READY:   Your lip glistens with sweat. Your hands shake.

AIM:        Your mouth goes dry. Your mind goes blank.

FIRE!       Some reporter poised with a notebook thinking he’s Mike Wallace is about to stick a microphone in your face and pull the trigger.

You’ve just been led in front of the media firing squad!

Sooner or later, you will be called on to “meet the press.” Even if you haven’t been subjected to the media spotlight, you’re interested in getting more positive publicity for physicians or responding to some politician’s tirade on Medicare and those greedy doctors. If you aren’t prepared to use any and all media encounters as an opportunity to tell your story or actively seek media coverage, you can be sure your opponents are.

Medicine has become a highly charged political issue. The media is largely responsible for setting the agenda and directing the public interest on those issues. You have a responsibility to get your profession’s message to the media, and through it, to the public and policy-makers.

Medicine and the Media Collide

The clash between physicians and the press in the U.S. is older than the republic itself. The first recorded debate goes back to the Boston smallpox outbreak of 1721. Newspapers, including Benjamin Franklin’s The Courant, launched a crusade against Dr. Zabdiel Boylston’s practice of immunization.

That conflict continues today, fueled by the explosion of both media and medicine. Doctors believe that reporters are biased and hostile, looking for the sensationalistic angle rather than striving for a balanced story. Reporters view doctors as arrogant, rich and insensitive.

A comprehensive study of the relationship between physicians and the news media corroborates those attitudes. “There is bad feeling on both sides; the evidence of it is inescapable,” writes John Siegenthaler, Chairman of the Freedom Forum at Vanderbilt University.(1) The Freedom Forum’s survey of physicians, reporters and editors is blunt: “physicians don’t trust the news media, and the news media don’t trust doctors.”(2)

The report emphasizes the public’s need for information about medicine and public policy.”With such a great need for information, how sad that the two institutions with the talent and technology to provide it are so estranged.”(3)

Doctors must recognize the most compelling reason for the need to talk to the media — to minimize government’s role in the patient-physician relationship. “The federal government’s intrusion into the field of medicine should encourage both medical and media professionals to seek an accommodation of mutual respect. Government oversight and regulation usually mean trouble for the industry involved. Health care professionals will be best served if they can publicly expose government abuses — which inevitably will occur — through the news media.”(4)

The Freedom Forum report recommendations support the thesis of this article: doctors should be as accessible to the press as their schedules allow, keeping reporter’s deadlines in mind, and doctors who expect to have contact with the press should seek media training in order to better understand reporter’s needs and constraints.(5) Simply, the better prepared you are to “meet the press” the better you will be able to serve your profession and patients by telling your side of the story.

Should Doctors Talk to the Press?

Doctors have been imbued with the attitude that talking to the media is unprofessional, and to be avoided lest one be pegged as a “publicity hound.” But it is unfounded. Responding to the Freedom Forum’s question “Most physicians who allow themselves to be interviewed for stories are just seeking publicity,” 64% of your medical colleagues disagreed, as did 83% of the reporters polled.(6)

If you overcome your reluctance to speak out and change your attitude towards reporters, you can learn the skills and techniques to give you the confidence to not only respond to the press, but seek out opportunities.

The keys to positive media encounters are to be prepared, tell the truth (tell it simply, tell it quickly), and stay in control. If you do your homework and use the following guidelines to hone your communications skills, you will greatly increase your odds of keeping reporters honest.

Make Reporters Your Friends

It is much easier to work with journalists if you understand what makes them tick. Take heart in the fact that most reporters aren’t “out to get you,” but instead are out to get a good story. And the odds are against them.

The reporter’s daily battle is to get their story on the air or in print. It’s the academic equivalent of publish or peril. They fight editors with blue pencils and producers with stopwatches for a few more inches or an additional ten seconds. The better the story, the more interesting quotes from their sources, the better their chance of getting their byline on page one or their face on the air.

The reporter’s day is a frenzied rush to grab interviews and make deadline, often with little expertise or advance preparation. As a television assignment editor, I didn’t hesitate to send a crew on a marathon covering four stories beginning with the mayor’s news conference at 9 a.m., ending with a new surgical procedure at 2 p.m.(And they still had to get back to the newsroom in time to write the stories and meet unwavering deadlines.)

This may seem no way to run a newsroom, but it is exactly what you can use to your advantage. Simply, you are the expert, and the reporter needs you and your credibility to make the story compelling enough to please their editors.

Become a trusted source for reporters. Reporters view themselves as professionals, so extend them the same professional courtesy you would expect. If they know they can count on you to tell the truth, and to tell it in a lively, simple manner which their audience can understand, they will come to respect you and present your side fairly. If a reporter calls you on a subject which is out of your realm of expertise, give them the same professional courtesy you would give a medical colleague — make a referral. Suggest someone who might be able to help, or send them to AAPS for information. Soon they will regard you as a valuable resource who can help them do their job, rather than another adversary in the media wars.

What to Expect from a Reporter

Your receptionist buzzes with the call — there’s a reporter on line 2. Of course, it always comes at the worst possible time — you’re with a patient, and eight more are scheduled before lunch. Don’t panic.

Your only response at this point should be “I’d like to help you.” But tell them you’re busy at the moment and will call right back. Get their name, who they work for and their title. This not only gives you a chance to collect your thoughts, but also to confirm who’s at the other end of the phone. I was always astonished when I said I was “calling from KOMO TV” people would spill their guts without confirming my identity. It could be your opposition mining for information or a free lance journalist hoping to make a hit and taking up your time.

Keep your promise to call back even if you have no intention of consenting to an interview. The next day won’t do. An unreturned phone call is an opportunity missed forever. And the surest way to alienate a reporter or editor is to ignore deadlines or not return a call. You probably won’t get called again — and the next time may have been the one story you wanted to get out to the public.

It’s time for you to play reporter and ask the questions. The reporter’s basics are who, what, when and why. Now it’s time to figure out the “what, when and why.” Here are the questions to ask:

• Tell me about the story

• What part of the story do you hope to get from me?

• Who else are you talking to?

• How big is the story?

• When will the story run or be published?

Based on the information you glean, make a decision about the interview. If you don’t believe you are the best person to be quoted for the story, tell them. Suggest other sources friendly to your cause. Even if you don’t want to do the interview, but can provide background information, it is in your interest to do so. To get the story I wanted, I’ve spent many hours on the phone with reporters explaining issues without ever showing up as a source in the finished article.

Ask their deadline. If the interview is for a newspaper, they will probably want to do it right away on the phone. Again, offer to call back in a few minutes. If it’s for television, set up a time.

Prepare for the Interview

Even the most media savvy should prepare for a specific interview. Here are the steps:

1. Define your goals. What do you want to accomplish with this story? Is it to educate the public or pass a specific piece of legislation? The best public appeal includes a call for action. What steps do you want your audience to take?

2. Define your message. What is the one thing you want the reader or viewer to get out of this story? We call this the Single Overriding Communications Objective or SOCO. Think of it this way: if you could write the headline for the story, what would it be? Take for example, a story on private contracting in medicare. You could talk about reimbursement rates, relative value scales and how you have to turn away Medicare patients. But your SOCO would be: “People over the age of 65 lose their rights as patients because of Medicare restrictions.” If your goal is a specific action, link your SOCO to that end.

3. Get your facts straight. This should go without saying. Review any tests, surveys or statistics so you can tick them off with ease.

4. Anticipate the questions. Again, play reporter. Pretend you know little about the subject. What will they ask you? Most important, what is the question you don’t want them to ask? Be prepared, because they probably will. Brainstorm with your staff and colleagues, and have them throw you a few questions.

5. Practice your answers. It’s unfortunate, but the media war is won by the side with the best sound bites. I have my clients practice speaking in 7-10 second sound bites to make sure you get that one attention grabbing headline to support your SOCO. Come up with several ways of making the point. Then develop your points in support of your SOCO. You should be able to get this out in less than a minute.

Let’s say your SOCO is “Managed care is bad for patients.” Your support statements: “Managed care treats patients like pets because the ‘owner’ (the company) decides if ‘Spot’ is worth treating. It replaces the Hippocratic ethic with a veterinary ethic. Physicians are subject to an untenable conflict of interest of being caught between the best interests of their patients and the bottom line of the company.” You can then go on to cite various studies about patient satisfaction or the AAPS survey which shows doctors oppose managed care and tell the audience what to do if your goal includes a specific action (“Call Congress and tell them you support the AAPS Patients’ Bill of Rights”). But you’ve made your primary point in just a few sentences.

Face to Face with a Reporter

Remember, everything you say is there for a reporter to use. Anything a reporter does or says which is sneaky or low will be edited out. If you anticipate frequent speaking engagements or media appearances, it is wise to seek some formal media training. But here are a few tips:

Assume you are always “on the record.” If you do want to go off the record, you must tell the reporter before you make the statement. If doesn’t fly to say “But that was off the record.”

Speak to your audience. Unless you are being interviewed for a medical trade publication, assume your audience is less educated and knows little about the subject. Speak plainly and avoid technical terms, or be sure to explain them. Involve the audience. Tell them how this issue affects them. You will accomplish little if you can’t make them understand why they should care. Use stories and specific examples to humanize the issue.

Don’t lose your cool. Always stay in control of the interview. Reporters may try to goad you to get you to lose your temper to get that one good quote.

Anticipate interview traps. We reporters have a full bag of questioning tricks to trap you, from asking “let’s pretend” to the “loaded preface” (“Considering the low regard people have for greedy doctors who bilk Medicare of millions...”). Don’t take the bait. Instead, use what we call the “bridging technique.” Use their question as a jumping off point to answer the question you want answer and make the point you want to make (“Yes, there are a few highly publicized cases of fraud, but what’s really important is....” or “I don’t have a crystal ball, but what I can tell you is...”).

Don’t be alarmed if the reporter repeats a question. Your first instinct may be suspicion, but they may just be trying to get you to say something more succinctly or clearly so they can use that as a quote or sound bite.

Fight Back and Win

The most frequent complaint I hear from my clients is “Why don’t they ever cover our side of the story and get it right?” You may have been misquoted or a story has wrong information. They only talked to the opposition. You disagree with an editorial or a guest column.

You can fight back. But this is the time for “don’t get mad, get even.” If a story left out your side, call the reporter first. Calmly point out the problem. Suggest a follow up story with any new or additional information you can provide. Help them get the whole story. Only go over the reporter’s head to the editor if the reporter is unresponsive.

If you can’t generate a story, you have other routes. Try for a guest column. Call the “op ed” editor and explain the premise for your article. They won’t give you guarantee, but will give an indication of their interest. Ask for a specific word length, and stick to it.

Don’t ignore letters to the editor. Reader polls consistently show these to be one of the most highly read sections of newspapers. Make your point clearly and succinctly, usually in less than 300 words.

If you don’t have time or skills to fight back, let AAPS know about the story. We can’t set the record straight or get the word out if we don’t know about it.

Getting Out the Good News

When you have a good working relationship with the media, you can get your share of positive stories. Cultivate a local reporter. Invite him to events. Send him research and information with a note “thought you’d be interested” even when you have no direct involvement in it.

Look for stories with people angles. If you and your colleagues volunteer for a clinic, tell a reporter. Don’t be discouraged if they don’t cover it. Keep trying. Much of media success is in playing the numbers.

Building goodwill and developing a professional relationship with the media helps promote the good stories but also increases your chances of being treated with trust and respect in bad or controversial moments.

Conclusion

As long as the only stories hitting the airwaves or getting in print come from our opponents, the misperceptions about doctors will continue. In the words of one of my clients, Dr. Michael Schlitt, AAPS Board Member and president of the Washington state chapter, “The most important lesson I’ve learned since medical school is that making the media your friend is critical to the cause.” It is your responsibility to use the news to help tell our story. If you don’t, who will?

References

1. Rubin R, Rogers HL, Jr. Under the Microscope: The Relationship Between Physicians and the News Media. The Freedom Forum First Amendment Center at Vanderbilt University, 1993, p.i.

2. Ibid., p.3.

3. Ibid., p.2.

4. Ibid., p.iii.

5. Ibid., p.4.

6. Ibid., p.13.

Kathryn Serkes, President of Square One Media Network, is an Emmy-award winning producer/reporter, media consultant, and the public affairs consultant for AAPS. Her address is 1932 First Avenue, Suite 401, Seattle WA 98101.

Originally published in the Medical Sentinel 1997;2(3):101-103. Copyright ©1997Association of American Physicians and Surgeons (AAPS).(206) 448-2666, Fax (206) 728-2318.