Transcription:
Facing the Future of Reputational Risk for Hospitals and Health Systems

Intro: The following SHSMD podcast is a production of DoctorPodcasting.com.

Bill Klaproth (Host): On this edition of the SHSMD podcast, in the coming decade, health systems will face four new and ominous reputational risks. We're talking political risk, value risk, expertise risk, and health gap risk. Hm. That word risk. That implies danger, loss or harm. We better pay attention to these and no better a person to ask than Chris Bevolo, Chief Brand Officer at Revive who is going to take us through each of these and explain each one. But don't worry, we will end on a note of optimism because Chris is good like that. You know what I'm talking about? You know what I'm talking about. And one more thing. There is no risk when you listen to the SHSMD podcast, only upside. So let's get to it, as I say, right now!

This is the SHSMD podcast, Rapid Insights for healthcare strategy professionals in planning, business development, marketing, communications, and public relations. I'm your host, Bill Klaproth. And in this episode, we talk with Chris Bevolo. Chief Brand Officer at Revive. Chris is also an award-winning author of six books, including Joe Public Doesn't Care About Your Hospital, which became a field guide for driving transformation in hospital marketing departments across the country. And in this episode, we talk about facing the future of reputational risk for hospitals and health systems. This episode sponsored by Revive, an agency that works with brands who leads the way in healthcare. Learn more at reviveagency.com. Chris, welcome to the SHSMD podcast. As you know, we start every episode of the SHSMD podcast with Rapid Insights. One quick tip someone can use to make their marketing communications better today. Chris, give us your Rapid Insight.

Chris Bevolo (Guest): So, my Rapid Insight for this conversation is as a hospital and health system, you can no longer sit above the fray. And that very fact is going to change dramatically the way in which you engage with your communities and your, your markets in the next five to 10 years.

Host: I love that Rapid Insight. You can no longer sit above the fray. We got to get into it. Chris, we got, we got to get in there. You're so right about that. And that's what we're going to talk about today. So, thank you so much for your time. It's always great to talk with you. So, in the coming decade, health systems will face four new and ominous, reputational risks; political risk, value risk expertise risk, and health gap risk.

So, Chris, let me ask you. We're using the word risk, which implies, you know, exposure to danger, harm or loss. So, what are the risks to our reputation? I mean, what is the danger if we don't pay attention to these four?

Chris: Yeah, the number one risk is just that you're going to lose some semblance of your reputation, of your brand. Your perception may change toward the negative. You will be embroiled in more controversies in media. Just overall, what you're going to find is if you're not managing these the right way, your value in the eyes of the audiences that you most covet is going to drop.

But I would also say the second risk is the inability to manage these four is really going to become a sap on the time and the energy and the focus for your leadership. If you're not out ahead of these, that group is going to be spendin and that can include your board, that can include your C-suite and other leadership; they're going to be spending more and more of their valuable time dealing with situations related to these four risks.

Host: So, instead of providing brilliant healthcare, you'll be going from crisis to crisis, putting out fire to fire, which really takes your attention away from what you're really there to do. Is that right?

Chris: That's exactly right.

Host: Okay. So, let's talk about these four. There's political risk, value risk, expertise risk, and health gap risk. I'm very interested to hear your thoughts on each of these. So, let's start with political risk. Explain that one to us.

Chris: Yeah. And I should say, before we dive into that one specifically, none of these are new, per se. They've been around with us forever. What's new is the extent to which they're now going to occupy our time and our focus and the potential risk to our organization. So, as an example, Bill, political risk obviously is something we've been seeing, tied to COVID, tied to the vaccines.

But that's not new. If you go back and look at the Spanish flu, you'll find stories in the paper about the anti mask society of San Francisco, holding a strike and all that good stuff. What's different this time is kind of a combination of three things that all came together in 2020. In fact, 2020, for three of four of these risks we're going to talk about, was a huge trigger for why we need to pay attention to all of these. So, the three things that came together were first, obviously COVID-19, which has just turned our world upside down and has brought politicalism to healthcare at a level that we've never seen before. That really began last year when everything from shutting down, you know, closing businesses, to wearing masks, all the way through the vaccines this year, kids in school, all of these things have been politicized. And what I mean by that is, you can look at research now when you do public opinion surveys about any of those topics and the number one correlation that you will find in any factor about a respondent to their response is their political affiliation. That did not used to be the case.

So, in other words, if you want to know how somebody thinks about those issues I just said, if you know, whether they're on the right or the left politically, you're going to be able to guess their answers better than any other thing about them, their age, where they live, anything like that. And so that's the first one.

The second one is we had a huge social justice movement, which, you know, we've had those in our history before. 2020 was not unlike 1968 and other key years in these movements. And that as we talked about at that Rapid Insight, has forced hospitals and health systems to actually go out there and take a stand on thing. And we'll talk about where all this comes in at the end here of the three things. And the third obviously was a pretty insanely heated political environment overall. So, you've got a president who is a lightening rod. You've got really different kind of election. I mean, we, we all kind of roll our eyes at the elections and the politicians and all that. 2020 was different. What came right after the election in January, also new to us.

So you've got these three things that have come together and essentially hospitals and health systems are going to have to think about the political affiliation of those that they serve and how that impacts everything from how they deliver care, to the treatments they offer, the content they put out, the stands they take, their brands positions, everything. And that is really new for this group of organizations.

Host: That's really fascinating. So, correct me if I'm wrong. Are you saying, when you say we have to take a stand how do I say this? So, you mean there could be a hospital for conservatives and hospitals for liberals. Is that kind of what you're saying?

Chris: Actually, we have some interesting content coming up, in 2030, we've got a book coming out and talks exactly about that. So, I'll leave that here for now, but yeah, that's a potential, of where all this could go. But for now, think about it this way. You know, you had a lot of hospitals and health systems who took a stand after the George Floyd murder in Minneapolis was just where I'm from. That's something that organizations used to be able to just kind of not address, but it's really difficult to not address that in this day and age. The challenge is whether you're addressing social justice, whether you're addressing DEI, whether you're addressing vaccines, right?

So, this is where it's really coming into our world of the medical world, masking things that scientifically and clinically. What's the problem? Because those are all political, if you take a stand one way, you have to think about what percentage of the population am I alienating? And it goes both ways.

If you're resisting a vaccine mandate as a health system, you've got a portion of the population that's going to hold you accountable for that. So, is a rock and a hard place. Most organizations, aren't going to be able to just sit it out because sitting it out is actually delivering a message, in one way or the other too.

Host: Yeah, I was just going to ask you about that. You're absolutely right on that. Wow, there's a lot of terrain, a lot to unpack and that we can have a whole podcast just about that for sure. But that certainly is a risk and something to watch. Okay. So let's talk about the next one, value risk.

Chris: Yeah, so, what we mean by value is, the classic definition, the financial definition of value is, you know, delivery of benefit divided by cost. So, it's the combination of the two. That's what value really means, how much value something brings is relative to both the benefit and the cost. And we've been watching this one for a long time Bill. I would say going on four years now, and this is the one that I said wasn't triggered by COVID. Actually COVID gave hospitals and health systems a break from the value risk, and the value risk is essentially hospitals and health systems being held up as one of the villains in the narrative of high costs of healthcare in this country. The traditional villains for this have always been pharma and health plans and hospitals come into the spotlight here and there. There's, there's been a couple of cover stories on Time Magazine.

There's one called Bitter Pill from, I don't even know how long within the last decade, that kind of talks about the high cost of healthcare and then it goes away. And what we've been watching, going into COVID, was this dramatic increase in focus on this issue. The idea of pinning the problem for costs in this country on hospitals and health systems, not insurance companies, not on pharma, not anybody else, but it's their fault.

The challenge with this is, the conversation is always about one part of that equation. It's always about cost. It's not about the value that hospitals and health systems provide. That's kind of shoved aside or dismissed or taken for granted. It's only about the cost and what's missing for hospitals and health systems are two things. One, you got to bring that part of the equation back in, the value that's given, not just in patient care, but the value that a hospital or health system brings to the communities that it serves. The way it supports people who can't afford care, the programs it has in the community. It's usually a very large employer.

There's all kinds of value that these organizations bring, that is being dismissed. That's the first thing that's missing. The second thing that's missing is a collective narrative. Hospitals and health systems for whatever reason, have not been able to band together to tell this side of the story. And they're up against some very powerful constituents that have a real stake in telling their side and that being the health insurance industry and the pharma industry who don't want to be blamed for the costs.

So, they found an easy target. And that's the challenge. So, it went away in 2020. We were heroes, kind of everybody didn't really think about it, but you can even see it bubbling up then because there was all kinds of questions about how much would be covered in terms of COVID costs. How much of the tests costs, all those things. Well, now it's back. Full bore is it back. And of course we see the transparency, pricing transparency guidelines that put into effect as law at the beginning of this year, that was in the Trump administration. Biden has supported that too. So this is just pick right back up where it was in 2019 is going to continue to be a sore spot for organizations moving forward.

Host: Right. So, we're not properly selling our value. It's the old features and benefits, right? Don't sell the features, sell the benefits, so, people really understand the difference it can make in their lives, the positive difference. So, it sounds like we need to really do a better job at that and work on that collective narrative, as you say, so we're all providing that same message of value.

Chris: Yep. And heck just sell features. If that's all you It's just, it can't always be focused on the cost. You know, it's usually, oh, somebody got a surprise bill or this surgery costs this much and this I'm not holding. We're not holding hospitals and health systems unaccountable for their role to play. There is a role they play in the high cost of healthcare, but to suggest that health plans are immune from this conversation, there was a article that was great. I'll leave you with this, where the author said something to the effect, well, I guess you could argue that hospitals and health systems are doing something by delivering care, but it's still blah, blah, blah. It's kind of like they just completely dismissed that they have a whole role to play. What, you know, could argue the role of insurance companies. That you could argue, but you can't really get by without hospitals and health systems and physicians and nurses and all that.

Host: Right. Yeah. Hey, they saved your life, but the cost, are you kidding me? Oh my God. Over the top, right? It's almost like the, the focus is away from, hey, we just saved your life and the focus is right away too, but look at the cost. So, yeah, that makes sense. Okay. So the next one is expertise risk.

Chris: Yeah, this one, again, it's been around for a while. So, the best way to kind of trigger physicians, if you want to talk about this historically, used to talk about Doctor Google. Right. So, people going out when they, right, when they finally figured out they'd go and do the research and they, they bring in a bunch of printouts saying, well, this is what I think I have, and this is the drug you should give me.

That's been bugging physicians for a decade, but this is different. And this again comes from really the deterioration of trust in National healthcare experts. That's where this starts. So, as we remember last year, the CDC, the FDA, the CMS, Health and Human services, they all took dramatic hits in terms of public trust, in their expertise, for all kinds of reasons, some of them were unfair.

Some of them were political. Some of them were self-inflicted wounds, like the CDCs first round of COVID tests going out in March and they didn't work. So, you had this real drop, and of course that hasn't really gone away. You can't really look at that and say, well, that was just a political situation. People didn't trust the administration that was in office and that's where it was tied to. It's still here with a different administration, right? You've seen the trust of Dr. Fauci go down and he plays a prominent role in all of this in terms of COVID. There's been all of the, the booster confusion, who gets a booster, when and why. And is it safe or is it not safe enough to have it. You know, Saturday Night Live made joke about this a couple of weeks ago where they said, now the FDA has come out and said, well, you can mix and match your boosters. And they're like, well, I guess we've got to that part of the pandemic was just like, you're on your own. Do whatever you want to do, mix and match. They're like when's the last time you heard a doctor say, just mix and match. It'll be fine.

All of this is at that level and it's seeped down to the state level, state down to the economy level. The problem for hospitals and health systems is this is now bleeding into their space. Hospitals and health systems and physicians in particular, have always been by research, the most trusted source for medical information. They've always been that, and that was true through the pandemic last year, but we're starting to see that dissolve. A lot of this because of what we talked about in the first risk, the political side of things, where people have a worldview. And if the doctor is not fitting their worldview in terms of what they think they have, whether it's COVID or not, what's the right treatment. But this potentially could bring all kinds of ramifications, if you can't get in front of this. From patients not trusting your advice, to not following the treatment protocols, you've given them, to just not coming to your organization because they don't like what you have to say, or they don't trust you.

There's all kinds of other influences to this that we could get into, from social media to the fact that we have an NFL quarterback that is quoting a radio personality as his source for medical expertise, not a doctor. So, you can see all the different things that are kind of piling on here, but it's really going to make it more difficult for hospital and health systems to deliver the care that needs to be delivered.

Host: Yeah, this is an issue. That's for sure, because the public trust has eroded and when you do have people like the said superstar quarterback who doesn't want to take valued years, decades long, medical advice and listen to somebody and then wind up taking the horse de-worming drug. Where are we at? I mean, come on. I mean, it's just crazy. And that guy is influencing so many other people?

Chris: Yes.

Host: Hey. Oh, so expertise, risk. I think that's gotta be a tough one to overcome. How do you say our doctors really know what they're talking about when people might be like, nah, I don't trust any of you guys. So, how do you overcome that? That's that's a tough one. Okay. And then we have another tough one, the health gap risk as well. Tell us about that.

Chris: Yeah. So we use health gap as a shorthand for a collection of issues that people are familiar with, health inequities, health disparities, there are actual distinctions in those terms. So, rather than kind of get bogged down in all of that, we lumped them into health gap. And basically what we mean by that is, the way we talk about it is, even though we're not talking about it financially, the rich are going to get richer and the poor are going to get poorer in terms of health gap, in terms of access to care, in terms of the quality of care, in terms of the experience that they receive. So, when I say rich and poor, I don't mean financially rich and poor.

I just mean the haves and the have-nots is the best way to put it. And this is going to, again, we've had these issues for decades, for as long as there's been healthcare, we've had these issues in this country, 2020 really brought these forward in a dramatic way. Of course, COVID-19 actually worsened health disparities.

If you look at all of the data, it affected communities of color as an example, disproportionately than it did others. And so this has become a crisis point and really going forward, you're not going to be able to avoid trying to figure this out. And there's really two ways in which hospitals and health systems are going to be held accountable for this.

The first is the degree to which they contribute to the health gap within their own delivery of care. So, if a person of color walks into your emergency room, do they receive a different experience than a white person? Does an elderly person receive a different level of experience than a thirty-something? Are the protocols the same? Are the treatment plans the same?

If you go and look at the research, it's stunning, the gaps that exist at almost every step of the way in the clinical journey. So, there's that side of it. And there's a ton of work to be done there. But equally as daunting, is the role of hospitals and health systems to help solve for health inequities and health disparities in the communities they serve. And that's equally a difficult problem because you can have somebody come into the ED and present with whatever it is. But if they go back home and they can't afford the electricity and they can't afford decent food and they live in a high crime neighborhood or whatever the situation is, it doesn't matter what pill you gave them; it's unlikely they're going to actually see through their medical success.

So, social determinants of health is a big part of that. And we know a lot of hospitals and health systems are working through those, trying to solve those. But more and more looking at that gap, both from an internal and external perspective is going to be critical to how you're valued as a brand. And again, the time and energy you're spending, to deal with issues that may crop up as a result of this.

Host: Oh, man, this health gap risk. This is a huge one too. Chris, I'm depressed now.

Chris: I know. Hey, it is, it is the reputational risk for reputational risk. It's not like, you know, here's things that you will get to celebrate.

Host: My brain hurts.

Chris: The way I think about this Bill, is because yes, it can make you feel a little depressed, but in each of these risks, lies opportunity. And that's the way to kind of think about this, the opportunity to be a leader in terms of political risk, the opportunity to shine through and show what you really bring to community with value risk, the opportunity to reinforce that, hey, we have the experts here. You can trust us and the opportunity to make a real difference in this world with the health gap risk. Those are amazing opportunities if you can look at it through that lens.

Host: I love it. That's the optimism I was looking for, Chris. Thank, Thank you. All right. One last question. So, I'm sitting here and I'm listening to all these risks and I love the optimistic message at the end. We can turn these into opportunities. So, if I come to you and I say, Chris, I need to look at all four of these. Where do I start? Where does someone start to address these? Where's our jumping off point? Maybe that's the wrong word. Where's our, maybe that's a bad phrase. Where do we, where do we start this process of evaluating these?

Chris: The trick here too is there's obviously other risks. There's risks that we've been living with forever. There's, there's special risks that pop up that aren't related to these. We're just of the opinion that you ought to focus on these four. Our suggestion would be the first place to start is A make sure your leadership is on board and understands these risks. So, do they understand what we're talking about with each of these four and why there should be energy put behind trying to understand, assess and manage them.

That's the very first thing you got to do, because if you're going to go out there and spend a lot of time and effort to try to do that, but your leadership doesn't buy into the fact that these are risks or doesn't understand it; you're not going to get anywhere with actually addressing them. So, that's the first thing. And then the second thing is figuring out, how do you know where you're at today? Where are you at in each of these buckets in terms of the risk you face today?

And also what's that going to look like down the road, right? Depending on your organization, depending on the market with which you're in, there's all kinds of different variables to look at. But you've got to start by kind of setting a benchmark, and understanding and prioritizing where do you need to kind of emphasize first? Where do you dive in first? So those would be, those would be the first two things. I gave you a bonus, Bill.

Host: You're you're always good for a bonus. I like it, Chris. And your optimistic message at the end. That was great. Okay. Well that really helps us out and it really helps shine a light on these four things, which you said there are more, but as you said, these are the four you're pointing out that provide exceptional risk as we move into the future.

And you're right. There's a lot of landmines in here. I mean, this is, this is tough stuff navigating through these four things. So, thank you for bringing them to our attention, illustrating each of the potential risks of these and you know, what we need to do to try to evaluate and figure out which way to go when we're addressing these four reputational risks. Chris, as always, a pleasure to talk to you. Thank you so much for your time. We appreciate it.

Chris: Thanks for having me Bill.

Host: And once again, that's Chris Bevolo from Revive and this episode is sponsored by Revive. Learn more at reviveagency.com. And to learn more about SHSMD, that's S-H-S-M-D, visit SHSMD.org and visit our education page to learn about our upcoming programs at SHSMD.org/education. And if you found this podcast helpful, and please people, how could you not, please share it on all of your social channels and please hit the subscribe or follow button to get every episode. They're worthwhile. I'm telling you not just because I'm biased and I'm the host. Pretty good stuff here. That's what I'm saying to you. All right. This has been a production of Dr. Podcasting. I'm Bill Klaproth. See ya.