Follow the drama–lasik surgery

Since this is one reputation crisis playing out in real time, let’s keep following the lasik drama.

Fact one: there is a minor furor going on. Just check google and see all the current news reports, blog postings, etc.

Fact two: the furor was caused by the FDA holding a hearing–which they now did on April 25. The “news” as I mentioned in my last blog post was there was going to be a hearing. That’s the news hook–but the stories as they were broadcast over NBC and others led one to believe that the news was that the dangers of lasik were now being brought to light. That jump is what I consider egregious.

Fact three: as a medical procedure, lasik appears to me to be incredibly safe. Numbers vary from 7 million (in the Fox Report) to over 12 million (in the NBC report) as to how many US folks have had lasik surgery–that doesn’t count worldwide numbers. The FDA says they recognize that over 95% of the patients are “satisfied” with their results and less than 1% (according to Dr. Solomon) have severe side effects that impacts their vision.

Let me be clear–if I was in that 1% I would be concerned too. But, how many plastic surgery patients are “satisfied?” By my quick review walking the sidewalks of Beverly Hills, I would say a good 50% have a right to be very unhappy. And unhappiness does not equate with poor results or severe side effects.

It is perfectly right and appropriate for the FDA to hold hearings. They would be doing a disservice if they did not. What I object to, as strenuously as I can in the blog without becoming another ticked off blogger, is how the media/regulatory environment works to the detriment of most of us and our freedom to decide. Look at the headlines coming out of the hearing: (Fox News:

Patients Harmed by Lasik Surgery Alternate Between Fury, Despair at FDA Hearing

(obvious, I did a cut and paste here)

How would a headline like this work: “Experts demonstrate that lasik eye surgery one of the safest elective surgeries available.”  Nope, wouldn’t work. Wouldn’t get eyes glued to the screen or the paper. I’m not saying there weren’t sad stories and some people aren’t ticked off and have a right to be. Bad procedures, bad doctors and bad choices exist (note the story of one “victim” who insisted on having it despite the doctor advising against it–it’s not just docs that make bad choices.)

The entirely predictable process works like this (I described it in Now Is Too Late2):

- an event happens (in this case something really mild like FDA holding hearings

- news media figure out a way to use it to gather an audience

- method used is outrage and melodrama (black hats, white hats, that whole thing)

- elected officials or regulators view the outrage as meaning they should take action

- new laws are passed or more restrictive regulations issued NOT based on scientific reality, but the fear of appearing to not care and do nothing. Where is the old logic of government action that said, “Let’s not just do something, let’s stand here.”?

- freedom of choice is curtailed, costs skyrocket so fewer and fewer people can afford the benefits, and elected officials and regulators who are the most active at taking these steps get reelected or reappointed.

And it all starts because our “news” environment is driven by a singular need to attract and hold an audience.

Do I think we have a problem here? We have a problem here.

NBC News and Lasik surgery–an egregious example

We now take it as commonplace to see the kind of coverage that NBC News provided about lasik eye surgery. I think Brian Williams is the class act on network news and they have done a stellar job of set design, integration with msnbc.com, etc. But their coverage of lasik surgery is a great example of what is wrong with news today.

Here is the video of the report.

It starts with the teaser-which suggested (I am recalling from viewing the original report a couple of days ago) that there was new information about the dangers of lasik surgery. Get attention? As Williams suggested in this opening lines–this will be of high interest to those who got surgery or who are contemplating it.

What was the news? The FDA is holding hearings. That was the only news. But, what was the message conveyed? The lasik eye surgery is a highly risky procedure with potentially disabling side effects. What was the evidence? The sad experience of one young man. I want to take nothing away from the misery endured by this man who suffers from extreme dry eyes, apparently from his surgery.  But the story mentioned that 12.4 million people have had this surgery, that 700,000 people get it every year, and showed one doctor in the report that indicated he turns away a number of patients because they are not good candidates.

The reporter and NBC News will say in defense that see, they reported all the “good stuff,” but the truth is the way the story was set up by the teaser, the tone of it, and the singular focus on one pitiful case of surgery gone sideways left a clear and indelible message that this is something highly dangerous, under-regulated, with millions taking undue risks because doctors are hiding the risks. If anyone who watched it didn’t get that message let me know.

I have some sensitivity to the issue because a few years ago one of my clients had one of the largest and most successful lasik surgery clinics in North America. He was driven out of business by a huge jump in insurance premiums based on a class action lawsuit. The enterprising attorney was attempting to assemble a class for action, and got on Good Morning America–with a couple of patients (sisters I believe) who had surgery and complained about their problems. The truth was, they refused to come in for secondary treatment which is relatively common. They wanted the problem and didn’t want it to go away and the attorney wanted to assemble a class. Good Morning America was more than willing to comply. We offered to come on the show with them–they denied us the opportunity and gave us 15 minutes to offer a written statement. Which we did and they waved at the camera during the completely bogus report.

As a result of this combination of legal entrepreneurship with media ratings hunting, the lasik clinic with likely the highest safety and performance rating at that time had to be shut down.

It is common for the public to buy into the media’s own messiah-complex that they are operating for the public good–in this case trying to save innocent people from the horrors experienced by the gentleman pictured. But, they can and frequently do untold damage by these kinds of reports as well. Innocent people get hurt by bad surgery, and innocent people get hurt by audience-greedy journalists as well.

Crisis Planning seems to be big–but how do you know if they are any good?

I found it very interesting that just today I got two invitations to participate in webinars on crisis planning. One put on by PRSA, and the other by PR University from Bulldog Reporter. Both of these look like worthwhile presentations by expert presenters.

My question is this: how can anyone determine whether a crisis plan will be effective?

I think this question is coming out of the work I have been doing lately in creating a JIC Evaluation Tool and also reviewing the draft of the National Response Team JIC Model. If those putting plans in place and training participants don’t have an adequate understanding of rapidly changing demands of today’s audiences, how can those plans and models be effective. I suspect–more than suspect since I have seen a lot of evidence of it lately–that a lot of crisis plans are being put in place that would work in yesterday’s world but not in todays. Yes, things have changed that much.

Crisis plans developed today need to meet the expectations of today’s audiences–and, as much as possible, anticipate future demands. If not, they will be outdated before the big red notebooks get distributed.

Here are a few suggestions aimed at helping you evaluate whether your current plans (or brand new ones you are creating) are outdated:

– are they media centric? -in other words do they anticipate that the primary if not exclusive means of getting information out to key audiences is through the media?

– do they anticipate getting initial messages out in the first half hour? Impossible, you huff. Maybe, but essential. The determining factor for speed used to be “how soon will the news helicopters arrive?” Now it is “how soon will someone with a cellphone and cell camera convey it to the news media?” Instant news is now instant news.

–do they plan for using mass-individual distribution methods–such as text, text-to-voice conversion as well as email?  Today’s audiences have an increasingly well defined expectation for direct communication–just ask any student on any campus following Virginia Tech.

–do they plan for ongoing communication well beyond the initial news media coverage?  The news media comes and goes with increasing speed. But not so interested audiences. Plans that assume communication stops when the news media’s interest wanes are simply outdated.

–do they include the buildout of comprehensive information and audience contact information in advance? You need to know whom you absolutely need to communicate with in advance and have the preparation to do that virtually immediately. And questions need to be anticipated in advance with answers ready to go or pre-posted on dark site–because you simply won’t have the time or resources to do these things when it really hits the fan. Preparation today is much much more than identifying spokespersons and giving them media training.

–does your plan anticipate team operating on a vritual communications platform–I can guarantee you the crisis you fear most won’t happen when you are sitting at your computer waiting for all hell to break loose. You will be gone, or your key leadership team, or your whole office may have floated away. Being able to operate virtually is now not a luxury, but a necessity.

–is social media engagement more than a casual after-thought? Social media serves multiple roles in a crisis, some positive, some potentially negative. But it is an essential part of today’s information environment and any current crisis plan must have blog monitoring, blog participation, social media sites as communication media, blog policies and all these sorts of things worked out in advance. No longer can you hide your head in the sand and say: well, no one pays any attention to them anyway.

These are a few of the items that I can think of to help determine if crisis plans will actually work when you need them. Would love for crisisblogger readers to add to this list (or tell me why these don’t apply).

Take this crisis communication survey

I was very pleased to see on crisisblogger comments from Fred Bagg–I sat in on his presentation about crisis communication technology about five years ago at the PRSA conference when PIER was just a baby. I also listened to Dan Millar who at that time I believe was part of the Institute for Crisis Management. Both of them are seasoned and savy crisis communication experts.

Fred has posted a survey about crisis communication and to return the favor of me learning good things from him, I’d like to encourage all crisisblogger readers to take this survey. Here is the link:http://www.surveymonkey.com/s.aspx?sm=lePNFw4D8iU6EHS5L2J%2fGQ%3d%3d

PRSA Teleseminar on Building Trust

I am very pleased to have been invited by the Professional Development group of PRSA to present my presentation “Building Trust in Media Maelstrom” as a teleseminar on May 1. This is similar to the presentation I did at last year’s PRSA International Conference that appeared to be very well received.

I’d love to have you join us on the call so if interested, here is how to register.

As the teaser for this seminar, PRSA says those who attend will learn:

The two essentials of building trust.
The three drivers of today’s communications and why ignoring them is a recipe for failure.
The four critical steps of crisis communication planning.

If you are a frequent crisisblogger reader, you can probably identify each of these items. In fact, I’ll send a free copy of my book Now Is Too Late2 to any crisisblogger reader who correctly identifies the two, three and four “secrets” referenced above. Hope to see you on the call.

Here is your chance to rewrite the JIC manual

Thanks to Chuck Wolf of Media Consultants in Houston, I am attaching a copy of the working draft of the revised NRT Joint Information Center model. You are invited–no, strongly encouraged to provide input as soon as possible as the working group is moving toward completion of this draft.

This document has served as the foundation for all subsequent thinking about Joint Information Structure since it first was published in 2000. It was initially created, as far as I can determine anyway, by a group of four Public Affairs Officers from the Coast Guard. As I recall they were Tod Lyons, Adam Wine, Chris Haley and one other whose name escapes me.

This document has served as the foundational model for all subsequent efforts at defining the Joint Information Center (which if you are new to the concept, is the communication element of the Incident Command System, and since 2003, the National Incident Management System or NIMS.) It has many variants and enhancements. The Federal Government’s ESF 15 is one version ( a very inadequate one in my humble opinion) and the new FEMA “Basic Guidance for PIOs” (Nov 2007) is a much better version. One of the best iterations of this foundational document is Phil Pfuhl’s JIC Guide–a guide for creating custom JIC manuals.

The updated NRT JIC Manual will no doubt continue to serve as a foundation for planning and operating most JICs around the country–and increasingly around the world. Since its original creation, the world has changed substantially in technology and in audience expectations and demands. I will be looking through it with that in mind and those of you who have had JIC experience, or crisis response experience involving multiple agencies or organizations are strongly encouraged to contribute your thoughts.

You can download the pdf of the current draft at www.piersystems.com/uasi. Click on: 2008 DRAFT NRT JIC Manual.

If you have comments, you can leave them here on this blog by using the comment box, or email them to me at gbaron@piersystems.com, or Chuck Wolf of Media Consultants (he is actively involved in the draft review process) at mediacon@aol.com.

Seattle Sonics, Clay Bennett, Paul Silvi and "fungus"

Here’s a simple message to organizations and their communication leaders: Don’t lie. Simple. People don’t like liars. Dishonesty will be rewarded with complete lack of trust. And that will cause you endless problems.

Case in point: Clay Bennett and the Seattle Supersonics. Bennett, a businessman from Oklahoma, bought the Sonics from Howard Schulz of Starbucks fame. Bennett said he would keep the team in Seattle but if he couldn’t because of concerns about recently renovated Key Arena, he would move them to Oklahoma.

Obviously a huge stir in Seattle. The legislature and city turned down very expensive demands from Bennett for public funding of a new arena. All the while Bennett is loudly claiming to the NBA and Seattle that he is doing all he can to keep the team in Seattle. And while he is doing this, he is writing emails to his buddies back in Oklahoma telling them to “hang in with me boys” and that they’ll get this team to Oklahoma soon.

As expected, the public airing of these private emails has created a sensation in Seattle. The Governor is all over the news saying: “We’ve all been lied to. I’m shocked, I’m very disappointed.”

King 5 TV sports anchor, Paul Silvi, has gone a lot further. Last night he aired a video combining a replaying of the damning emails along with music that repeated “liar, liar.” And he put out commentary saying that there is no way the NBA should allow this kind of “fungus” to infect their group which is already suffering from credibility problems.

Seattle is exploring all their legal options to keep the team in Seattle, but those seem doomed to fail. It comes down to the NBA and so far they have seemed cautiously supportive of Bennett’s intention to move the team. Now he has really stepped in it big time. Suddenly Sonic fans have the leverage they never had legally or politically to put the pressure on Bennett. And that lever is a few emails that Bennett never believed would see the light of day.

Lesson 1: Don’t lie.

Lesson 2: If you are going to be as stupid, devious, deceptive and fungal as Bennett is, then for Pete’s sake, don’t use email.

Nationwide text alert system? That's what they say.

Breaking News!!

According to this story in CNN, the federal government is about to launch a new nationwide emergency text alerting system. It depends on the cooperation of cell phone providers which looks like they will support it, and it requires and “opt out” not an opt-in for the cellphone subscribers–which gets away from the problem that universities were having with small opt-in response.

Hmmm–wonder what this will do to the nation’s cell traffic in an event of an emergency? Will anyone be able to make a cellphone call? And who is going to sue whom if some get the message and others don’t. Welcome feds, to the wonderful world of emergency text messaging.

While I predicted that after Virginia Tech, the demand for instant notification on the part of all citizens within communities would grow rapidly, I must admit I did not anticipate any federal agency trying to take this frog type leap. Not sure it is viable or practical as most situations are localized–not immediately national. And that includes major terrorist events. It would have to take one heck of a threat to scare the bejesus out of everyone at once–even if technically you could do it. What it does show is that the demand for instant and direct communication is pressuring those with responsibility to come up with innovative ways to meet that demand. And that is the real lesson for all emergency managers and crisis communicators. How will you meet the demand for instant and direct information?

Dying broke–my new goal

I happened on Stephen Pollan’s book called “Die Broke” at a sidewalk book sale in sunny Scottsdale this past weekend. I must say it has transformed my thinking–I think in very healthy ways. (Hold on now, there will be a connection to crisis management in here somewhere.)

He makes a compelling point that the idea we have all bought into about working our tails off so we can have an enjoyable and comfortable retirement is a new concept–created in the 1930s as part of a plan to help pull us out of depression. When 65 was set as the retirement age, the average lifespan was 63. Now it is into the high 70s and if you get into your 60s you have a good chance of productive, reasonably healthy living for another 20 years.

Die broke is only one part of his philosophy. Another key is to never retire. Keep working because retirement for most people frankly sucks. Those who do well at it find some form of work–charitable or profitable, but they work.

So what does this have to do with crisis management? It’s the philosophy of the journey rather than the destination that is important. If you plan on running out of money just as you run out of life, your focus becomes the journey you are on rather than the destination. Focusing everything on “getting there” only to find out at the end that the destination you planned for your whole life wasn’t worth all the sacrifice is deeply disappointing. It is like the guy who took a train ride through the most beautiful countryside and slept all the way because he wanted to be wide awake when he got to the city he was going to. He found the city a mess and realized he had missed out on the best part of it by sleeping through the beauty.

Building trust is the end goal of communications–especially in crisis communication. That is a mantra repeated here over and over. But it is not a destination, it is a journey. It is not something to be done once and then you are done, it is something to be started right now and the focus of everything we do every day we do it as professional communicators. You want to build trust with your superiors and you want to help your organization build trust among the people who matter most to its future. That’s what your focus ought to be right now.

Dealing with crisis planning is simply the process of thinking through what might go wrong and putting the pieces in place to deal with it if it should happen. The focus of all of that is to build trust. You build trust when you examine the safety and health risks, confront them and do something about them. You build trust putting in place the plans, information and technology needed to communicate quickly and directly when you most need that trust. It is not something to wait for. It is something to do right now and keep doing until the day you retire–what? You aren’t going to, remember?

JIC Performance Standards–a little help please

I commented not long ago on the depressing performance of a JIC (Joint Information Center–part of Incident Command System and National Incident Management System) involving a large government crisis exercise. But it led to the question–is there a standard out there for JIC performance? Do PIOs (public information officers) have any resource they can go that says–here is what your JIC should be able to do, by when, and these are the standards by which you will be measured?

If anyone knows of such a standard, please let me know–because it will save me a ton of work. There being none as far as I know, I am setting about creating one. I’m convinced that perhaps the biggest problem of public information management today–both on the part of public and private communicators–is not understanding how the demands have escalated. The media, stakeholders and impacted publics have much greater expectations and demands than even 5 years ago. That means the bar keeps moving. What might have been a successful JIC ten years ago would be an abysmal failure today. But how do you show people who care about these things what is expected? I believe a JIC evaluation method which reflects current expectations of those impacted by an event is the best tool.

If I am right, the best thinking should be consolidated by some government consulting firm, then distilled into a JIC Evaluation Form and distributed to every jurisdiction in the country. After all, if DHS can mandate use of the JIC as part of NIMS, it ought to be able to publish standards of performance that the JICs it helps fund can use to determine if they are operating properly.

So, if you know of any JIC performance standards document somewhere in the bowels of bureaucracy, please let me know. If not, please contribute your thoughts about how JICs should be evaluated and what the performance criteria ought to be. And now, excuse me, I’ve got a lot of work to do.