there’s an element where leadership here, it has as an opportunity to, through a durable optimism approach, say, “let’s take a look at what we’re dealing with right now. Maybe we can’t be, here’s where we stand in the industry. Here’s our financial position. Here are the things that are positive about this organization. Here are the tools we have to work with and here’s our position within the industry, and here’s what we do know.” And create a vision in saying that “we here at this health system are actually in a relatively stable position. These are things that you, the workforce, you, the board, us, the management team, we can count on this universe of knowns. And therefore, we are to a certain extent, maybe better than others in a position to control our destiny, even if that destiny is in the near term.”

So, I come back to your point about energy. When I’m tired, when I’m down, when I’m lazy, when I just don’t feel up to it, something energetic snaps me out of it. And I think that the energy, David, of the communication, as much as the context of the communication, is what may be necessary, in part, to counter this fatigue. The sense of loss of faith that nothing matters anymore because the future is changing every day.

[00:18:34] David Jarrard: I love the phrase durable optimism. I wrote it down as you said it. I think that’s so important to this. And to your other point, which I fully agree, and as part of our change management work is, before you can really talk about change, you have to talk about those things that aren’t changing. That will never change. This is what we know to be true.

And if you worry about all the changes that are happening, you can begin to worry that everything is going to change. That these shifts are going to change, this floor is going to change, and our mission’s going to change. And we know as an organization that short of something truly extraordinary, these things aren’t changing. This is who we are and who we’ve been for a hundred years or whatever the message is.

So, that ability to ground those things and put off the table those things that can bring some foundation and some solid ground, I think is a really important part of the message.

[00:19:30] Michael Peregrine: Don’t you think that’s a message that has to be delivered not just by the CEO, but by the linked arms of senior management and the board?

[00:19:37] David Jarrard: Yes. And the important role of the board here can be overstated to deliver that message to senior leadership. It’s the board’s commitment to this direction or these fundamentals that is key to unleashed leadership to get into this work.

[00:19:54] David Shifrin: All right. For the last couple of minutes here, let’s get very tactical. How do healthcare boards and executive teams deliver those messages? What are the tactics that are needed right now to make that connection with employees while also providing an opportunity for feedback and acknowledging the personal stress that leadership is undergoing themselves? How do you roll that in what’s the day-to-day for delivering these? Michael, I’ll start with you here.

[00:20:19] Michael Peregrine: Well, David, from my perspective, it has to start with leadership in the boardroom. And basically, the board chair and other leaders saying, “this is not a soft issue. This is a big deal. In all of our lives. We need to realize that we need to confront it, and we need to understand that for the potential risk, it is to our organization and our culture.”

So, David, I would start off by saying board leadership has to own the issue and convince the board that this is something that they must attack as a strategic concern for the organization. It’s got to start so that it’s buying in with the tone at the top. That’s job number one for me.

[00:20:57] David Jarrard: Very much so, and to affect that, is to recognize the needs of the senior leadership. And it’s, we talk about the mental health of our staff and colleagues and physicians and nurses and burnout and stress. It happens at the top, too. And as we move through dramatic things like this, recognizing that’s a need. And this group needs to be together and solid and comfortable addressing those things before they can be who they need to be within their organization.

[00:21:25] Michael Peregrine: That’s why I think that the board has to shift into high gear if it’s not already in high gear already. And begin to take a series of steps that represent a visible demonstration of their leadership and their buy-in on this issue and send that message of durable optimism. Meeting more as a board as opposed to meeting less. Having more sessions with the executive leadership team. Being visible in the institutional community. Having more town hall meetings between management and employees. A visible demonstration of board’s commitment and belief. And belief in the future and stability of the organization, not just the economic and quality and delivery of care stability, but the mission stability. As you said, David, we continue to stand for what we’ve always stood for, and you can count on that. That isn’t changing.

[00:22:21] David Jarrard: I remember years ago, during another sort of economic downturn working with a number of Catholic hospitals who were run by a group of sisters. And even though things were hard and there were questions about the future, they would tell stories about selling the chandeliers and selling this piece of land, that piece of property, or doing away with this practice because we will always support this. We will never not be that. And it was such a grounding story that they told that reminded people that we’re committed to this, no matter what we have to do to get there. I think that the level of commitment and that storytelling and remembering who we are, remembering why we are is really important.

And I really want to highlight a message you just delivered about visibility and that visibility through personal engagement. One of our core beliefs is that communications happen in a lot of ways. And part of it is the words that you use and the emails that you send out. But the messages that are delivered through the theater of physical interaction, walking the halls, body language in a presentation, being so optimistic that you’re willing to be present with people and shake their hands and hear their concerns, and cry with them, or pray with them, or be with them is hugely impactful. And it creates a kind of trust that is gold in times of change like this. Really want to highlight that point. I think it’s fundamentally important here.

[00:23:50] David Shifrin: Well, Michael and David, thanks so much for your time. It’s always fun. Always fascinating. And look forward to our next conversation. This has been great.

[00:23:57] Michael Peregrine: Thank you both.

[00:23:58] David Jarrard: Thanks, David. Thanks, Michael.

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In Change Management, High Stakes, J|Insights, Quick Think

Arnold and the Art of Capturing Attention

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The Big Story: Arnold Schwarzenegger speaks to Russians in emotional plea against war in Ukraine

A masterclass in communications.

The headline tells you exactly what happened late last week. But it comes nowhere near capturing the why, the how, the pure power of one public figure wading with deep authenticity into geopolitics. But powerful it was. Catching our attention. Holding us rapt. Moving us.

Watch it twice. Once to feel it. And then again to understand how it works.

We’re witnessing an extraordinary moment of powerful communications and communicators.

Russia’s brutal invasion of Ukraine has unleashed a parallel communications battle the likes of which we haven’t seen in this generation and which is beyond the scope of our weekly Quick Think. No surprise if textbooks are written about the situation, featuring, among other things:

  • The eloquent, razor-sharp messages – delivered through words and deeds – of Ukraine President Volodymyr Zelensky.
  • The harnessing of social media for “You Are There” journalism and “Are You Really There?” manipulation.
  • The Orwellian efforts by Russia to change the narrative against a sea of troubles, to block a tide of digital and tragically tangible information that cannot be denied.

But for today, we look at a single example from someone whose career trajectory broadly mirrors that of Zelensky – from kitschy actor to prominent politician. That training alone is worth noting when it comes to communications.

Outlandishly long in our distracted age of no attention spans, Arnold Schwarzenegger’s unexpected video – viewed by more than 30 million watchers within in 24 hours of its release – speaks directly to the people of Russia. We’ve captured several outstanding aspects of his compelling, at times personal message. If you take away just one thing, let it be this: The messenger must match the moment. Nothing brings home profound facts and difficult calls to action more than clear-eyed honesty and personal stories well and sincerely told.

Beyond that, a bit of video analysis…

  • It’s built for maximum reach. Schwarzenegger starts by telegraphing a basic communications principle. He says that he’s posting the video on multiple channels to make it as accessible as possible. It’s also subtitled in both Russian and English.
  • It’s built to target specific audiences. Difficult to pull off in a single piece, Schwarzenegger speaks sequentially to Russian soldiers, Russian citizens and Russian leaders – and then even more directly to Putin. The core message remains consistent as the specifics are adjusted for the audience. And in doing so, he is never manipulative. He tells viewers exactly who he’s speaking to – no games, no obfuscation, full transparency.
  • It’s direct about the goal from the start. Schwarzenegger begins by looking into the camera and giving a personal message to the people of Russia, expresses his life-long connection and affection for them, and then explaining where he’s going with it all. The environment is set to emphasize the directness and empathy: a tight shot of him at a table with a sober, but soft, expression.
  • It’s anchored by stories. After his intro, Schwarzenegger tells a story about his connection with Russia and the conflict that connection caused between him and his father – because of his father’s own painful connection to Russia from World War II. Throughout the remaining minutes, he continues to weave in personal stories.
  • It establishes credibility and rapport. Before detailing how the Russian people have been lied to, Schwarzenegger says, “No one likes to hear something critical of their government. But…as a longtime friend of the Russian people, I hope you will hear what I have to say.” By this point he’s already demonstrated his affinity for those very people. He also points out his consistency. He’s not targeting Russians but is “speaking with the same heartfelt concern” that he did to Americans after January 6, 2021.
  • It points no fingers (except at Putin and the Kremlin). He is surgically careful to separate the people to whom he is speaking from their leaders. He is explicit that they are not to blame. On the contrary, he assures them they have been misled. In effect, he comes alongside them with an arm around the shoulder rather than facing them down.
  • It’s methodical. Schwarzenegger knocks down the major points of current Kremlin propaganda one at a time. The Russian people, he said, have been told the invasion is a rescue operation to de-Nazify Ukraine. “This is not true,” he intones. He states facts and frames them with stories. Not only is Ukraine not being led by Nazis, but the current president is a Jew “whose father’s three brothers were all murdered by the Nazis.”
  • It offers emotional context for facts. For example, he shares the fact that civilian centers have been targeted and backs it up with the emotional stories and images from the deaths of mothers and children in the maternity hospital bombing. Even relatively dry data is given emotional weight. He doesn’t just say that the UN has condemned Russia. He adds that 141 members voted against Russia – with only four voting in favor.
  • It includes clear calls to action. Schwarzenegger asks the various audiences to understand they’re being fed propaganda and to consider that what he says is the reality. He asks people to spread the truth. He asks soldiers to consider the effects of the action they’ve been told to take. More than 11 million Russians have family connections to Ukraine and so, “Every bullet you shoot, you shoot a brother or sister.” He calls on Putin, by name, to end the invasion. But for every viewer, an unspoken challenge is clear: Now that you know, what will you do?
  • It ends with words of support and encouragement. To those Russians who have protested and spoken out he says, “The world has seen your bravery. You are my new heroes.” It’s true, and it helps the medicine go down.

A masterclass indeed.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

In High Stakes, Issue Navigation, Quick Think

Speaking Up or Thoughtful Silence

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A Note on Responding to Current Events, from CEO David Jarrard

2.5-minute read / 13-minute podcast

Do you weigh in as an organization?

It’s not a simple answer. It’s a challenge our clients have faced many times over the past two years as outlier events have swept across the globe. This is true again as Russia continues its brutal invasion of Ukraine. Our clients ask us: “Do we need to issue a statement? Can you help us create a message? We’re not sure what to say but we think we need to say something.”

The first question to ask: Why?

Thoughtful leaders want to acknowledge important moments. To take a stand. To show solidarity with those in trouble or in need. As you consider whether to do so for your organization, the answer may lie in how you’ve asked yourself the question. If you’ve asked, “Do I have to weigh in?” when no one is looking for your corporate position, then the answer is very likely “No.” But if circumstances or your mission call you to weigh in, the answer may well be “Yes.”

We all recognize that organizations speak with the greatest authority when the subject is aligned with their expertise and reputation. A healthcare organization opining about important healthcare issues is your natural lane (i.e. COVID vaccinations and health equity). It is expected that your organization would speak to these and other important matters; it’s desired and needed, in fact.

The further the subject strays from your organization’s mission and expertise – to national politics, for example, or events around the globe – the thread connecting the subject and your authority, credibility and relevance weakens. If you comment on one disconnected event to which you bring no authority, you create the expectation that you will be commenting on an array of disconnected matters in the future.

The cliché is true: If you have nothing to say, don’t say it.

But. But! Sometimes what may appear to be a distant matter is actually close to home. There may be local ties in your community that bring it to your doorstep. You may have a service providing care that is directly impacted by the issue. You may serve a community bound to the region affected. You may have staff personally affected by it. Then, the call to speak is strong, local and relevant.

Do you serve a Russian or Ukrainian community within your market? Do you have Russian or Ukrainian immigrants or their descendants working in your facilities? Do you have a unique service that offers aid to that war-torn region or even to others oppressed in or from violent areas? If yes, the call to speak – to make clear your position and expectations – is strong. In fact, you should.

There is a third scenario, one in which you don’t have a direct line to the situation but your heart and mission simply demand your voice. As you speak – and many will – we suggest you simply acknowledge the uniquely and tragically horrific circumstances that call for your voice so, again, you don’t find yourself expected to provide commentary on world events in the many days to come.

An unfortunate byproduct of the social media era is that everyone has an opinion on everything, and people, leaders and organizations often feel like they’re expected to say something. So they worry about getting called out if they don’t. It’s part of that social media hype chamber. If that’s you, and you’ve concluded that saying something isn’t necessary or directly connected to your mission, give yourself permission for intentional silence.

A final note: If someone does come after your organization on social media for not saying something, the best practice is to respond publicly while bringing the conversation offline. Reply, “Thanks for your feedback. I’d love to talk about this and hear your perspective. Can we set up a conversation?” The key is to be responsive and not react disproportionately.

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This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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In COVID-19, High Stakes, Issue Navigation, Quick Think

Navigating Fallout from the Johnson & Johnson Vaccine Pause

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When the CDC and FDA announced the recommended pause in use of the Johnson & Johnson COVID-19 vaccine, healthcare marcom teams were forced into overdrive, along with their operational and clinical colleagues. The announcement has had instant ramifications for patients and healthcare providers alike. It is causing fear among the 6.8 million people who have already received the J&J vaccine. It is confounding distribution of the J&J vaccine. It is perpetuating and reinforcing vaccine hesitancy. And, it is adding one more burden on an already-fatigued healthcare workforce.

Even as this story continues to develop and the list of things we don’t know runs long, we do know that your staff and patients have questions. And that doctors, nurses and provider organizations are the ones to answer them because they are the most trusted voices when it comes to speaking on healthcare issues. It’s wise to activate them in this moment.

As you communicate with your community and your employees, keep these seven actions in mind.

  • Be proactive, even aggressive. Pausing J&J vaccination administration comes at a pivotal moment in pandemic response. While this news is damaging, we should focus on the merits of other available vaccines to stave off an overall increase in hesitancy. As you craft your communications, lean into the rigorous safety precautions and robust real-world data cited by the CDC and FDA to instill confidence in the Pfizer and Moderna options. Don’t take on the responsibility of vouching for J&J’s safety. Do share, without minimizing the significance of the blood-clotting cases, that it was six cases out of 121 million Americans receiving any COVID-19 vaccine. That illustrates the extraordinary focus federal agencies are placing on safety. The adverse effects are frightening, yet, as one person we spoke with said, their discovery in the context of the J&J vaccine “is a testament to how effective our vaccine monitoring system is.”
  • Prepare your people. Your physicians and nurses will be peppered with questions about the J&J vaccine – from patients who’ve gotten one, to those who were signed up to receive one, to others who are reluctant to get vaccinated at all. Develop your talking points and FAQs to distribute across your organization, along with processes to ensure your entire system is providing a consistent message.
  • Centralize the inbound inquiries. Part of preparing your people is to avoid unnecessarily burdening them. Yes, educate your clinicians to answer questions. But also build out scalable systems to distribute information and respond to questions. Consider a call center to address frequently asked questions and handle scheduling changes. Post FAQs and your policies on your website and other digital channels.
  • Activate your government relations team. Reach out now to your state officials for the latest on their recommendations, requirements, next steps and timing. We’ve seen a patchwork of state requirements at every stage of the pandemic, and there’s no reason to believe this will be any different. Keep the lines of communication open with officials so that you can respond to whatever they say and do next.
  • Don’t get out ahead of government agencies. This isn’t the time to take an action before the CDC or your governor’s office mandates something else. You’ll be fielding enough questions as it is. Don’t put yourself in the position of having to explain why your decisions diverged from later guidelines. In addition, be mindful to balance communicating effectively on this issue while still upholding the CDC and FDA as owners and arbiters of vaccine safety.
  • Tune into your channels. This is a hot issue. People are talking. Keep a close eye on your social media accounts. Make sure your marcom and patient relations teams are listening across all your channels to flag questions or concerns and, as necessary, escalate them.
  • Be prepared to communicate about this. A lot. It’s not going away and, despite our best efforts, will likely affect the overall perception of the COVID-19 vaccine campaign. Questions and concerns will continue. Listen for clues that certain subpopulations (in this case, particularly women of childbearing age) may need tailored communications if they are ever found to be at greater risk for side effects.

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In High Stakes, J|Insights, Strategic Positioning

Healthcare Consolidation in the Spotlight

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Today we’re catching up on healthcare mergers, acquisitions and partnerships with CEO David Jarrard and Isaac Squyres, a partner in our regional practice and leader of our M&A team. What does consolidation look like post-COVID-19 and under the Biden administration? David and Isaac are watching this issue closely, as is our network of brokers, transaction attorneys and strategy experts across the country. We recently surveyed that network to get a sense of the trends to expect in 2021, and the short version is that even as there will be a lot of legal and regulatory wrangling, it’s more important than ever to have a clear purpose and a clear story to tell about the value of care that hospitals provide and why a transaction is the right thing to do. Scale for the sake of scale won’t cut it.

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In COVID-19, High Stakes, Issue Navigation, J|Insights

Taking a Stand: Healthcare CEO Visibility & Legal Considerations, with Michael Peregrine

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The expectations for healthcare executives have changed.

Hospital and health system CEOs are expected to take a stand on issues and to be public figures. Here, David Jarrard, CEO of Jarrard Inc. and Michael Peregrine, Partner at McDermott Will & Emery, discuss the changing environment for healthcare CEOs, the pressure on leaders to take a stand and how they can do that in a transparent way without stepping across legal lines. Between social change and the COVID-19 pandemic, the relationship between healthcare executives, their boards and their legal and communications teams is more important than ever.

Listen to the podcast, watch the conversation or read the transcript below.

Read the Transcript

David Shifrin:  Well, welcome to High Stakes from Jarrard Phillips Cate & Hancock. I’m David Shifrin. And today I am joined by our CEO, David Jarrard and Michael Peregrine, who’s a partner at, our good friends at McDermott Will and Emery. He’s an attorney who specializes in corporate governance and corporate structure.

And the genesis of this conversation came about because we’ve been looking at a number of different things. Michael has been thinking about the relationship between the chief executive officer as well as chief counsel, and the reason why that relationship is so important.

And what we’re seeing is that the CEO of organizations in general really need to be more visible now than ever. People are, as we know from numerous surveys, looking to leaders and executives for trusted advice and direction. And that’s very true right now in healthcare. In addition, people are beginning to expect more of CEOs. The idea of what a lot of people call a social impact company, like say Patagonia or a Tom’s Shoes, it’s shifting from sort of an outlier  to the mainstream.

So healthcare leaders in particular hold a unique position today because so much of society revolves around the pandemic and healthcare. And of course, healthcare should be by definition a social impact industry. We’re mission driven to care for people. So the question becomes in this current environment with COVID-19 and, you know, we’re preparing for a vaccine rollout that is happening as we speak, is how a healthcare executive sort of walks the line of taking a stand, both in terms of healthcare issues as well as larger social concerns and provide necessary information while not falling into foolish talk or legal liability. So again, I’m grateful to have you, Michael, and you David, join us for this conversation and really looking forward to what we can come up with.

Michael Peregrine: Well, David, you made it a lot of great points in your introduction.

I do think there is an expectation of CEOs to take more of a public position. And, you know, as David knows, in the old days CEOs kind of shied from the public venue, they shy away from major high profiles, and their board wanted them to shy away from a high profile situation. You know, it’s a great way to get in trouble.

As some, as the board members would say. All sorts of legal risks, disclosure problems, antitrust concerns. But David that’s changing. I started to notice this. I’m curious about your perspective, all of a sudden, you know, earlier this year we saw some of the corporate social responsibility conversations on gun control and immigration and some of those issues, but it seems like things began to change when CEOs started speaking out in November about the presidential election transition. And that started to morph into the period of the vaccine. And I was curious, are you seeing it the same way I am that this…all of a sudden the landscape is changing for CEOs and public commentary?

David Jarrard: Yeah, Michael, we, we are . I think CEOs are finding an opportunity to fill a vacuum of trust that exists in the community.

They recognize that because of who they are, and the organization they represent, they have some credibility, they have some strengths they can bring to the conversation, and many are taking advantage of that some wisely and some not so much.

Michael Peregrine: We’ve seen that a lot. And I guess one of the things that I always wanted to remind clients is historically, you know, who do they go to in terms of advice on what to say and when to say it and things of that nature? David, my view has always been, you better check with the board chair before you venture out there, but perhaps first, you know, CEOs look to a team of colleagues on their executive leadership team, the chief communications officer and the chief legal officer and touch base with them first.

And those are two folks who don’t usually communicate a lot. They don’t talk a lot or collaborate a lot on projects, but on this one, it seems like they ought to.

David Jarrard: Ought to, and more and more generally we would hope that a CEO or a leadership team would check with the communications officer because there is a communication strategy.

And you want the voice of your CEO or the leadership team to echo and support the strategies put in place, which is usually about building market share or providing a level of trust with customers and patients in your organization. What we’re seeing now are CEOs who are sometimes acknowledging the communication strategy, but sometimes going well outside of the bounds of the traditional strategy that they would be following.

Michael Peregrine: Well, that’s why I suggest they talk to the chief legal officer first, who also is the board’s chief legal advisor. And yeah, just kind of clear the way here and make sure that the CEO is now stepping into forbidden territory. But I think David, part of that is maybe sharing with the board and educating the board on, now might be the time for the CEO, especially in healthcare, to start speaking out on some of these issues. You know, it’s not just the vaccination, although that’s certainly the key thing, right?

You know, we forget about things like the social determinants of health the racial disparities in delivery of healthcare. There are a lot of issues on which they ought to be speaking about.

David Jarrard: There’sa lot of issues that they ought to be speaking out on, and they have a unique opportunity to speak out.

You know, David mentioned early on a number of surveys that reflect the level of authority or credibility that certain voices have in the community. We’ve conducted some of these surveys ourselves. And one thing we certainly find, particularly on healthcare issues, is that hospitals and local hospital leaders,  physicians, and nurses have enormous credibility, enormous power to influence how people think, and that the community is looking for these people to speak out on these issues.

So it’s an opportunity, but it’s also a responsibility we would argue for these mission-driven organizations to speak out on the things that they have credibility on.

David Shifrin: David and Michael, I wanted to expand on that a little bit, because, so here the firm, we talk about an idea of responsible transparency and Michael, in your article that you wrote for Corporate Counsel that just came out on the relationship between a CEO and CLO, you use this phrase “right and legal,” which I think is kind of a similar idea to responsible transparency. But  you both are talking about sharing the right information. What does that mean, both in terms of the communications and being proactive and offering information, and then also legally, you know, right versus legal. And how do you, how do you balance that?

Michael Peregrine: Giving credit where credit was due. The concept of, the questions of, is it right? And is it legal? Are the basic questions that the chief legal officer is expected to ask. The modern chief… chief legal officer. That’s a concept that can be attributed to Ben Heineman, the esteemed former general counsel of General Electric for many years. And his point was you’re more than a technical legal expert. You’re a business partner to management and you’re a voice of responsibility and conscience to the organization. And I think, David, that’s where some of these issues come up.

You know,  the thing that jumped out at me as today as we’re taping this is, you know, this confluence of the vaccination. I was talking to clients today where the vaccine had arrived at their institutions today. We have that, we have Dr. Fauci, his comments about the need to have up to 75% of the population expanded.

And then you and I both were reading the same stories in The Times today about certain voices out there saying this is a communist conspiracy. Right. Don’t do it. Yeah. It’s, so, the question of, is it right? Is it consistent with the mission? That’s a conversation, David, I think that the CEO ought to be having with the board chair and the general counsel.

I think that falls in the category of, is it right? And then how do we make it legal?

David Jarrard: Michael, I agree. And I love your emphasis on the CEO engaging with the board. Because many of the boards we work with, the health systems of course are representative of their community and  reflect a public mission of, often, a public health mission to advance public wellness in their organization.

And they do that through the operation of their health systems, but they also can do it by being strong advocates in this case for the vaccine and for other things that would cause population health to be improved  in their community. But it’s right that the board ought to be aware and an endorser of the CEO’s actions.

I think sometimes the challenge is, is when the CEOs and other leaders go off the reservation and they lose some credibility when they speak about the things that they are not naturally connected with. Right.

Michael Peregrine: We’ve seen some examples in our industry  where that has occurred and the board has acted swiftly because of the damage to the institution.

And that damage, David, I guess, could be immediate, can’t it, with the wrong kind of public communication.

David Jarrard: It can. Reputations are, are, are hard to build and they can take a lot of time, but they can be quickly dismantled.

Michael Peregrine: How do you handle that, David, when you get a call from an institutional client that says, “I have to respond to this comment on vaccination, that’s so contrary to what we need and must do. I need to get something out right away.”

How do you slow him or her down? What’s your course. How do you approach that conversation in terms of structuring the communication such that it doesn’t risk the CEO or the institution.

David Jarrard: You, you start with the core of your organization. You’ve got a mission, you’ve got a purpose and everything you say ought to be reflective of that.

Even if it is controversial with some opinions in the community it needs to reflect who you are as an organization. The board is truly helpful in helping define that. That’s thing one. Thing two is, there’s very few issues that are going to be raised that are a surprise. It’s not a surprise that vaccines are controversial. It’s not a surprise that this has been politicized issue like masking throughout pandemic. Smart communications officers and CEOs will have run scenarios, anticipated the questions that are going to come and be able to lean into them swiftly when the question comes.

Michael Peregrine: Are there limits to the venues that you would recommend a CEO use to set, send this public health message, social media versus print interviews, things of that nature?

How do you structure the communications plan?

David Jarrard: If it’s a question of the CEO speaking, you want a voice where the CEO’s message can be delivered in full. RIght? Those personal interactions. Those in-person engagements are the most powerful and the most persuasive. Social media is great, but  it’s like a loose cannon ball running around on a ship, hard to control.

And you have no idea what happens to it afterwards. So they can be a supporting actor there. And I, and I think it should be because so many people get their information there, but you’ve got to start with a core message that comes through personal engagement.

Michael Peregrine: And that’s the hope where you… that the chief senior communications officers are going to reach out and say, we also have to touch base with the chief legal officer and vice-versa and David Shifrin this goes to the point you raised, and this is one of those situations where collaboration horizontally in the C-suite between these two senior officers. And they work together from time to time. But really, it seems to me, David Jarrard is acute. You they’ve got to know that both they, they both have jurisdiction over the issue, that they both have a message to say, and they continue together. One going forward on this issue without the other in tow, it seems to me a real risk.

David Jarrard: I love your phrase that both have jurisdiction. We think of it in terms of like a political campaign where you have a variety of interests who are in charge of pushing the organization forward and pushing this message forward.

And these different voices need to be working together in tandem all the time, particularly in a moment of heightened scrutiny, like this, and heightened exposure like this. It ought to be not an occasional conversation or just a board meeting conversation. They need to be talking every day, emailing each other back and forth every day about what has, what has been, what is coming and what can you expect next?

David Shifrin: Something I’d like to highlight here. You’ve both touched on, but I think it’s really worth calling out is there may be issues that are legal. But, and again, this goes back to right and legal and responsible transparency, but there needs to be that, that communications perspective about how you should say it.

Or whether you should say it at all and the reverse is true. Right? And so having everybody in the room at the same time. I know David, we’ve got colleagues here who are strong advocates for having, you know, marketing and communications folks at the table in the room when operational and strategic, and in this case, legal decisions are made.

So they can be there to provide a perspective on how that might be… that message might be received as well as to craft the message in real time.

Michael Peregrine: Well, then those are messages, for example, the chief legal officer may be completely unaware of some of the critical concerns that David and people in his area are aware of and vice versa.

Historically again, this goes back to why CLOs have, have advised CEOs to be very wary of public communication. The potential impact that they may have in terms of sharing confidential information, the perception there’s somehow signaling anticompetitive messaging to within the organization or to colleagues or other organizations, they are somehow sending a message that’s antithetical to their charitable or tax exempt purposes.

If they’re a charitable organization or that they’re saying something that could have a dramatically negative effect on ongoing negotiations with the business partner, that’s the CLOs world. David but what does the CEO need to know from, from you as to things that he or she should be considering as he or she evaluates his advice to the chief executive.

David Jarrard: Well, I’m ticking in through my head the number of issues that just your comments have raised with me already where the CLO needs to be a partner in the conversation. I mean, right now we’re having any number of conversations with leadership teams who want to know how to talk about the vaccine and generate such a, such a conversation that causes vaccine hesitancy to be reduced where people feel confident about taking the vaccine. And sometimes the emotional reaction is just to provide an unambiguous assurance. “The vaccine is totally and utterly safe.” I hope that… I hope that would scare a CLO. We don’t want to hint in that direction.

Michael Peregrine: Yeah. Well, I think that the, the other issue is that the CLO would benefit from discussion from the chief communications officer of the real impact. What you think of a CEO coming out and speaking, as opposed to the chief of the medical staff or some other clinician or researcher, how would you describe the impact of a message from the CEO of a major metropolitan academic medical center in this issue?

David Jarrard: It’s different in every case. And clearly when we’re talking about vaccines or clinical issues, the clinical leader has much more credibility and authority from which to speak. Nurses and doctors are powerful spokespeople when it comes to the delivery of medicine.

Sometimes the CEO needs to speak because it’s a business issue or the CEO is speaking to his or her staff and colleagues in an environment, which we’re in now, nurses and physicians are looking for the leadership team with their organizations to have their back.

They get frustrated that the experience they’re having in the hospital of watching people die from COVID is not reflected when they go to Walmart or go to the grocery store and they see a community not having the same experience. And so they’re looking for leadership teams to speak for them, to have their back in those conversations.

And it’s an opportunity for CEOs to do the right things for their internal audience, as well as their external audiences.

Michael Peregrine: How does that relate to the upcoming decision that many institutions are going to have to take about whether or not to mandate vaccination. Who delivers that message? And what does that look like?

David Jarrard: It’s a great question because it needs to come both from the clinical voice and the voice of authority and the leadership of the organization. The clinical voice needs to say “here’s why medicine and science tells us this is the right thing to do.” The, the CEO has a, has a business decision to make.

And frankly, to your point earlier, both llegal exposure, labor exposure, any number of exposures that have to be considered as they take a position like that. And I would hope that the board is involved in a decision like that because of the trailing consequences about it in the organization itself.

David Shifrin: Michael, can you talk a bit about that legal exposure that could arise from those decisions as well?

Michael Peregrine:  It’s a fascinating topic, David and  it’s one of those things that the lawyers love to hate, which is it’s a muddy situation. It’s absolutely, going to David Jarrard’s question, a board issue.

Ultimately, that’s the kind of a decision that has such stakes. You can’t ask management to make it alone, and there are a number of factors the board’s going to have to take into consideration. Number one is obviously the, what is the right thing? What are the public health implications? Right? What is the value of to the organization and its workforce from mandating vaccination How do you prove it?

But I think the legal issue in where the CLO comes into play is the question of, okay. There’s a basic… the law basically says you have a duty to make sure of the health and safety of the work first and that the workplace is free of hazard. And that’s the way the organizations have previously put out mandates on other elements of flu.

This, it gets complicated though. And David, this goes to your area. If you have large sections of your workforce that are a part of an ethnic or religious group that has, that has real fundamental problems with the concept of vaccine or distrust with the vaccine, how does that work out?

Again… and then the following question or issue is, how does that play with your community? Is a mandate seen as authoritarian. And then what are your legal exposure in terms of the corporation as a board, will you be sued for issues arising out of the vaccination? None of those are – other than perhaps the legal issue – the issue of whether or not you have the right to do it is a up or down concern, David or a lot of those other issues go to the kinds of things you were talking about.

What do you, what is your knowledge base about the, your workforce? What are the community views on this issue? What would be the impact on the consumer? If you say, “we have made a decision at ABC medical center to require our employees to be vaccinated.”

David Jarrard: It is as you know, Michael, it’s not an insignificant issue.

And the latest surveys tell us that 36%, I think of nurses say they are very hesitant about taking the vaccine and in fact do not plan to take it. And so would you as an organization require 36% of your nurses to take the vaccine or leave? It’s a challenge for hospitals and health systems because they can’t afford to lose the nurses. We need every single one that we have. So it becomes a stalemate on with both a labor issue and a philosophical issue for an organization. Not a small topic. The hope is that as more people take the vaccine, they’ll see its efficacy. And they’ll say that it is being able to be received without side effects. And over time it’ll become accepted, which we’re not there yet.

Michael Peregrine: To both of you. That, from my perspective, advising client boards say, be prepared to make this issue. Be prepared to move swiftly, start to have these conversations in the evening, don’t let it wait till after the holidays. Recognize the public health concerns, recognize these frightening statistics about  the resistance to the vaccine and start to prepare your CEO for the kind of communication plan that you need to, because this all goes to the kind of back to where we began, David.

And that is, we’re in an environment now where I would say business leaders generally, and certainly in healthcare, are going to be expected to be engaged more in, uh, have with the public profile.  David Jarrard, you’re lead… your concept of leadership,  it is part and parcel of a values based company portfolio. I would say, consistent with these concepts of social responsibility.

Would we be having this conversation three years ago? Probably not. But, it neatly fits within where corporate purpose conversations are going. My message, again, fellows, is boards need to be preparing tonight to start that conversation. So they’re positioning their CEO to work with their communications consultants to clarify the, their legal rights, and to get those messages out before the window of vaccination opportunities past.

David Jarrard: Michael, I think that’s so smart. And, I think it’s smart, the boards being prepared, and I think it’s smart that boards need to be prepared tonight. Because we’ve been talking about the CEO and the leadership team as being the spokespeople. But as the boards, particularly of our not-for-profit hospitals, go out into the community, they’re the spokespeople.

And they have incredible power as they speak in their, within their church circles, within their grocery circles, with their social circles, what they say matters. And if it’s, if they’re saying something that’s consistent with their organization, they can advance it, but it’s easy for that to be disrupted and miscommunicated.

So then they need to be as consistent as the CEO in what they say and what they talk about.

Michael Peregrine: And David, are you concerned as I am that if they don’t make a decision and act on this relatively soon, the voices of those who were on the… on the fringe, the voices that we are reading about now that are saying this, this is a conspiracy, this is an awful thing and urging the public to reject the vaccination, that those voices will become accepted more broadly by the population.

David Jarrard: We cannot create a vacuum that allows those voices to be the only voice that is heard. Our belief is that hospitals and health systems are the original purpose-built organization. And we have a responsibility as boards and leadership teams to exude that purpose in our communications and messaging, particularly right now.

You’re, you’re exactly right, Michael. We’re at a key moment, a turning point moment. The pandemic has been raging for 10 months. We now have a solution, a reason for hope. We have to endorse that hope. We may not be able to fully explain everything, that is how it’s going to work and how it’s going to roll out over the next six months.

But if we can lend our own emotional voice of support, we will have a quicker and a better outcome.

David Shifrin: Well, thanks so much to both of you. So, move quickly but thoughtfully, have those conversations tonight. The board needs to be involved. Any other, you know, very specific action items that healthcare leaders should take home right now. And, and …either that you’ve covered that you want to highlight again, or that we haven’t covered.

Michael Peregrine: You know, David, I would say that it doesn’t have to be the CEO there. I’m sure there are CEOs who prefer not to have a public profile who are by nature people who like to operate outside of the public glare and David Jarrard, in that instance  who’s the default? Is that the board chairs and the chief of staff? We, we don’t want to put this all on the CEO, even though that’s the logical person.

David Jarrard: It should not all be the CEO. The clinical voices here are powerful. Your chief medical officer, your chief nursing officer are valuable. Also what’s valuable is somebody who’s good at it. Somebody who’s comfortable at it, Michael, to your point, they… somebody who’s passionate about it, but can’t deliver that message. It’s not really helpful. So it’s a role of the communications officer to train those key leaders up to play that role.

And as I said earlier, board members, whether they like it or not are spokespeople, so they’ve, they’ve got to be equipped and trained.

Michael Peregrine: And David, I would go beyond this, the particular immediate issue of vaccination. I would say that there are others we want to keep in mind. There are other public health issues on which CEOs really need to be speaking out on. We forget about them with the pressure of the pandemic,  but DavidJarrard, the, you know, there’s so many other things that have occurred this year that require our attention and require CEO attention.

We don’t want to miss those.

David Jarrard: You’re exactly right, Michael. And it’s, it’s not a secret what those are: the racial inequities and price transparency and surprise billing. We could go on and on with the list, but so can any other leadership team in a healthcare organization, and there’s no excuse for not writing down that list, coming up with your answers for that.

So you’re prepared when the time comes and when the questions comes. Because they’re coming.

Michael Peregrine: Especially when you see alternative views expressed on media outlets from ranging from 60 Minutes as it was last Sunday to, to social media, to the newspapers and things of that nature. It’s a different world for CEOs now, isn’t it?

David Jarrard: It is a different world. And we have to be prepared to answer those alternative views that are responsible in a way that’s responsible. We also have to be prepared to know how to deal with the crazy, cause the cazy is coming too, and it deserves something or nothing from us. We need to make those decisions instead of in the moment.

Michael Peregrine:  I thought we were done with that stuff!

David and David. Thanks very much.

David Shifrin: Thank you, Michael. Thank you, David.

David Jarrard: Thank you.

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