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crisis communications

Whither Cochrane, for e-patients and everyone else?

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Image from Twitter user @Rasha_Fadlallah

This will be the third, and last, in my short series on attending the Cochrane Colloquium in Edinburgh in September of this year. In the first post, I talked about what that conference was like; in the second, I shared an overview of Cochrane as a global movement to make medical evidence work better for clinicians, patients, and communities around the world. This last one will talk about some of the issues Cochrane is facing, as an organization and as a proponent of science in a world that seems to have a rising suspicion of science and research.

I watched the Cochrane Colloquium open not just with a welcome to Edinburgh – although there was that, in spades – but with a behind-the-scenes PR flame war that wound up sucking up the the headline space for Cochrane that week, and in the weeks since. I talked about it in my podcast the following week, and have watched the conversation go by since my first day on the ground at the Edinburgh International Convention Center. The short-snort version of what happened is this:

  • On September 14, the Friday before the Cochrane Colloquium was to kick off (on Sunday the 16th), a letter went up on the Cochrane Nordic Center site’s News page from Dr. Peter Gøtzsche, wherein he announced that he had been expelled from the Cochrane governing board by a slim majority vote by that board. He cast it as a moral crisis, caused by Cochrane’s too-chummy relationship with the pharmaceutical industry. That letter has since disappeared from the Cochrane Nordic pages, the link is to a PDF on the Mad In America site.
  • Cochrane itself stayed silent for 24 hours, putting up its response to Gøtzsche’s letter late on Saturday, referencing only an independent review of “complaints related to the conduct of a Member” and saying that they would comment further only when the review was complete (confusing, right?).
  • Throughout the Colloquium, conversations went on everywhere but on the platform about this letter, the expulsion of Gøtzsche from Cochrane’s governing body, and what the reasons for same might be. There seemed to be no real detail on “reasons” beyond “behavior,” which behavior was never specifically defined.
  • This took over the entire agenda of the Cochrane Annual General Meeting at the Colloquium, bumping the report from the Cochrane Consumer Network, and other agenda items. Image in this post is from a Cochrane AGM attendee during the meeting.
  • Conversations about this appeared in mainstream media, including the Boston Globe’s STAT News, “Turmoil erupts over expulsion of member from leading evidence-based medicine group“; in the journal Nature, “Mass resignation guts board of prestigious Cochrane Collaboration“; in the BMJ blog, “Trish Greenhalgh: The Cochrane Collaboration—what crisis?” (note: I find this post by Trish Greenhalgh to be the most even-handed of the ones linked so far).
  • Hilda Bastian, a scientist, writer, and cartoonist, put up a great piece on her PLOSOne blog, “Boilover: The Cochrane HPV Vaccine Fire Isn’t Really About the Evidence – but it’s Critical to Science” that captures the issue well, with the bonus of visuals.

I’m a professional communicator, so I’m amazed that Cochrane let the guy they were drop-kicking get the story out first. That’s PR 101 – s/he who gets the story out first owns the narrative. When the drop-kickee got the first announcement out, Cochrane was left in damage control mode, with neither side fleshing out any of the details regarding the “behavior” that led to the drop-kick. The social exhaust of that damage control continues to waft across the landscape. Cochrane will most certainly survive, and I hope that they learned from this series of unfortunate events. Crisis communications planning is totally a thing – a thing I recommend every organization and enterprise get savvy to.

My point? Science is as messy a business as any other human endeavor. As soon as you think you’ve got your hands, and your mind, wrapped around something … it squirrels away, and changes the entire question. Add human behavior and emotion, and stuff can flame up quickly.

Here’s my suggestion: Cochrane needs more ground-level troops – the ones called “patients,” or “citizen scientists,” or just “people” – to participate in the scientific inquiry that forms the body of their work. This is true across all scientific fields, but it’s particularly true in medical science. Human health and care is the ultimate purpose of all medical research, which means that having people/patients included in that work is critical. Much of the “science denial” hooey behind stuff like the anti-vaxx movement and the silliness that is anything Mehmet Oz says, or Gwyneth Paltrow ditto, is rooted in the giant castle walls that have separated people from Important Work In Science with paywalls, and the mindset that said “doctor knows best” when it came to medical practice. But those castle walls are being stormed on the regular since the democratization of knowledge and access to information that arrived when Tim Berners-Lee came up with the World Wide Web at CERN back in 1989.

Medical science is threaded through with uncertainty. Intuition, hypothesis, testing that hypothesis, analyzing results … lather, rinse, repeat. Getting citizen scientists and front line clinicians involved in the creation, analysis, and compilation of the science that informs how humans get and/or stay healthy is a civil/human rights issue, as well as an acceleration-of-discovery play. Paternalism can’t run the table any more. There also has to be an ongoing, robust discussion of that science: is it trustworthy, who paid for it, how much implicit bias was either included or removed, how can population-level science intersect with n-of-1 precision medicine, the 21st century medical science unicorn? Everybody in, nobody out, bring on the inevitable arguments. Scientific papers are basically arguments – don’t be afraid of conflict, from conflict can come consensus, alignment, and progress. Participatory science, it can totally be a thing.

Whither Cochrane? I think it’s up to us, the citizens of the world who care about making healthcare better for everyone. Let’s get to work.

This post originally appeared on the Society for Participatory Medicine blog

When Jet Blue’s Ship Came In, They Were At the Airport

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Well, of course they were at the airport. They’re an airline.

My point is that by not responding quickly to the Steven Slater Beer-Slide incident, they’ve really missed the boat on kicking off a great conversation about and among an entire industry and its customers. The conversation is kicked off, and JetBlue is a major part of the story, but they screwed up a huge opportunity to manage a crisis well.

It took them TWO DAYS to formulate a response on their blog. In hiding behind the “we don’t comment on individuals” curtain, they missed a chance to become the Great & Powerful Oz of the air travel industry, at least in the customer-cabin-crew-connection-and-convo category.

What would I recommend to a company who finds themselves in the position that Jet Blue was in on Monday?

  • Offer a comment along the lines of “today’s events are offering us an opportunity to start a conversation across our industry about customer service and workplace conditions. If you’d like to share your views with us, [blog/email/Facebook/Twitter] – we welcome the chance to explore how we can improve our relationships with our customers AND our employees.” That doesn’t assess or assume blame, but it says you’re paying attention.
  • Monitor traffic, engage in conversations with heart but not an excess of passion (IOW, don’t pull a Slater).
  • Monitor commentary about your brand, and the individual who set off the situation. Respond only to direct queries by pointing them at your crisis-comms traffic cops mentioned in Bullet 1.

Jet Blue wasn’t completely silent. Unfortunately, the cries and whispers of the guy who manages their corporate comms Twitter feed got into a Twit-fight with Andy Borowitz (@BorowitzReport). In a battle of wits with a comedian, Jet Blue’s guy is an unarmed combatant. And he forgot the 1st rule of crisis communications: don’t say anything that will make the crisis worse.

You could wind up Dipstick Du Jour on Gawker.

I hope both Jet Blue and Steven Slater find their way through, and past, this slide down the barbed-wire fence of corporate celebrity. I also hope that other individuals, and the companies who employ them, find better ways to manage workplace stress.

That’s my story, and I’m stickin’ to it…

The 9 Rules of Media Relations Crisis Management

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As the tragedy at the Sago mine in West Virginia unfolded on our televisions and front pages in January of 2006, I’m certain we all wondered how the story could have become such a terrific example of corporate media-relations bungling.

Perhaps I was in the minority thinking the bungling was terrific, but I’m in the media relations business – this mess was going to be a terrific teaching tool to illustrate how not to behave in a crisis.

How did such utterly wrong “facts” get released? And why did International Coal Group, the company that owns the Sago mine, let the wrong story spread for three hours before admitting to the real facts – twelve miners were dead. There was only one survivor. Not twelve, as had been joyfully reported by broadcasters and newspapers around the world.

There is one primary rule in media relations – never let the story get away from you. International Coal Group violated that rule, and wound up the poster child for corporate blundering. ICG will have “Sago mine disaster” inserted in every story about their company for years to come. The coal industry isn’t known for its safety record – now ICG has the dubious distinction of joining the “worst mining disasters” list.

Most business owners, large or small, will never face a media disaster of these epic proportions. They can, however, learn some valuable lessons by being aware of what can happen if you violate that one primary media relations rule – never let the story get away from you. Every company should have a media relations crisis plan – even if you will only end up talking to a community newspaper.

Plans for any company should follow these guidelines:

1. Be prepared

2. Tell the truth

3. Establish one point of contact

4. Tell the truth

5. Maintain your message – know what to say, and say only that

6. Tell the truth

7. Know what is, and isn’t, newsworthy

8. Tell the truth

9. Be aware of deadlines

You’ve likely noticed that one rule is so important, it’s in there four times – no matter what you have to say, if it isn’t true, you’ll be found out. It might be within three hours, like it was for ICG. It might be three weeks, three months – but you will be found out, and you’ll have an accelerating disaster on your hands that your business may not survive.

Here are two more real-world examples that show how important the truth is when your company faces a crisis:

In Sept. 1982, a series of deaths in the Midwest were found to be caused by cyanide-tainted Tylenol. In the nation-wide panic that followed, Johnson & Johnson, Tylenol’s manufacturer, responded by recalling all Tylenol products and investigating their manufacturing plants – and keeping the public updated on what they were doing, and what they discovered.

They stated that they recognized this as a public health crisis first, and a company crisis second. Working with the FBI, the FDA and the Chicago Police Department, the company was praised for its honesty with the public during the Tylenol crisis. In 2006 – 24 years later – Tylenol has 35% of the painkiller market in the US.

On Dec. 3, 1984, a Union Carbide chemical plant in Bhopal, India accidentally released a cloud of pesticide – methyl isocyanate – that covered the city.

Over 1,500 people died within 24 hours.

Even though the company deployed a medical team immediately, the company’s statements – via the medical teams on the ground and corporate press appearances – downplayed the effects of the accident. Months later, Union Carbide was still denying that mortality rates were as high as they were being reported in the press.

The company never fully recovered, and was bought out by Dow Chemical ten years later.

Like I said before – tell the truth. It won’t just set you free, it’ll keep you in business.

You should have a media plan in place before you speak to a community calendar newsletter, your local paper’s business editor, a local radio or television reporter, or launch a product or service at a trade show.

It doesn’t matter whether you’re talking to a suburban community paper or the New York Times, having a plan in place gives you the confidence to speak your message, stay on track, and stay in control of your company’s news, and its future.

In the fast-moving, 24-hour spin cycle that is today’s news business, you don’t want to wind up circling the drain, getting caught off guard if your company suddenly becomes newsworthy.

If you’re lucky enough to come up with that fresh take on the mousetrap that has the world, and the media, beating a path to your door, you don’t want to answer the door in your underwear.

By being prepared with a media plan, developed using the guidelines I’ve given you, you’ll answer your door looking (and sounding) sharp, successful and newsworthy.

And you’ll enjoy your ride on the media train, instead of finding yourself ground under its wheels.