Sometimes the title of a podcast picks itself. Today, our two favorite outspoken insiders, Kim Fox, and Tim Stewart, take on the vaccine rollout. It’s been rocky, and there’s plenty of blame to go around, but there’s still time for hospitals, health systems and other healthcare providers to swerve around the potholes.
Be sure to listen and subscribe to the podcast on Apple Podcasts or Spotify.
What can you do about it? How do you respond when your caregivers – so influential to your patients — are hesitating to take what most healthcare authorities say is the very solution to protect our community health and lead us out of this pandemic mess?
Almost one-third of people living in households with someone working in healthcare are on the fence or unlikely to get the vaccine, per a new Jarrard Inc. national survey. The Wall Street Journal has also highlighted this issue, calling skeptical healthcare workers “an unexpected obstacle” to vaccine distribution. Meanwhile, the vast majority of Americans (79%) think hospital workers should be required to be vaccinated, according to our study.
Why the reluctance? Healthcare workers told us they’re worried most about potential side effects. But they’re also concerned they could catch the coronavirus from a vaccine or, simply, that the vaccines aren’t effective. They aren’t alone. Of the nearly half of Americans worried about COVID-19 vaccines, six in ten are concerned about side effects.
With the public overwhelmingly agreeing that the vaccine should be mandated for hospital workers and a notable proportion of healthcare workers skeptical themselves, the risk of tension between employee and employer and public is real. Will it matter when it comes to public perception of your organization or willingness for people to come in to receive care? Can public expectations be used to help encourage hesitant employees to get the vaccine?
Ideally, we can reduce the number of employees who opt out of vaccination through education and highlighting the positive outcomes. To get further, faster, consider these tactics for driving COVID-19 vaccine acceptance rates within your organization.
The good news is public opinion on the COVID-19 vaccination is increasing, and more Americans are expressing their intention to get vaccinated once eligible. By listening to your caregivers and meeting them where they are with the information they need, you can be in a better position to empower them to make the best decisions for themselves, their families and their community.
That’s the acceptance rate for the COVID-19 vaccine at Glens Falls Hospital in Upstate New York. Moreover, the organization has already completed its administration of first doses. Remarkable milestones, certainly.
Glens Falls has some advantages – most significant being that it’s a small hospital with 400 beds and 2,500 employees. Even so, the level of vaccine acceptance among the employee base is stunning – especially in comparison to nearby hospitals that are sitting at 50 to 60 percent.
We wanted to know how they did it, so we chatted with Ray Agnew, vice president of hospital and community engagement, who explained his organization’s secret sauce. (See video for full conversation). Here are his top takes:
While its implementation may have been largely overshadowed by other issues, the rule is in place and providers should be thinking about it.
Whatever your plans were for the rule beforehand – list your prices, implement user-friendly price estimator tools, ignore the rule for now and pay the fine – it’s worth considering how your approach can affect your reputation and, potentially, bottom line going forward.
We spoke with James Cervantes, associate vice president and leader of the price transparency work here at Jarrard Inc., and Prashant Karamchandani, director in the revenue cycle practice at The Chartis Group, about key considerations for providers now that the rule is off and running. Watch the video or read the transcript below.
PK: CMS has put out there the regulation around price transparency and wanting organizations – healthcare organizations – to start to list the rates that they have with insurance companies, as well as, they want patients to have visibility into what they’re charging and then what the reimbursement is and have an opportunity to do some comparisons.
And I think that’s the letter of the law and regulation. You have to have some level of viewing your shoppable services, but I think organizations that look at the regulation as just the only thing they need to do to be compliant are missing a key opportunity to use this regulation as a catalyst for change.
Which is aligning more to a more enhanced and better patient experience across the enterprise. And by that we mean starting to look at this to bring patients in. So if patients are coming to your website, looking at your rates, looking at your service offerings, you should be hooking them into a better workflow to continue them through that entire process.
Meaning, once they look at that information, they should then have an opportunity to identify what’s their actual estimate going to be for those services, start to think through, ‘How do I schedule for those services?’ And then if they can make payment or cannot make payments, start to engage in a conversation with the organization as to how they can address some of that.
So, yeah,there’s more you can do. And the more you can do with it is a different strategy. And it’s where folks should be spending that time right now – on that strategy – as well as complying with the letter of the law. So it’s a combination of both.
JC: So once you’ve created the program and you created your workflows and you operationalize that program, the next step is really to then communicate and share those tools and information with your patients and your community. So, how are you guiding patients to the front door of your health system or your hospital?
How are you directing them to the cost assessment or price estimator tool that you have? How are you reminding them of any financial or personal assistance programs that you have? Reminding them that if you’re providing estimates to procedures or surgeries, where to go for that information. So this is really in many ways a great time to remind patients and those that are seeking care at your organization of all the tools and information that they’ll have access to as they make their financial decisions about receiving care.
PK: I think there’s some key tangible benefits. So patient acquisition and patient retention, you’re going to instill trust within your patient population by providing this information out there and also continue having them coming back because you’ve created a whole new experience and level of transparency that they’re not used to today.
So it’s more than just listing pricing online, which is, I think, why we want to view it as a broader strategy. It’s really getting them into that better enabled and self-service workflow, which is how you want to be engaged with your patients and with all kinds of technology out there that you have, different things you can do to build that ecosystem. But I think that’s a key thing from an acquisition and retention perspective.
I think additionally, it helps from a patient financial experience for both not only the patient, but also for the organization. You can start to have more upfront conversations, easily, around expected out of pocket costs, how they might be able to pay for it, providing the mechanisms in which they can pay with all different types of technology, whether it be credit card or Google Pay, Apple Pay, the various things that are out there. That’s a key opportunity as well.
And then I think there’s a handful of patients out there – and it’s continuing to increase – where we’re seeing larger deductibles and out of pocket costs be placed on patients. So, we call under-insured and even the uninsured where you want to have a more upfront financial assistance conversation and creating that tightly knit workflow to help identify that through the price transparency and estimation will enable patients to better know, ‘can we afford it? Can we not? If we can’t afford it, what are my options?’ So they don’t feel reluctant to get care, but they feel like the provider organizations are really working with them to be helpful. And helping them find a solution so they can get care, but they also don’t create an extra financial burden on themselves.
JC: As providers share this information and communicate with patients. I think it’s really important to make it very clear and in a concise way using language that patients understand. So we’re talking a lot about price transparency. That doesn’t necessarily mean that price transparency needs to be the way that you refer to this program.
It’s really making sure that patients… it’s communicating very clearly all the tools and information and resources that they have access to. And for most patients that might just mean connecting them with your financial services team or your personal assistance program and having that really be a dialogue.
I think it’s important to make sure that the information is clear. It’s concise. You’re not using language that is a legal term that patients wouldn’t understand. So sort of putting it at their level and making sure that it’s just very clear and easy to access if they’re going through a website or if they’re calling the phone number to talk with someone.
PK: So I think there’s some key considerations you’re looking for. And some fall in the realm of the operations side of the house and some fall in the realm of technology and digitally enabling patients to have this experience. So first, I think it’s creating a strategy around the patient financial experience or the patient experience overall and using the price transparency component as a large initiative underneath it.
And then once you do that, you start to identify creating a much more refined and streamlined workflow for patients to enter into. So really it’s on an operational side, you’re mapping it out. And these are the functions that are going to hit scheduling departments, departments that do key revenue cycle functions around patient access.
So, pre-registration registration, insurance verification, et cetera, financial counseling, like we talked about. And then you have your component on the back end, which is the actual collections, which might happen at times. So you’re really looking at a more holistic view in terms of how you need to operationalize this.
And it’s more than just within the revenue cycle. If you’re a large provider organization, you need to get your clinics involved, your key departments involved, providers have to be integrally involved in these conversations. And then I think technically you need to evaluate your ecosystem and say, ‘within our core systems that we have today, can I do these things like provide an estimate? Can I do these things like collect payments ahead of time or pre-service based off of the estimate? And can I do it in such a way that’s engaging with the patient to enable a level of self-service and customization so it’s not a generic experience? And I think those are the key things. So, defining the strategy, working with those departments to create that operational workflow, but making sure that workflow is supplemented with the right technology, both within your organization – and that might be infrastructure-related – as well as more patient-facing to get them in there. But really, when you think about it, that means it’s more than just a revenue cycle issue or a clinic issue. We’re talking about several different departments working in an integrated fashion to create that seamless experience.
For the first time since 2008, Democrats are poised to control both chambers of Congress and the White House once Joe Biden is sworn into office. The last time Democrats had complete control of Washington they used their political capital to pass the Affordable Care Act (ACA).
So, should we expect more sweeping change now that Democrats can once again run the field? Probably not.
There are two big differences between 2008 and now: Democrats razor-thin majorities in Congress and the COVID-19 pandemic that will continue to dominate DC.
What can healthcare leaders expect from a Democratic-controlled Washington? Here are a few thoughts:
More and bigger COVID-19 relief. While the idea of $2,000 stimulus checks for most Americans has grabbed headlines, Biden and congressional Democrats are certain to push for a new round of federal COVID-19 relief. That means additional dollars to support cash-strapped healthcare providers and more money to boost the sluggish vaccine rollout. Knowing this, now is the time for healthcare leaders to be in contact with their federal elected representatives to discuss the impact COVID-19 has had on their organization, team and community.
Shoring up the ACA. The thin majorities in the House and the Senate limit Democrats’ ability for large-scale healthcare reform like a public option or Medicare for all. However, expect Biden and congressional Democrats to restore ACA funding that was cut by the Trump administration and push for new exchange subsidies that would lower the overall consumer cost to purchase plans through the exchange.
Additional scrutiny on (some) healthcare consolidation. For months, experts have predicted that the financial challenges created by the pandemic will accelerate health system consolidation. At the same time, president-elect Biden has suggested healthcare mergers, especially mega-mergers, will receive additional scrutiny. Acquisitions of rural hospitals and smaller health systems are unlikely to receive the same attention from federal regulators as the mega-mergers.
Friendlier environment for unions. President-elect Biden has promised to be “the strongest labor president” ever. Additionally, Biden has chosen Boston Mayor Marty Walsh, a former labor union leader, as his Labor secretary. With Biden in the White House and Democrats controlling Congress, look for movement on the PRO Act, a rewrite of the National Labor Relations Act, that would make union organizing easier and weaken right-to-work laws.
With changes expected on both the legislative and regulatory fronts, now is the time for healthcare executives to have a thoughtful conversation with their leadership team about how change in Washington will impact their organizations. And, it never hurts to establish or renew relationships with your elected representatives to ensure your organization’s point of view is known.
The partnership of Amazon, JPMorgan Chase and Berkshire Hathaway was launched in 2018 to credulous fawning, despite the announcement being utterly devoid of anything.
Turns out, all the money in the world can’t buy a clear vision for success in healthcare. The industry is immune to half-hearted, drive-by attempts at big change, no matter your brand. It’s all or nothing, and without total buy-in from leadership (and deep pocketed backers), you end up where Haven did: What could have been a Manhattan Project turning out to be a side project.
It’s as easy today to mock Haven’s failure as it was to be skeptical at its creation – so we won’t judge if you do some mocking, because it’s fun. And fun can be hard to come by these days.
But once we’re done laughing and enjoying some self-righteous “told-you-so’s”, we face the same reality this industry has faced for decades: Who’s going to get healthcare costs under control?
We’re 11 years out from the passage of the ACA, which was successful in expanding coverage and unsuccessful in reining in costs. The cool kid “disruptors” have been narrowly focused on disrupting the wheelbarrows of healthcare money long enough to scoop some up for themselves, not on changing the market dynamics in a way that pays off for patients.
Big employers may yet unlock the vault with instructions for bending the cost curve, and it would still be dumb to bet against the world’s richest person and Amazon Care. But as costs continue to rise and many patients are forced to rely on having the best GoFundMe story in order to pay for their medical expenses, demands for substantive change will only increase.
This line, from one of the many Haven postmortems, stands out: “Healthcare providers and insurers have significant market leverage, and that’s difficult to overcome in trying to control costs,” said Kaiser Family Foundation’s Larry Levitt. To put another way: Providers and insurers are the reason healthcare costs are high.
For the moment, and as we have detailed throughout the last year, healthcare providers enjoy a considerable amount of trust, along with favorability ratings that we haven’t seen this century. Hospitals and health systems should view that positivity as ephemeral, a byproduct of the heroism displayed by frontline clinicians throughout the pandemic. As insurers continue, uh, let’s call it throwing their weight around, providers can leverage the current landscape to draw sharp contrasts with them – keeping in mind that the public goodwill might not extend indefinitely.
As we move through 2021 and the pandemic begins to recede, other elements are likely to come into sharper focus and scrutiny, including issues like price transparency and hospital consolidation. Now is the time to lead on these issues. You may not like the price transparency rule (ok, I know you don’t), because of the context it lacks. If that’s the case, then get to work providing that context. Get out ahead of the regulators and your consumers. Maybe you have a great partnership opportunity on the horizon – now is the time to start building a comprehensive story beyond “uh, scale?” for why it is great for the people you serve.
If the “incumbents” in healthcare aren’t going to change, and even the biggest disruptors can’t shake up care delivery in a meaningful (read: cheaper) way, then it is only a matter of time (and polling trends) before a broad coalition across this country views greater federal involvement in the delivery of healthcare as their only hope. If that bothers you, you’ve got time to change course. But not much.
National healthcare communications consultancy Jarrard Phillips Cate & Hancock, Inc., expanded its full-time team by 20 percent over the course of 2020, President and CEO David Jarrard announced in a year-end recap. With 12 new hires, plus the addition of five of-counsel professionals, the firm’s growth and acquisition by The Chartis Group highlighted the critical communications needs hospitals, health systems and health services companies experienced during the COVID-19 pandemic.
Two vice presidents and two associate vice presidents headline the new team members. They are:
Emily Shirden
Vice President, National & Academic Health System Practice
Shirden joined Jarrard from Finn Partners, where she led thought leadership, issues management and integrated communications programs with a strong focus on analytics and measurement.
Kristen Nicholson
Vice President of Business Development, Growth Services Team
Nicholson has 20-plus years in the healthcare industry where she has focused on growth and development for an array of companies. Immediately prior to joining Jarrard Inc., she was senior vice president of account management for Shearwater Health.
Teresa Hicks
Associate Vice President, National & Academic Health System Practice
Hicks is a former journalist who most recently led communications strategy for Ballad Health, taking the organization through a groundbreaking health system merger and subsequent integration, helping achieve regulatory approval in two states and marshalling community support.
Dan Schlacter
Associate Vice President, Health Services Practice
Schlacter has more than 15 years of integrated marketing and communications agency experience. His background includes work with clients in health IT, life sciences, healthcare consultancies, provider services, industry organizations and patient advocate groups. Prior to joining Jarrard Inc., Schacter was a senior account supervisor with MP&F Strategic Communications.
“This year, perhaps more than any other, has reinforced the value of clear and strategic communications for healthcare providers of all types,” Jarrard said.
“We know how difficult it has been for executives and Marcom teams as they’ve been faced with relentless pressure and questions from policy-makers, the media and an often-skeptical public, all while working to fulfill their mission of delivering care under extraordinarily challenging circumstances. We have been proud to work alongside so many of these organizations to develop the strategies needed to bring people together as society confronts the coronavirus.”
Expansion occurred across the firm’s National & Academic Health System Practice, Regional Health Systems Practice and Health Services Practice as well as its Growth Services Team and client-focused Digital Services Team.
“Healthcare has changed in so many ways this year, and yet, our experience indicates that the foundational principles and underlying trends have not – they’ve simply accelerated,” said Jarrard. “Our new colleagues bring a wealth of experience in everything from marketing strategy to crisis communications, allowing us to help clients lead and shape the future of healthcare as we emerge from the pandemic and take stock of the many lessons learned.”
Situation: As shipments of COVID-19 vaccines roll out across the country and healthcare workers start rolling up their sleeves to receive the shot we’ve hoped and prayed for all year, there’s never been a more important time for hospitals to keep lines of communication open with the public. Providers have an opportunity and responsibility to be a visible source of truth in this critical phase of the pandemic. And the media can be a powerful ally for reaching the masses. Here are a few tips for engaging with reporters right now.
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.
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.
As the healthcare industry begins mobilizing for the massive vaccine push, every move that providers make is under scrutiny. Yes, caution is warranted. But you can’t be cagey. In this tense moment, you must carefully calibrate words and actions to provide clarity without going too far.
Our most important communications advice here: Don’t make promises or statements that suggest your organization has signed off on the safety of vaccines. Instead, cite authorities and couch safety statements in terms of the information you’re relying on from other others: “We only recommend vaccines that are deemed to be safe by their developers and the CDC…” Then, explain what those organizations have found and how they reached their conclusions. Don’t put yourself in the risky position of affirming safety – talk to your counsel to see where you could end up with legal liability.
Other tips to help you walk the line of responsible transparency:
Don’t shoot yourself in the foot. Consider this: A $15 billion merger was just wrecked because a CEO bragged about leaving his mask at home. Foolish behavior won’t be tolerated – whether that’s hypocrisy from leaders or legally loose promises. Be careful, be responsible. Think before you speak.
