Fallout from COVID-19: Fear among the community and providers

People trust hospitals but are afraid of them.

Jarrard Inc. just completed a survey in partnership with Public Opinion Strategies, surveying American adults across the country to get a sense of their perception of the healthcare industry and how they will interact with it going forward. One of the major findings is that people are scared to go back to hospitals. That’s not particularly surprising. But what is surprising is that healthcare providers and their families don’t feel much safer than the general public. That’s concerning for multiple reasons, and David Jarrard and David Shifrin get into those results to discuss.

Listen to the podcast or read the transcript below.

Read the transcript

David Shifrin: Alright, welcome back to J|Insights on the High Stakes podcast. I’m David Shifrin, and we at Jarrard just recently completed a survey in partnership with Public Opinion Strategies, surveying American adults across the country to get a sense of their perception of the healthcare industry and how they want to engage with care going forward in light of the pandemic.

So we’ve released those results and some really interesting findings came out of it. But one of the big things is people are scared to go back to hospitals. And in a lot of ways that’s not surprising. We’ve been sort of inundated with this deadly virus and been told to keep our distance and all these things, and it’s really a frightening time. But what was really interesting is, as we looked into the crosstabs of the results, we found that healthcare workers and people who live with or are family with healthcare workers are really not that much more comfortable in hospital settings these days.

So on a scale of one to 10, the mean was around a five, and for healthcare workers and their families, it’s about a six. And when you think about it, that’s concerning. There’s a lot of emotional weight to this event.

And so, with that long intro, David Jarrard and I wanted to talk about that and just think about what this means for healthcare providers. It’s not just going back to the patients and saying it’s safe to return. It’s also about going to the people who are doing that work.

David Jarrard: Yeah David, thank you. You’re exactly right. It is concerning, and it is a call-to-action for those of us who are leaders in hospitals and health systems who are focused on taking care of our people so they can take care of others.

You know, some of the ideas behind the survey was to explore the attitudes of consumers because of the great desire by our clients to bring consumers back, to get patients to come back to the ER, to get patients to come back to do the elective procedures and for patients to come back and address the suffering, right? The pain that they have. And we learned that there are real concerns people have about doing that.

And when you think about it, it’s not a surprise, right? We’ve spent the last 60 days scaring the heck out of people. To keep them indoors, to enforce social distancing, to emphasize that we’re trying to save a broad swath of people from the effects of this pandemic. And mission accomplished. We scared people. And now we’re finding people are more knowledgeable about healthcare issues and more knowledge about this issue, so they’re concerned about this.

And even watching the national media at all, and just about everybody has for the last 30 or 60 days because we’ve all been sheltering at home, what you’ve seen are the dramatic stories of hospitals that have been turned into war zones in New York, in Manhattan. It feels like a MASH unit. It feels like they’re being besieged, and it’s not hard, certainly for the average consumer to translate what’s happening there is happening everywhere. And that their hospital may be similarly affected like the hospitals in Manhattan.

If you’re translating that at home and you’re very worried about the coronavirus, as everybody is, and you’re trying to protect your family, which just about everybody is, then it’s not a far leap to be really concerned about going back and maybe putting off that procedure and not going into that ER because the consequences may be worse than the treatment that you’re trying to get.

The survey gets at that healthcare workers are just slightly more confident about their safety in a hospital or an ambulatory surgery center or a doctor’s office than the folks who are not involved in the healthcare industry.

So this is important for a couple of reasons. One, you want everybody to feel safe and that your staff, your physicians, and your nurses and others who also live in the community, and they’re affected just like everybody else. But also, we know that they are highly trusted spokespeople for your organization, and they’re ambassadors. If they’re feeling good, they’re going to communicate that to the community, and they’ll feel good. And so you have to lean into that fear and emotion. Acknowledge it, recognize that it’s there. And then speak to it. Speak to it with evidence, but also speak to it with your confidence about who they are and what you can accomplish together.

DS: Yeah, and in some ways, it makes sense. My initial thought was, ‘Wow, that’s really surprising that healthcare workers and their families are almost as concerned or feel almost as unsafe as the general public.’ But I guess it makes a lot of sense because the general public is being told how bad it could get and healthcare workers are seeing, either firsthand or from their colleagues across the country, how bad it can get or how bad it is. And they know what that means in very real terms.

So, I mean, I’m extrapolating here, but on the public’s side, it’s sort of this fear of the unknown. And in the case of the healthcare workers, it’s the fear of the known. So you end up at the same place where nobody feels safe.

And I guess the one thing that also struck me about that is, it shows also the enormous emotional component of all of this. So even if a hospital does have the PPE, does have the protocols in place, everyone’s following them, everybody’s geared up, it’s still scary because facts go a long way. But there’s still an emotional appeal here. And so that has to be addressed and dealt with, with more than just checklists.

DJ: It does mean it has to be dealt with more than just checklists, and it has to be dealt with more than just reassuring words – ‘Just trust us. We’re safe. Just trust us that everything is going to be okay.’

In a sense, we’ve all become highly, intensely educated in the last 30 days. We’ve all gone to school, you know, there’s lessons on how to build your own mask, how to wear your own mask, how to wash your hands. And so with a healthcare organization, we want to bring people back or we want to bring our own staff along, we have to recognize that education and speak to it. And what does that mean? That translates into specific evidence.

It’s not just enough to say, ‘We’re safe or this environment is as safe as it can be.’ It’s, ‘We’re doing this thing. We’re sanitizing this way. We’re wearing gloves like this. We’re wearing masks like this. We’re enforcing six-weeks rules like this. When you come in, you’re going to go in this entrance. When the COVID patient goes in, they’re going into that entrance.’

We need to provide specific evidence so that what we say in general, ‘We’re safe and it’s safe to return’ is demonstrated with specific evidence.

DS: Another interesting thing that’s come up with just some of the observations we’ve been making and also I think is relevant here, David, is to your point about specific evidence – it’s also really important to not overstate or to create false expectations, right?

Because if you start saying, ‘Our facility is safe’ or some version of that, I think you run the risk of that being read as there is no COVID or we’re done with COVID or there aren’t any problems.

DJ: I guess the point there is that, even before COVID, there was no risk-free environment. I mean, you’re going to the grocery store, you’re entering, you’re choosing to enter some sort of risk, and there’s been a really interesting discussion about risk. So I think it’s right for caregivers to talk to their patients like they’re adults. That we all recognize that there are risks. And we can’t tell you that anything is risk-free, but we can tell you all that we’re doing to be as safe as one can reasonably be in this moment.

I think there’s a chance that there may be a resurge of the coronavirus. I think there is a chance that if this pandemic is dealt with, another is to come. And to make false promises or set expectations that you can’t make, may have an initial benefit of a spike in patients returning to your hospital, but the long-term cost will be high.

DS: Yeah, and even if they’re not formal, explicit, false promises, nobody’s going out and intentionally saying something that isn’t true, hopefully. But you have to look at what you’re saying, how you’re saying it, the visuals you use to make sure that it can’t be misinterpreted because then somebody – and that somebody could be a staff member. What happens if a nurse or a physician is harmed? They say, ‘Well, I thought you said…” and now you’ve got a whole ‘nother storm that was completely avoidable. And I think, you would have damaged some of that trust that has been gained throughout this crisis.

DJ: Yes, I agree with that.

DS: So I guess having that as a word of warning, you take a step back. You look at what you’re saying. You’re creating the right message to your team internally, so that they understand the expectations, both on them and the way that they can think about their work and the way that they deliver care. And then take that as advocates for your organization out to the community, right. So it kind of circles back.

Because if they’re not totally confident in their ability to work in a safe environment, or they have questions about how leadership is presenting the reopening stages of this whole situation, they’re not going to be convincing. And appropriately so. They’re not going to be strong advocates to help people feel comfortable coming back, right?

DJ: That’s right and well said. It’s important that they be convincing, so it’s important that they be convinced. And here’s why. Because when we ask consumers, ‘Who do you want to hear from to convince yourself that it’s safe?’ Who is most influential in that? The number one answer is your doctor or better said, it’s my doctor.

It’s not doctors in general. It’s not the hospital. It’s certainly not the president. It’s not local news media or national media. All those have some value, but they’re way down the scale compared to hearing from my physician, ‘It’s safe to come back and please do.’

That’s a powerful voice here. And for those good physicians to be convinced, we all know physicians, they’re evidence-based scientists – they need to have the evidence that convinces them that this is a safe place to be.

DS: Because somebody will call them and say, ‘Okay, if it was your mom, would you bring her in?’

DJ: Right. Because if the answer is not yes, and that’s exactly what I would do, that’s a conversation that will be shared and shared and shared. You want it to be right the first time.

David Jarrard