Keeping the issue alive: How to keep medical liability in the news
■ Public relations professionals and organized medicine leaders who have been working at it offer their thoughts on how to make the media stay interested in tort reform.
By Tanya Albert amednews correspondent — Posted Jan. 31, 2005
The local newspaper reporter wrote about the dramatic increases in physicians' liability premiums when rates started rising in 2001 and 2002. Television reporters covered it, too.
Since then, members of the media have interviewed the family physician who stopped delivering babies.
They've talked to the physician who retired early.
And they've reported on the legislation introduced in several states and in Congress that would limit the noneconomic portion of jury awards, commonly known as the pain and suffering awards.
They've covered physician rallies at state capitols urging lawmakers to pass "tort reform now." Newspapers have run editorials and letters to the editor on the topic as well.
Yet in many states, the problem shows no signs of abating. Doctors want to keep the issue alive in hopes that lawmakers ultimately will pass the reforms physicians believe will help stabilize the professional liability market. That means that in a day and age when the public and the media devour one topic and quickly move on to the next, doctors must have a strategy for keeping their several-year-old issue from becoming a victim of media fatigue.
"It's always going to be a challenge, because you reach a saturation point," said Charles Moran, spokesman for the Pennsylvania Medical Society. But, experts said, the challenge can be met.
"[The] bottom line is that these issues have many angles that could be of interest to reporters," said Bill Berry, president of Berry & Company Public Relations, a New York Citybased agency that focuses on health care. "You can keep them alive by providing reporters with information to help them report on a story from different angles. Story fatigue sets in when there is nothing new to report and reporters either can't or don't take the time to develop fresh perspectives."
Keeping it newsworthy
Often, stories involving medical liability sell themselves.
In states such as Florida, Nevada, Ohio, Pennsylvania and Texas, it was only natural for the mainstream media to cover the introduction of new legislation or a voter initiative on the issue.
Rallies involving physicians clad in white coats and carrying signs asking "Who will deliver your baby?" and declaring "Tort reform now" are also a natural for local news coverage.
So, too, are the stories of patients who didn't get needed medical care as quickly as they otherwise would have because the type of physician they needed was no longer practicing in the area.
These types of events, said AMA President John C. Nelson, MD, MPH, have made it less of a challenge to keep the issue in the news. The Association's media relations department has logged countless calls from reporters on liability. In addition, AMA leaders have made numerous visits to newspaper editorial boards over the past few years to discuss the issue.
"You tell the truth," Dr. Nelson said. "Health care in America costs more because of lawsuits."
In Texas, where media coverage was intense in the days leading up to voters passing a constitutional amendment implementing a $250,000 noneconomic damages cap in 2003, medical liability continues to be in the news. The new angle on the story is whether the cap is working.
"The trial bar is trying to find some way to whittle away at the cap," said Steve Levine, spokesman for the Texas Medical Assn. "What we have to do is point out the positive consequences."
But newsworthy events aren't always going to naturally present themselves, even when the issue is still faced by doctors every day. And without news events, keeping the issue alive in the mainstream media takes work. Second, third and fourth rallies are not likely to garner the media attention that the first one did.
On the front lines in Pennsylvania, doctors have been dealing with the fallout from rising premiums perhaps longer than physicians in any other state.
In 2004, the Pennsylvania Medical Society's media department saw a drop-off in the number of calls it received on the tort reform and liability issue compared with the previous year, Moran said.
But that doesn't mean that the issue isn't still getting attention. Although the department gets calls about flu shots and other mainstream medical issues, calls about tort reform still lead the pack, Moran said.
And the medical society's interviews with about 20 reporters around the state showed that there was still interest in the topic, he said.
"The feeling we got was that they would cover it if there was something new or controversial," Moran said. "But in the past year, the noise has gotten quiet. The anger has settled down a little bit."
That lull is expected to end soon.
At press time, new legislation was expected to be introduced in the legislative session that began in January. People are beginning to think about who might run for governor in the next election, and the tort reform position of the candidates is expected to be a hot topic. Also, abatements of physicians' payments into the state compensation fund, commonly known as Mcare, are expected to be an issue at the end of the year.
The lull is expected to end in Wyoming and Connecticut as well. After politically active autumns in those states, doctors are again gearing up for new legislative discussions.
"We expect the coverage to begin to pick up again," said Wendy Curran, the Wyoming Medical Society's executive director.
But lulls in coverage aren't automatically bad, public relations experts said.
"Every now and then, go away, otherwise people will get sick of you," said Richard Laermer, author of Full Frontal PR: Building Buzz About Your Business, Your Product or You.
Keeping it fresh
Several media experts said putting a patient face on the story is one way to keep the mainstream media interested in the issue.
"Everyone wants a story," said Laermer, who also is CEO of the public relations firm RLM Public Relations.
Marcia Austin, a communications expert with Hill & Knowlton's Tampa, Fla., office, which helped run a campaign when the Florida Legislature was considering now-passed tort reforms, agrees.
"When we started [the campaign], the story was about the physician impact," she said. "We had to push to find stories on how it impacted the patients."
The coalition that Austin helped represent included physicians, hospitals, business and patients.
She said one side benefit of a coalition was that people could jointly find stories that were of broad interest to citizens and the media.
They didn't find patients who had been harmed because medical care wasn't available. Instead, they focused on people whose lives were saved at Level I hospitals that were contemplating the possibility of becoming Level II or Level III centers because doctors were considering giving up procedures because of medical liability rates.
"It humanized the impact," Austin said.
Austin also suggested that doctors not rely only on the mainstream media to get out their message.
Posters and pamphlets in doctors offices and branching out to patients groups can make a difference, too. They used those vehicles to get out the message in Florida, and most other state medical societies have used them as well.
In Ohio, where they have passed some significant tort reforms, the Ohio State Medical Society took out full-page ads in the state's major newspapers with a physician next to each of the words "Going. Going. Gone." And then asking readers: "Is your doctor next?"
"It prompts the reader of the ad to think about the medical liability crisis and how it might effect them," said Tim Maglione, senior director of Government Relations for OSMS.
Approaching the media
Using a self-sensor to ask whether a story is really interesting to the general public is one of the best things physicians and those dealing with the media on their behalf can do to keep the issue alive.
"If reporters are pitched stale story ideas, you get a lot of eye rolling," Laermer said.
He offered this advice:
- Take a deep breath and think about whether people would care about the story.
- Pitch stories about humans, not data.
- Avoid information dumps. Give reporters the nugget that is key to the story.
- Don't think you are interesting by virtue of your profession alone. Talk to your colleagues and lay people to ferret out the interesting part of a story.
Laermer said it's especially important to avoid public relations machines. If reporters are inundated with information everyday, they tend not to notice when a truly newsworthy event comes along.
"It's more than being selective; it's being hyper-selective," Laermer said. "People often forget that journalists are people, too. They like interesting stories."