23 March 2008

The power of apology

"Sorry from me, what does it absolutely mean?"

Louise Jones, interim Chief Executive Officer, Eastern Health

Some public relations practitioners specialize in reputation management.  We all do to one extent or another, but in some mystical parts of the world, there is enough business to sustain an entire practice on it.

Tiger Two is a public relations firm in the United Kingdom that, among other things, has a blog devoted to online reputation management.

Follow that link and you'll find a post summarising a recent article in the Wall Street Journal on the five typical approaches corporations take to online comments that may have an effect on the corporation reputation:

  1. The Do-Nothing Approach
  2. Putting Lawyers on it
  3. Throw Money at the Problem
  4. Invite and Engage the Critics
  5. Stop it before it Starts

Those five describe what most companies and individuals in Newfoundland and Labrador do when something out there is said which can adversely affect reputation. The Premier accuses you publicly of unfair trade practices without a shred of evidence?  Well, publicly traded Aliant opted to do nothing.

That pretty much is the anatomy of Eastern Health's ongoing breast cancer scandal. They opted to stay quiet - a form of doing nothing - and then when things got dicey, the lawyers wound up on the job.  The result of their approach is playing out on the Internet and in newsrooms right now as a result of a public inquiry into the mess. Before it is done, there'll be quite a lot of money thrown at the problem in various ways, including one suspects a settlement to the members of a class action lawsuit.

The list above was compiled in order of popularity.  If you check with a public relations practitioner, especially one who specializes in reputation management, the first one they'd suggest if the fifth one on the list.

That's why we've observed both here and at Persuasion Business that the entire breast cancer scandal would have turned out much differently if Eastern Health nd the provincial department to which it reports handled things differently at the outset.

Truth be told, if Louise Jones had offered a simple apology on behalf of the organization she leads, she might have started the long journey out of what must surely be a very dark place for a great many people.  One of the reasons her organization is in the mess it is in at the moment stems from the largely impersonal, bureaucratic way which the organization as a whole relates to the people who come to them for care.

That's what they are:  people who come to a hospital for care. They are weak, emotional, confused and often fragile and vulnerable, none moreso than a woman facing breast cancer.

The old word for them is patient and while it is an old word, it carries with it the old attitude of care and of a strong personal relationship between the healer and the person seeking healing.  Doesn't matter if the healer is a doctor, nurse, or pharmacist or one of a raft of other health professionals. Old isn't a bad thing, in this case.

But to Eastern Health, as an organization, they were and are clients. Jones referred to them in her scrum as clients, as cold and impersonal a term as anyone ever imagined to describe sick people. It's not Jones' fault.  Her training and her professional and work environment adopted that term some time ago,  Some people in the health care business use it instinctively and often without much consideration. 

The fact that so impersonal a word came to her so effortlessly tells a lot about where her head is, that is, as the person who singularly speaks for the entire regional care system.  It sets the tone at the top, or, in this instance, perpetuates it.  A leader sets the standard for the behaviour of those below in the organization. Even in the bits we've seen thus far, the tone at the top was often wrong.

It still is.

Impersonal and bureaucratic pretty much sums up the response thus far to the scandal. You see, to some, an apology might be seen by some as an admission of liability.  The lawyers (and the government) would scream at the prospect of what, to their way of thinking, increases the payout. Saying nothing and doing nothing is the traditional strategy designed to minimize legal risk and with it, the assumption goes that financial risk is limited as well.

Sounds logical and obvious enough, but in this instance, an apology is all many of the witnesses called to testify at the inquiry so far were looking for. They sought any indication that someone actually cared.  Cared enough to tell them up front that mistakes had been made.  Cared enough to tell them in a timely way, let alone at all what was going on.

That sounds even more logical and obvious: a patient looking for some sign of caring from a health organization.

An apology is also a sign of responsibility.  Someone apologizes and takes responsibility even if if he or she personally did not make the mistake.  Taking responsibility for other people's cock-ups comes with a leader's job.  The tone at the top of the top doesn't encourage that behaviour these days - taking responsibility -  but that's another story. 

Suffice it to say that in her poorly considered comments last week, Louise Jones set entirely the wrong tone in relation to this inquiry and the breast cancer issue. She set the wrong tone for many of the people who work under Louise Jones, diligently labouring every day to deliver care despite working environment both physical, and one suspects mental.

Again, she's not alone in setting the wrong tone. Ross Wiseman's easy condemnation of a doctor who, we learned this week threw a sheet of paper at a patient, screams Ross Wiseman's complete lack of appreciation - former health care, human resources bureaucrat that he is - for the stresses and strains physicians and others have been working under as a direct consequence of the laboratory cock-ups.

Imagine for a moment, the doctor, who is foremost in delivering care for extremely sick patients, who trusts that labs are working properly and makes a treatment recommendation based on those lab results only to find that the whole thing was wrong. He made a mistake  - not his fault - and his patient suffered, in some cases suffered grievously, as a consequence.

And if that weren't enough, because of management decisions made way above his head in the organization, a patient who ought to have been contacted by someone else is now sitting in front of him demanding answers he cannot give. 

Wiseman is lucky that all doctors, nurses and lab staff have done  - let alone patients in this case - is toss the odd piece of paper.  Wiseman is lucky too, to be so far out of touch, so distant and removed from the human issues in the breast cancer scandal that he can willingly, almost cavalierly condemn another but hold himself as somehow a model of virtue in the process.

Ask Fred Kasirye about Wiseman's virtue.

Does he forget the facilities report scandal?  A guy who all but lied about hospital facilities reports to the media and the public has nothing to be the least bit proud of. Hypocrisy just isn't a strong enough word for it and goodness knows, Wiseman and his colleagues have made "hypocrisy" a cliche these days in many cases on many issues.

A simple apology could have done so much:  changed tone, showed an acceptance of responsibility, given a sign, no matter how small, of humanity instead of cold bureaucracy.

Unfortunately, Louise Jones was right in some of her other remarks to reporters outside the inquiry hearings.  She said  "the story [of what occurred] is not going to be told for some time."  It isn't.  That's largely because the organizational culture led to a do-nothing strategy at the front end and that same impersonal management culture still pushes for doing the least at every step. 

Take Jones' comments on the value of an apology that the bureaucratic culture is firmly entrenched, despite the revelations so far. If at the end of this inquiry, the patients involved in this scandal receive an apology only after the legal bills have been tallied, then nothing will have changed at all.

At that point, "I'm sorry" will truly have no meaning.

Here's hoping that in the time it takes for the story to unfold, someone somewhere in the health ministry or Eastern Health learns the simple human value of simple human words:  "I'm sorry."