How Big Is the Perception Gap?
Recently an organization involved in healthcare in Connecticut, most intimately with hospitals, asked Mintz & Hoke to give a broad strategic assessment of the challenges they face as health care reform looms before us. Following is a non-proprietary excerpt from our report.
Issues Facing Hospitals
It would be difficult to find institutions in Connecticut less understood than our hospitals. The perceptual gaps are wide and complex, reinforced on a daily basis both through direct "experience" and through media and political commentary.
Almost no one in the state, outside the healthcare field itself, is aware that nearly every Connecticut hospital is a not-for-profit. Instead, most people believe hospitals are big businesses run by large corporations for lots of profit. There is a cascade of half-truths and misconceptions fueling this belief.
Every day, the media covers the battle to lower healthcare costs - costs that are reportedly crippling the state's employers through skyrocketing insurance costs and costing jobs. Costs that affect family income, forcing us all to make hard, emotional decisions. How do you ask for understanding as a not-for-profit in the face of such huge emotional issues?
Healthcare in Connecticut is a $6 billion industry. Look what it contributes to the state's economy, including about 50,000 jobs. But many in the state believe, if it's so big, why would it need anyone's help? Why would such an economic powerhouse need to go beyond all the perceived revenue streams to raise additional money?
They think hospitals are big corporations. Public skepticism about corporations - fueled by recent events - translates into a lack of sympathy (not outright hostility, it should be noted) for hospitals, and their management in particular.
There is increasingly competitive marketing of hospitals and surgical/healthcare groups occurring in the state. It's hard to ride a major highway or turn on the TV without seeing one of these messages. Hospitals vs. Public Opinion. How Big Is the Perception Gap? It's obvious healthcare providers are in a share battle. People accept that every institution has a right to market itself, but have trouble differentiating between promoting services and the profit motive, especially as these marketing tactics become more sophisticated, blurring the distinction between hospitals and consumer products and services.
" …but have trouble differentiating between promoting services and the profit motive…"
Advertising for health insurance plans often expresses the same sensibilities as that for hospitals. They stress that their plan "will take care of you." To the public that means both their physical and fiscal health. Insurers will foot the bill. Except for the part participants pay - an ever growing percentage. On top of that, there is a very public debate going on (mostly uninformed) about the government's eagerness to contribute "revenue streams" to health providers through Medicare and Medicaid, and now potentially government-run insurance. Given all that, the perception goes, why are hospitals ever in financial trouble? "Tell me again, why should I care about your financial circumstances?"
People are especially jaded when they've responded to a slick ad only to be let down by the service of an over-extended health provider. The face of healthcare often becomes the administrative staff, whose role appears to many as guardians of the medical staff. Doctors are universally perceived as highly compensated individuals who need no one's help to make a decent living.
People don't understand the financial pressures on doctors, things like malpractice insurance and medical school costs, and seem to extend that lack of sympathy to the majority of hospital workers, who aren't paid nearly as well despite the critical nature of their work and the pressures they face.
Most of the public is unaware that public support is needed to help fund hospital expansion and improve operations. They think that's the domain of corporations trying to score PR points, or wealthy philanthropic families. They'd rather support their very local charity or a healthcare issue/ prevention campaign that has affected them, or their own, directly.
" People don't understand the financial pressures on doctors, things like malpractice insurance and medical school costs…"
State Legislators, even those knowledgeable about healthcare issues, also contribute to perceptual distortions. Not because of malice, but sheer confusion. With the government, health insurance, healthcare providers and business concerns entangled in a swirl of controversy, how does he or she take sides? Unfortunately for many, the answer lies in political expediency, often at the expense of public perception.
Few people appreciate that in the State of Connecticut no one can be refused care at a hospital. It's the law. Hospitals in poor urban centers are particularly vulnerable to this.
The cost burden is transferred in ways that are invisible to the public, creating an information vacuum. Filling this vacuum are politicians and commentators who loudly lament escalating healthcare costs, often directing their ire at healthcare providers, with little acknowledgement of the underlying causes.
For Connecticut's hospitals, it's proof that no good deed goes unpunished.
Communications Implications The challenge of changing perceptions on issues that are both highly complex and emotionally charged is greatly complicated by:
- A general public over-saturated with information. The first task is to identify the fewest number of messages needed to counter public misperceptions, and to articulate those messages in as clear and easily understood terms as possible (without being patronizing or overly simplistic). And then deliver those messages with unerring consistency.
- Prevailing skepticism of what may appear to be self-serving public positions. You can't look as if you're marketing, but rather that you are advocating positions clearly in the public interest. The look and feel of the communications is critical. The quality of the content is far more important than the production values. In fact, any suggestion of "slickness" would probably undermine the effort. It's equally important to hit the right tone. Public perception campaigns that threaten dark, forbidding consequences in an effort to make a strong emotional connection can backfire. People refuse to be "guilted" into helping or understanding. But they can be moved to compassion and concern - especially if they can see how their involvement could make a difference.
- Messages by special interest groups that exacerbate public confusion. There is nothing wrong with delivering your message by directly addressing public misconceptions. Even by debunking myths and countering claims. Sometimes, this is the only way to clear the field enough to allow your message to get through. In fact, sometimes obstacles become opportunities, as you leverage the existence of a misconception to propel your own message - "Most people think X. But did you know it is actually Y?"
- High cost of mounting a media campaign. While it's true that the cost of buying media at the level needed to make an impact on public perception has risen dramatically, there are new ways to extend media dollars and greatly improve the efficiency of your communications. Principally, this involves integrated campaigns that use a carefully orchestrated selection of tactics - advertising, public relations, direct marketing, but most significantly, the digital world: websites, e-marketing, webinars, podcasts, social media - that not only engage the audience, but capture them in ways that assures an ongoing relationship, not merely a one-time exchange. When your audience is exposed to your message in multiple venues, each impression reinforces the next, creating a whole that is far stronger than the sum of its parts.
This reduces waste, allowing you to put every communication dollar to work in the most efficient way possible, making little budgets look big and decent budgets overwhelming.
