Healthcare has lost its halo. Medical breakthroughs used to be received with enthusiasm, even awe. Now they're greeted with, "It's about time."
But today's tumultuous market presents some opportunities for hospitals, healthcare systems and managed-care plans to demonstrate a real interest in the health and well-being of consumers-something they apparently aren't being credited for now.
Legislative challenges to HMOs prove that point. Efforts to reduce the length of hospital stays and otherwise limit care have caused patients to look for heroes. They might as well be you.
The timing is perfect. Healthcare regulation will be a major issue in the upcoming elections. That gives providers the opportunity to change perceptions by telling the public, "Here's what we're doing with what we're allowed to do."
But when hospitals talk to the public, they need to make sure they're understood. Research has shown that the term not-for-profit organization, for example, has become meaningless to Americans. Hospitals once were seen as selfless organizations unmotivated by profit. But today, given the size and economics of not-for-profit hospitals, consumers are having trouble believing that they're as concerned about the quality of care they provide as they are about finances.
Private-sector hospitals long ago realized there wasn't much value in being referred to as for-profit hospitals. So, they created an investor-owned category. The pharmaceutical industry also found that if it talked about its research mission, consumers were more understanding about pricing. Not-for-profit hospitals need to make the same adjustment.
The healthcare polemic needs an interpreter. If, as research has shown, most people don't understand the basic vocabulary of healthcare, how can the industry expect the public to understand its issues?
I'll give you a personal example. After 20 years in the healthcare business, I still pause a moment every time I hear morbidity and mortality. I know that one is worse than the other, but I have to think before remembering that mortality is the end game and morbidity is an index of problems.
As an industry, we talk freely and without explanation about our mortality and morbidity rates, our ALOS and our continuum of care. Do we really think people understand what we're talking about? It's no wonder consumers find healthcare experiences so scary, even incomprehensible.
Like it or not, the communication that has evolved in our fast-paced society often departs drastically from the established rules of English and syntax. In 1997 the American Dialect Society confirmed that fact by nominating "soccer mom" as phrase of the year.
Add to that the fact that most goods and services are sold in the media with simple messages that last less than 30 seconds, and it's clear that to have a discernible message, much less a compelling one, you need to use words that speak clearly to people who don't have the time or interest to translate healthcare mumbo-jumbo.
In an article published in Drug Newsletter, Timothy Covington wrote that about 20% of the U.S. population are functionally illiterate, and for some subsets of the population, the proportion jumps to almost 40%.
Reading levels in print media are estimated to be between sixth- and 10th-grade levels for 35% of the population, and the electronic media communicate through 30-second sound bites. That means providers have a significant challenge.
An article in Business and Health magazine offered a realistic look at the extent of the communications barriers the healthcare industry has created for itself. Citing a survey by Siegal and Gale and Roper Starch Worldwide, the article reported that HMO was the most widely understood healthcare term, but the proportion was only 67% (See chart).
Many communication advisers suggest writing for the sixth-grade level. But when you develop public relations and educational materials for patients, you might want to consider setting your sights lower, say even at the fourth-grade level, to take into account the wide range and complexity of issues and the need to reach all members of society.
Many states are mandating managed-care options for the lowest-income and least-educated segments of the population. Sorting out healthcare options is difficult enough for well-educated people. Imagine the barriers for those less fortunate.
The best place to start the quest for clarity is to dump many of the words we're using now. They're confusing and hinder our ability to connect with the marketplace (See chart, p. 34).
One challenge is what to call integrated delivery systems. A term that's being used and deserves more consideration is "community benefit organization." The idea is being pioneered by systems like BJC Health System in St. Louis.
The phrase sounds as if it's moving in the right direction. It needs to be defined clearly to the public and backed up by actions. But it or a similar term deserves exploration.
Hospitals and systems also need to stand for something. In the debate over the future of healthcare, providers seem to be noticeably absent at the local level. To stand for something, providers need to be recognized for a particular point of view and pursue it adamantly.
There is no shortage of issues on which to take a stand. Just make sure you choose one that doesn't speak solely to your economic interests and work on owning it.
Hospitals and healthcare systems have an opportunity to recast public opinion of healthcare delivery. But like other windows, it might be open for just a short time. The cost is low compared with the expense of undoing growing confusion.
Sturm is president and chief executive officer of Sturm Rosenberg King & Co. in Chicago. He is the author of The New Rules of Healthcare Marketing, from which this guest editorial was adapted.