Tuesday, December 30, 2008

Standards of Apology

This article also appears in odwyerpr.com.

Some Observations on the Siemens Case
The state of the apology is faltering. What was once a heartfelt gesture of contrition, the apology has become a tool – an attempt at collecting a “get out of jail free card” by out-of-control entertainers, sports figures, politicians and business executives. Its sincerity has been lost to statements calculated by attorneys and publicists.

Of course, there are still authentic and appropriate apologies out there. Real remorse is evident, real emotion is displayed and, sometimes, real tears are shed. But I’ve read some arguments that, in the U.S. at least, we’ve gone overboard – we apologize too much and too often.

There are some problems with that claim, however. Does every slight warrant an apology? Of course not. I believe that part of the perception of over-apologizing may come from the fact that the apologizer didn’t get it right the first time. He or she had to try it again a second or even a third time. And, with a prolonged news cycle, we may witness the same person answering the apology call multiple times. In addition, I’ve noticed an increasing usage of apologies as instruments of attack. These “weaponized apologies,” as I’ll call them, are used most prevalently by politicians as they deflect criticism and instead demand some reparation from those who crossed them.

But there was no over-apologizing in a huge scandal that just concluded in a $1.6 billion settlement. Siemens, the global engineering powerhouse with interests in the industrial, energy and healthcare sectors, had admitted to years of bribes to secure contracts around the world. “Bribery was Siemens’s business model,” Uwe Dolata, the spokesman for the association of federal criminal investigators in Germany told The New York Times. “Siemens had institutionalized corruption.”

The words sorry, apology or regret are not found in the 26 page press release issued on December 15, 2008 when the Company reached an agreement with U.S. and German authorities following a two year investigation. OK, fine. Still, it should not have taken 22 pages to read that “The Company’s top management is committed to transparency and ethical business…” On the last page of the release, we are told that the events of the past two years since the first arrests “while among the Company’s most challenging moments, served as a catalyst for significant, long overdue changes.”

Indeed, the tone of the Company communications was rather self-congratulatory. At a press conference held on the same day, Gerhard Cromme, chairman of the supervisory board, said that he was “pleased that the criminal proceedings… could be concluded” in “record time, only two years” and that the settlement amount was “below the numbers that were speculated.” And, he noted that U.S. prosecutors said Siemens had undertaken “exemplary investigative and remedial efforts.” The expansive inquiry and organizational changes, he said, could “be seen as evidence that the company’s course of clarifying its structures and change has restored trust.” More than seven minutes into a ten minute speech he said, finally, that “we deeply regret that wrongdoing occurred in the past. But we have done everything in our power to remediate past wrong doing and expose and eliminate its causes.”

Peter Löscher, CEO, later stated emphatically that “Siemens stands for clean business everywhere and always” and that “We stand not at the end of a process but at a beginning.” But, with only a glancing mention of their corporate values, there was a presumption that “all Siemens employees have regained a good portion of their self esteem and self respect.”

Siemens is a venerable company with 160 years worth of technological accomplishments, an astonishing 55,000 patents and 430,000 employees around the world. (In fact, I’m a big fan of their efforts to support science education.) This world-class company missed some opportunities, though, to make a convincing case that it was doing more than just cooperating with the authorities and going through the necessary motions to bring itself into compliance with the law. Yes, actions do speak loudly but so does the manner in which they are communicated.

Monday, December 22, 2008

Let’s Not Get Burned and Drowned (By Information)

Right, Wrong; Too Much, Too Little; Too Early, Too Late
If Martha Stewart was in public relations she might say, “Information – it’s a good thing.” Information can educate. It can inspire. But, it can confuse. It can even harm.

We’re exposed – sometimes bombarded – by health information everyday. It comes from our healthcare providers, from the media, from consumer groups, from government institutions and advertisements. Shirley Wang wrote in The Wall Street Journal last week, “Too much information about drug safety – disseminated through media, online alerts from consumer watchdog groups and even by the Food and Drug Administration itself – might overwhelm patients and raise undue alarm, some medical professionals caution." Indeed, also reported in this story was a survey of 300 medical professionals released last March by Pfizer that found nearly all (89 percent) were at least “somewhat concerned that patients might stop their medications if potentially negative safety information was released to the public too early."

The clutter and confusion is an issue not only for patients and caregivers but for physicians, too. The database of clinical guidelines (those standards of care developed by a wide array of medical societies) maintained by the American Medical Association contains over 2,200 entries. Some were not subjected to peer review and some contradict others outright. Dr. Darshak Sanghavi, a pediatric cardiologist at the University of Massachusetts Medical School, wrote in The New York Times recently that in the past year “the American Academy of Pediatrics abruptly reversed its recommendation that healthy infants avoid peanuts and other potential food allergens, without citing any new data. Weeks after the American Heart Association widely publicized the need to perform cardiac testing in children treated with drugs for attention problems, the academy issued a contradictory guideline discouraging such testing.”

These guidelines carry weight in determining if a drug, device or procedure will be reimbursed by insurance, and are supposed to be developed using hard clinical data – so called evidence-based medicine. But here, too, lie a bevy of contradictions. For example, Stephanie Saul wrote in The New York Times last week about the CyberKnife, an FDA approved treatment for the treatment of a variety of tumors made by Accuray. In prostate cancer, the key advantage is that treatments take five days instead of eight weeks for conventional cancer radiation. “As it turns out, Medicare pays for the treatments in 33 states — but not in 17 others. “You can live on one side of the street and get a procedure, but on the other side of the street you can’t,” said Dr. Steven D. Pearson, president of the Institute for Clinical and Economic Review.”

Where does this leave us? Here are a few thoughts:

For consumers: Trust, but verify. We’re told to rely on sources of information that we trust. But be careful. Trust is easily misplaced – just ask those who invested with Bernard Madoff. Look for information that lists its authors. Look for references. Additional comfort can be gained if the information is attached to a major medical institution, or a government agency like the NIH or CDC.

For health information providers: Release information when it’s ready, not when it’s half-baked. Many studies and interim results are made public too early. Clearly, if there’s a serious potential adverse event or public health issue, it’s important to err on the side of safety. But, in other cases, try less for a change. Not everything is news, not everything needs an announcement.

For healthcare decision-makers: Set expectations in advance for what information is needed to render judgment, while leaving room for some flexibility in a dynamic field. We need a clearer understanding of the thresholds of acceptability, when enough information is enough and transparency in the review process.

Positive steps have been taken, to be sure, but we still need to work to ensure that information is of higher quality, delivered at the right time and conveyed in language appropriate to the audience.

Monday, December 15, 2008

Go Team!

Enhancing Cohesion and Success
We work and, thus, communicate in team settings a good deal of the time. Sometimes you can choose with whom to work, sometimes you can’t. And some people would just like to be left to work alone.

I was interacting recently with five teams of randomly assigned, similarly experienced people all working on comparable tasks. Most were in the same city but in remote locations and did not normally work together. After observing some struggles, I asked each of them (about 30 people) for some feedback on how their teams were functioning and what they were doing to improve their performance. Three common themes emerged:

Some people wouldn’t do the work; they wanted a free ride.

A dictator took over the team; before we knew it, this person was delegating.

Some people would do the work if assigned but they simply would not communicate.

I think you will agree that this example isn’t particularly unusual. Some people are passive, some are aggressive and some are passive-aggressive. Baseball Hall of Famer Casey Stengel had it right when he said, “Getting good players is one thing. The harder part is getting them to play together.”

I responded to the concerns voiced by the teams with some questions: Why was it so hard to push aside individual agendas and adopt a team agenda? Did you define upfront how the team would operate? Did you discuss and agree on roles and responsibilities? Did anyone suggest a schedule or timeline? Did you discuss and agree on the best way for the group to communicate – email, IM, phone? If more than one person wanted to lead, did you consider rotating the position? Was a leader even necessary? Was time ever set aside to review and assess team performance?

After some “oh yeahs” and “we should have done thats,” we discussed the importance of finding common ground, setting expectations and keeping focus on mutual goals. Then, I made a few more queries: Why weren’t these problems ever aired? Did you try to engage the individual in question? Did anyone confront the issue?

The responses were on the order of, “I wanted to speak up about a problem person but wanted to avoid confrontation – I didn’t want to make things worse.” When I asked if there were things that held them back I heard, “Well, I was hoping someone else on the team would step up.”

We know it’s hard for most people to articulate their feelings, especially around sensitive issues. Few people go looking for a confrontation but it’s a critical part of working in teams, supervising others and being a strategic communications advisor. But it’s up to you, not someone else. And it’s not “making waves.” Making waves connotes stirring up trouble and creating new problems. This is about airing and addressing the issues by asking questions, and seeking clarifications while showing respect for different views.

We routinely seek to understand stakeholder issues and concerns when developing a message strategy or a communication plan. We need to have the same mindset when working with colleagues. Also, it helps to have at least occasional face-to-face contact. As I wrote in the December 9th post, “Face-to-face allows us to observe all the nuances and evaluate the visual cues. With these additional inputs, we’re able to assemble a more accurate picture of the particular circumstance.” And, as James Surowiecki notes in The Wisdom of Teams, “A successful face-to-face group is more than just collectively intelligent. It makes everyone work harder, think smarter, and reach better conclusions than they would have on their own.”

Tuesday, December 9, 2008

?-to-Face Communication

Let's Not Waste Opportunities to Make a Personal Connection
Every now and then I see an advertisement where a faceless or headless person is given the task of pitching a particular product. Some recent examples include AstraZeneca’s Symbicort (R) and HP’s personal computers.

My message to these and other companies that use this technique is to please reconsider. Do it for my benefit – I find this approach dehumanizing and off-putting. Do it for your own benefit – you’re missing the mark on building trust and empathy with your audience.

For a drug company that has done an excellent job in increasing its transparency, why communicate important medical information with a silhouette? For a PC manufacturer whose motto is “the computer is personal again,” why showcase the product with a decapitated presenter?

Perhaps the ads scored creative points with the client or tested well in a focus group. Maybe we, the viewers, are supposed to be engaged by trying to guess which celebrity is talking from a disembodied, off-camera head. Or, is it that they want us to “insert yourself here”?

I’ll admit that there are certain circumstances where this can work. Apple’s i-Pod comes to mind. But Apple has always been associated with design and creativity. There is a definite “cool” factor that’s communicated when they use those blacked-out dancing figures with the signature white ear buds bouncing and waving to popular tunes. Cachet is being built not questioned.

For the vast majority of communications using faceless or headless persons, though, how are we supposed to make a connection to the person, the product or the company? If, as Herman Melville said, “The eyes are the gateway to the soul,” then we’re being denied the opportunity to make some important judgments. How do we bond? How do we believe? How do we trust?

This isn’t just about advertisements. These are the reasons why the phone is better than email, why a video conference better than the phone, and why face-to-face communication is better than a video conference. Face-to-face allows us to observe all the nuances and evaluate the visual cues. With these additional inputs, we’re able to assemble a more accurate picture of the particular circumstance. The bottom line is that it’s the job of the communicator to provide the most appropriate pieces of information and ensure that they are received by the intended audience.

Friday, December 5, 2008

Personalized Promise

Preparing For the Era of DNA-Guided Medicine
I have been involved with the field of personalized healthcare since helping to lobby for the Human Genome Project bill in the late 1980s. In 2000, it was great to see the first “working draft” of the genome get published ahead of schedule.

Like any new technology, however, there has been a lag in translating discovery into practical application. Although DNA-guided medicine – getting the right drug to the right patient in the right amount at the right time – is not moving into mainstream medicine as quickly as we would like, we can be optimistic that it will displace traditional trial-and-error approaches with increasing speed. In addition to the ongoing efforts in the diagnostic and biopharmaceutical industries, academia and government, a new piece of legislation should spur the development and adoption of personalized medicine.

The boost may come from The Genomics and Personalized Medicine Act, first introduced in 2006 as S. 3822 by then Senator Obama and now being expanded by Representative Patrick Kennedy in H.R. 6498. The bill acknowledges that promoting the shift toward personalized medicine “will require continued Federal leadership and agency collaboration, expansion and acceleration of genomics research, a capable genomics workforce, incentives to encourage development and collection of data on the analytic and clinical validity and clinical utility of genomic tests and therapies, and improved regulation over the quality of genetic tests, direct-to-consumer advertising of genetic tests, and use of personal genomic information.”

In addition, the bill directs the Director of the Centers for Disease Control and Prevention (CDC) to “expand efforts to educate and increase awareness of the general public about genomics and its applications to improve health, prevent disease and eliminate health disparities.” Yet, it seems that these efforts might be limited to the “ongoing collection of data on the awareness, knowledge and use of genetic tests through public health surveillance systems, and analysis of the impact of such tests on population health.”

I’m afraid that what might be collected is more about what we already know – public understanding of health and science, much less genomics, is low. (Really low. Of those surveyed by the National Science Foundation, about 10 percent knew what a molecule was, about 30 percent could define DNA and about half knew that it takes the earth one year to orbit the sun!) I’d like to see the legislation strengthened by including an initiative to identify gaps in public understanding which would then lead to new efforts in public education.

Why? It’s the only way to develop and sustain trust in the new technology. Despite assurances in the Genetic Information Nondiscrimination Act of 2008, people are wary about sharing their DNA. People need know what personalized medicine can and can’t deliver. Without some greater understanding and trust in the science – and the system of collecting and processing samples – we won’t see appropriate demand, we won’t see appropriate utilization and we won’t see enough people benefiting from the information that resides in their own bodies.

Monday, December 1, 2008

Communicating Hope

Some Textbook Message Delivery
Too often we find examples of communication blunders in the news, in our offices and in our relationships. With a surfeit of “what not to dos,” it’s refreshing to discuss an example worthy of some praise.

In the last week, President-elect Obama started to fill a gaping hole in American confidence with a series of press conferences about his economic program and the team that will assist him in its implementation. The carefully crafted events have inspired hope and assurance at home and around the world. Indeed, the announcements – held over a three-day period – had a role in sparking the biggest stock market rally in past 75 years. (At this writing, however, the market is down again by triple digits.)

The messenger, the moment and the mechanics converged to provide us with some valuable lessons. So, left or right, blue or red, we should take note of excellence in communications. Here’s what I observed in the last week:

Clarity. Where we are, where we need to be and how we will get there were explained clearly and concisely with minimal jargon. Stress and pain were acknowledged but the stated goals were characterized as within reach – not dreams, not aspirations.

Authenticity. The combination of unambiguous language and sober tone created a sense of trust and calm. Although there was a “down to business” quality to the proceedings, a few quips were allowed. It served to keep it “human” and reinforced the genuine nature of the communication.

Timeliness. Critical times call for urgent action. The incoming team has moved swiftly – with “deliberate haste” – and has started to address the concerns of the public, of business and of the markets.

Momentum. Parceling out the news over a three day period created a sense of anticipation for the next installment. And, with these bites of information – one building on the next – each got its time in the sun. We were able to take the time to digest the news and understand how the pieces fit into the big picture.

Interaction. There was more to the events than the reading of a prepared statement. Questions were taken, though more orchestrated and limited than I liked. There was an interest in clarifying an issue and a willingness to defend a position.

Clearly, we’re witnessing a work in progress. It’s too early to render any final judgments. But what we saw was vision plus pragmatism. It can’t be one or the other to be successful. Vision alone is just a good intention. Pragmatism alone carries no passion around which to rally. With both, we can begin to envision a future that is achievable.