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When public affairs fails to use proactive image-repair strategies

"We were disappointed and surprised that the Times News Service chose to use the Dayton Daily News Series on military medicine without asking the military services for their comments. You did a disservice to the thousands of dedicated and professional men and women who serve day in and day out in medical commands worldwide providing high quality health care for our active duty servicemembers, our retirees and their family members…"

A letter to the Times News Service by the Surgeons General of the U.S. military

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"There are physicians who may practice medicine poorly yet have excellent communication skills with their patients. The result is patients who are satisfied with their physicians regardless of the care received."

Response to a press query by Investigative Reporter Russ Carollo

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"The point here is that one cannot measure a physician’s capability or quality by looking at the number of malpractice claims."

Response to a press query by Investigative Reporter Russ Carollo

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Does the military have a proactive image repair strategy?

No.

Excerpts from an OSD/PA intra-office memo addressing Russ Carollo’s press query about military healthcare:

"The Department will not discuss individual cases of patients or practitioners."

"NOTE: The military services should be prepared to respond to the various cases raised by Mr. Carollo; if not in actual fact, at a minimum addressing the theoretical details."

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Application of Benoit's Taxonomy.

Public affairs officials should choose the appropriate image repair strategies carefully.

Denial

Denial, in both forms, would do more harm than good in this situation. Even in cases where the military is without blame, Benoit argues that, perceptions are more important than reality. It is not so important that the military is not responsible for the offensive act if the military is thought to be responsible for it. As long as the audience thinks the military is at fault, its image is at risk. Under evasion of responsibility provocation would not be a fruitful tactic, there is no excuse for allowing unqualified physicians to practice.

The next form is defeasibility . The military would allege a lack of control over important elements of the situation. As a result of downsizing, for example, the military’s healthcare system is under pressure from federal officials to do "more with less." In other cases, the military would use defeasibility by explaining how the healthcare system is bound by law to conduct itself in a particular way.

For example, should a settlement be reached before a malpractice claim goes to trial, the Justice Department will reach the settlement regardless of the merits of the case. As a result, a claim can be paid when there is no malpractice, and the military’s standard of care has been determined to have been met by the practicing physician (OSD/PA, 1997). In these cases, the physician’s name is not reported to the NPDB. Another approach to defeasability is claiming a lack of information.

It is common for public affairs officials to be the first informed of a situation by reporters. It would be perfectly reasonable to explain that the Department of Defense is a huge organization with bureaucratic obstacles to be negotiated. That challenge is further complicated by the transient nature of the military’s troops and family members (Benoit, 1997).

A third option is to claim an offensive action was an accident. If the military can convince the audience that the act in question happened accidentally, it should be held less accountable, and the damage to that military's image should be reduced (Benoit, 1997). This would not be an appropriate strategy due to the overwhelming number of cases currently being held against the military.

Fourth, the military can suggest that an offensive behavior was performed with good intentions. For example, the military is reluctant to report its physicians to the National Practitioners Data Bank. The reluctance is based on U.S. Military doctors who are career minded and would consider leaving the service rather than continuing a career stalled by an adverse report. If the military is at fault, the military should admit it immediately. This is the most effective tactic for evading responsibility. Not only is this the morally correct thing to do, but attempting to deny true accusations can backfire. If the military falsely denies responsibility, it risks substantially damaged credibility if the truth emerges (Benoit, 1997.

Reduce Offensiveness

When the military is accused of an offensive act, it may try to reduce the perceived offensiveness of that act. There are six versions to this strategy. First, the military may use bolstering to strengthen the internal audience's positive feelings toward the military (Benoit, 1997).

The military’s means for bolstering would be internal media: newspapers, radio, TV. Bolstering is also possible through public assemblies. Medals and awards presented to healthcare workers would be done on as high profile a scale as possible. These efforts would offset the negative feelings connected with the perceived problems in the healthcare system. The military may describe positive characteristics they have or positive acts they have done in the past. These sentiments, if accepted, should bolster its image and offset damage to its reputation (Benoit, 1997).

Here also, the military’s internal media would be used. The military would do well to improve its image as seen by state and national medical board members. State medical boards have a difficult time keeping track of doctors in the military health-care system. It’s understandably difficult to obtain extensive records on doctors who are constantly moving around or out of the country. However, board administrators also complain that they get very little cooperation from the military in terms of providing records, such as like patient records. Another option is to try to minimize the negative feelings associated with a wrongful act (Benoit, 1997).

Though active-duty service members cannot sue in court and win settlements for their injuries, public affairs officials should stress the fact that they can get financial assistance and free medical care from the Department of Veterans Affairs. Public affairs officials should use this option with caution, minimization cannot always be expected to improve one's image. The military should employ differentiation, meaning it would distinguish the offensive act from other similar, but more offensive actions.

Relating to this tactic is transcendence, which is placing the act in a more favorable context (Benoit). Public affairs officials would point out that while about ten percent of the military’s physicians are not state licensed, it is important to remember that a decade ago the military did not require state licenses at all for its physicians. This would open the opportunity to portray this as a period of transition for the military’s healthcare system, and explain that conditions are improving each year.

Another tactic for reducing offensiveness is for the accused to attack their accusers. This strategy is not appropriate for the military. It is likely that such an attack would backfire as a result of public distrust in the military and other federal institutions.

Corrective Action

Corrective action is another general image restoration strategy. The military would pledge to correct a problem. Public affairs officials should publicize plans to correct a problem and prevent its recurrence. This publicity is extremely important.

Members of both the internal and external audience will want to know whom to blame, and it is more reassuring to know that the military is taking steps to eliminate or avoid future problems. The military’s commitment to corrective action can be a very important component of image restoration discourse, especially important when the military admits responsibility.

Mortification

The final general strategy for image restoration is to confess and beg forgiveness (Benoit, 1997). This strategy is not appropriate for the military. The healthcare system is huge, worldwide. The bad in this organization is far outnumbered by the good. While it is morally right to take responsibility for mistakes, it is not necessary to beg forgiveness- an act which would negatively impact the internal and external audience’s credibility in military healthcare.

Proactive Image Repair

Public affairs practitioners are advised to take a proactive approach to Benoit’s image repair strategies with regard to the military’s healthcare system. The first step to building a proactive strategy is to identify crises which will damage the healthcare system’s image. As explained earlier in this paper, public affairs officials should anticipate high press interest in medical malpractice incidents.

Planning before a crisis occurs will reduce response time and help to prevent missteps in the initial response. Contingency plans should be prepared, even though actual crises will invariably differ from textbook crises. These contingencies should be incorporated into base-wide exercises. This would reap two benefits: realistic training for public affairs officials and an opportunity implement image repair strategies, evaluate their effectiveness, and modify them accordingly.

It is imperative that public affairs officials take charge in the development of these strategies. Too often, military healthcare officials make very public and damaging comments, such as this Navy commander’s quote in a 1994 military medical journal: "As military officers and federal employees, one of the benefits we enjoy is the relative freedom from being sued personally as a result of job performance. In this litigious society, that is no small thing" (Carollo, 1997).

Since image restoration rhetoric is derived from persuasive discourse, the development of a strategy should be based upon the basic principles of persuasion: avoid making false claims, provide adequate support for claims, develop themes throughout a campaign, avoid arguments that may backfire (Benoit, 1997).

Prioritize Target Audiences

The second step to building an image repair strategy is to prioritize the target audiences (Benoit, 1997). The military addresses multiple audiences, each with its own interests, concerns, and goals. The military’s audience can be divided among three categories: internal audiences (active duty, reservists, family members, civilian employees), external audiences (local community, national public opinion) and policy makers (local and federal officials, interest and lobbying groups).

Public affairs officials should consider their most important audience to be the military’s internal audience, for three reasons. Members of the internal audience accomplish the mission of the military. First, their faith in the healthcare system has a significant influence on troop morale.

Second, in taking the two-step flow view toward the internal audience, it is apparent that they are opinion leaders to the civilian public. The "horror stories" of a military member can have a strong influence on the public’s opinion of the military’s healthcare system. The third reason to consider the internal audience is the available means of reaching this audience. Public affairs officials have the military’s internal media at their disposal.

The next audience to consider would be the military’s external audience. The general public makes little distinction between the various branches and organizations within the military. It is essential that each crisis be handled individually so that public does not generalize its opinion to the entire military. The damaged image of one unit or command is often perceived as a reflection of the state of the entire military.

In addition to considering the salient audience for a crisis, it is important to understand the nature of the crisis itself. Public affairs officials should identify potential accusations and suspicions. Knowing the nature of the crisis allows for an appropriate response by image repair strategists The response will also be tailored according to the anticipated severity of the crisis.