High Stakes

What to Do When the President @s You

what to do when the president tweets you

You run a health system.

You’re navigating declining reimbursement levels, the best way to chart a course from fee-for-service to value-based models, star rating systems and HCAHPS. You’re pursuing potential partnerships, watching your competitors to see if they’re pursuing potential partnerships and trying to align all facets of your organization toward providing your community with exceptional care.

On top of all that, there’s the very small —  yet nonzero — chance the President of the United States might focus his Twitter fingers on your health system. Case in point: Last Friday afternoon, the NFL was gearing up for a slate of not-particularly-interesting early season matchups. Then 48 hours later, pregame plans of each team were national news. As Ferris Bueller and Twitter hack comics like to remind us, life moves pretty fast.

Let’s start with the obvious. You do not want to respond. New England Patriots owner Robert Kraft, a noted friend of and donor to the President, certainly did not want to respond.

Other owners, with either an impulse to agree with aspects of the President’s criticism or an aversion to putting themselves out front on anything remotely controversial, certainly did not want to respond. In an intensely partisan climate, they knew any response was going to irritate half the public.

Unfortunately for hypothetical you, like the NFL owners this weekend you have no choice but to respond. And you must respond even when the influential tweeter isn’t in the Oval Office. If the major employer in your town or an influential politician attacks your institution, employees or patients, it’s your job as a leader to steer the conversation.

Providing a voice of reason amid a social media yelling match is creeping into the job description of all leaders, even those in healthcare. That’s especially true when major bills that could upend the business model of the entire industry – such as the Graham-Cassidy bill that was pulled from the Senate floor this week– become the norm. Health systems often take a stand against political measures, opening themselves up to the ire of Twitter users from bots with egg avatars to a certain Commander in Chief.

So. In the case that someone powerful and vitriolic tweets at you, here’s the two-step secret formula to help guide your response:

1. Shore up your most important audience first.

Your job involves dealing with a wide range of constituencies. Balancing their interests and needs is a big part of what you do every day. NFL owners do not necessarily share the politics of their players, but when the President disparaged outspoken players (and their mothers), the messaging calculation for them started with the people who are the core of their organization. At the risk of alienating some segments of their fan base, and in many instances against their own instincts, owners stood behind their employees. You will only get the time and opportunity to reach your other audiences if you get it right with the most important group first.

2. Speak directly to them.

This is the part that you can take control of today, before the Twitter notification pops up. Many of the responses this weekend focused on conversations (or “dialogue,” an oft-used term in official statements) that the teams had begun with their players. There seemed to be a wide range of authenticity to these claims. The easiest way to have a dialogue in tough situations is to have built a foundation of trust and sincerity in advance.

The President probably isn’t going to tweet criticism of your health system. But when any major crisis hits, you are going to need to make these calculations quickly. The tone you set and the people you prioritize in your initial response can have a major influence in the duration and severity of the crisis.


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