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10 hours ago · Finding balance between COVID-19 and normal content in Give & Get Advice

I think there is a way here to responsibly leverage Covid19 to emphasize non-Covid content. For example, medication and dietary compliance is more important than ever for congestive heart failure patients to keep them oput of the ER. Emphasizing driving safety and is more important than ever; there's also the question of flu vaccinations. With gyms closed, ther is probably a lot which can be done to emphasize current exercise guidelines at home, including walking.

One area which will need to be addressed over the next several months which ahs a social media component will be physician retention and recruiting. Independent of Covid, we are entering a severe physician shortage, but because of Covid, there are active layoffs going on right now, so nimble organizations could be proactive in this area, thought hey will have to approach this carefully.

1 day ago · Criticizing Your Employer’s CoVid Response in Give & Get Advice

People have the right to express any opinion they choose, but as an employee they also agree to obeying certain policies, such as not speaking to the press, and not posting negative content about ones employer. For example, even when I was part owner of a fairly large clinic, I was contractually restricted from saying certain things about my organization online, and if I did, I would have certainly expected repercussions.

I think there are some things which companies, including healthcare organizations, may do which are so egregious that going straight to the public is both ethically warranted and necessary, However, in this particular case the issue seemed to be over a lack of adequate testing-which isn't just an institutional problem but a statewide problem-and a policy decision on the best place to test.

Regard the former, it's unlikely the institution has any control over the number of tests, and regarding the latter, the location of CoVid testing might need to be based on other issues, for example, would screening outside delay the care for other, more urgent patients, such as MIs and strokes, and trauma?

Now, for me personally, if I disagreed with an administrative policy-, likely one which the org medical director had likely already approved -I probably would first try to change it from within the org, and if that was ineffective, and I felt strongly enough about it, I could in theory, bring it up directly to the State Department of Health or OSHA, where I likely would have significant whistleblower protection, and likely would be in compliance with the contract I signed. Or, alternatively, and more likely-if I felt that my employer and I had significantly different approaches to care, I would simply move on.

But I just think for the most part, negative social media commentary is not the appropriate way to effect change against ones own employer, and likely will backfire, as it looked like it did here. Anyway, I am speculating here, It in this physician's case, it's possible he was putting his contracting employer into a breach of contract with the hospital, and after a warning, and a request to remove his posts was declined, his employer, the contracting org to the hospital, likely had no choice but to let him go.

So, the key point I am making is that although we have rights as citizens, we also have legal responsibilities when we choose to sign an employment contract, and we should only choose to break our contractual obligations in the rarest of circumstances, and when we do, we should expect repercussions. Often, I think we would find there are a lot of other options besides posting to Facebook.

2 days ago · Criticizing Your Employer’s CoVid Response in Give & Get Advice

Undoubtedly what healthcare administrations don’t want is photos of nurses wearing garbage bags posted to Facebook at the same time many of these administrators are probably trying to do their best. (see attached), but there is also the question of what healthcare providers should do in the context of Possibly inadequate PPE.

My advice to the providers is to work through the system using current reporting methods, and OSHA when necessary. IN fact, if providers are seeing things which even may be unsafe, it’s likely they have an ethical duty to point it out; However, I would stay off of social media.

And for administrators? 3 months, 6 months, or a year or two from now there will likely be a lot of legal pieces to pick up from this, which likely will include Worker injury claims, disability, wrongful termination, etc. Although I suspect state legislators which eventually get involved, it’s probably going to be a big mess for some orgs, but the orgs which have radical transparency with their staff now will probably fair much better, and if there are indeed PPE shortages its best to work with your staff rather than against them. I am not sure what this will entail – perhaps daily emails from your safety officer giving real updates, perhaps coordinating social media efforts with your staff, highlighting what you are trying to do……

But, regardless, I think most administrators need to take a good look at the attached photo and ask themselves now how to prevent this, rather than figure out how to react to these type me of photos. (Hint: threatening staff with discipline/termination without providing them a real avenue of participation/communication will probably not help).

3 days ago · Criticizing Your Employer’s CoVid Response in Give & Get Advice

Here’s a recent article about an ER physician in Bellingham, WA getting fired, presumably for criticizing via Facebook his contracted employer’s approach to CoVid.


For frontline clinicians these are going to be highly emotional times, and I can appreciate their desire to speak out online using social media.

However, generally speaking, most physicians have signed a contract or agreed to a social media policy which is heavily weighted towards the healthcare organization, and generally direct public criticism could well be in breech of the contract, possibly resulting in the termination of a very valuable staff member.

So, what to do? First I think the physicians and staff posting need to recognize that during an intensively emotional time, it’s probably not the right time to be posting public information on social media. In fact, the more passionate one is, the more important it may be to give it a day, before hitting the post button, Rephrased, ask yourself this: How will my attorney (and the hospital’s attorney feel about this post? (And truthfully, if you have to ask that question, you probably shouldn’t be posting it.). Anyway, an email reminder not just of the policy, but why it is the policy, may be helpful if it isn’t heavy handed.

Equally important, however, the CEO of the organization needs to recognize that if frontline workers are posting negative stuff about the organization online, then the normal channels of feedback may be dysfunctional, and that is clearly the CEOs responsibility.

I would recommend if there is a significant frontline safety issue which isn’t being addressed, then the CEO would like to hear from them directly. (And why would the CEOs agree to this? Because most of them would rather spend a few minutes on a phone, hearing from the frontline, rather than seeing their org on CNN or MSNBC in a negative light. )

Anyway, keep in mind that social media in the time of CoVid probably has equal potential to help and hurt, and marketing may be best positioned to help frontline staff not make a career ending mistake, but also make it clear to senior administration that there is a reason for types of negative posts, which probably could be nipped in the bud.

(Also, throughout all of this, keep in mind that several of these frontline staff may well die from CoVid in the next 3 months)

5 days ago · How are you responding to the public's ask to make homemade masks? in Give & Get Advice

One Washington State’s donation center Which is actively being shared on social media: https://www.suppliessaveliveswa.org/

Tue, Mar 24 8:13am · How are you responding to the public's ask to make homemade masks? in Give & Get Advice

I am not sure mask creation without some industry or statewide control is the best way to help, but there may be some orgs coming online with three-d printing- perhaps they will be looking for volunteers or other state level places to volunteer (hotlines, shelter setups etc). Having an active link list on places accepting volunteers may not be a bad thing to have on your CoVid info page.

The bigger issue is how to positively and proactively engage the public.

One thought would be “CoVid contests.” For example, give a 1st, 2nd, 3rd Place prize for the most creative hand washing video, targeting teenagers. Or the top social distancing photo in your region, etc.

Here, not only are you potentially spreading life-saving memes, you may indirectly be expanding your own digital networks, and over the next several months digital network strength and robustness will become increasingly valuable.

Mon, Mar 23 2:19pm · Medical Staff Comms during COVID-19 in Give & Get Advice

Then. based on that, you might want to consider a private LinkedIn group. it will be easily accessible by mobile founds, a complete sharing infrastructure is already there, it indirectly allows you to build your organizational platform (for example,l you staff will have to join linkedin to get to it), and the group administrator(s) can still monitor it. I would still avoid specific patient stories, but discussions about innovative PPE, etc could be valuable on this. To me, the big thing is that it is a reasonably private MOBILE platform – so you don't have to create any infrastructure, just some simple rules of engagement, ( for example, make it more about innovative approaches to Covid, rather than a complainsts session, etc).

I think making sure whatever you have has a mobile infrastructure is key to engagement, and for physicians, I would avoid facebook.

Mon, Mar 23 12:48pm · Medical Staff Comms during COVID-19 in Give & Get Advice

In terms of sharing technical or anecdotal information here I would be daily careful. I would probably as it to be directed to a central person, and have them review for broad dissemination. This person will need 1-2 backups, because you need to assume they will get dick for 2-6 weeks.

I think this is necessary because it’s likely clinical recommendations will change quickly. Also, I would keep in mind that much of this communication may be discoverable, which is hugely important because people are going to die, and at some point care management may be questioned (in Washington the statue of limitations is three years).

Check with your attorney, but there are ways to send internal communications to which are protected, and could be sanitized for careful distribution.

It should go without saying that you need to avoid public social media.

Now, for there are quality committees, such as M and M, which are protected spaces and where cases are discussed openly. If you could create an intranet space like this (a digital M and M) that could be very helpful, but it needs to be absolutely legally locked down and private, and probably will be tough to do on the fly.

Anyway, that’s my advice. Send important info carefully to a central Medical reviewer(s), who then decides to distribute, after sanitizing- possible via daily emails or newsletters.