One of my favorite board members at my last hospital would frequently say to us, "Everyone thinks their monkey is cute," in reference to the work we did for other departments in the hospital. It took me years to decipher what it meant. But after a while, I got it. Nuclear Medicine people scheduled meetings with me to try to get a major presence on the hospital's homepage; Home Care asked for TV spots to help boost their business; Risk Management thought it was a good idea to publicize the results of our Joint Commission survey to a larger, public audience.

All kinds of things that consumers really don't care about happen at hospitals. However, many of these things are radically important to the people working in the hospitals themselves. Hence the meetings to discuss "publicizing" these events--especially on Facebook. It's instant gratification to post the latest updates on the hosiptal's tax exempt status. But is it important to share that with the public?

I say the best offense is a good defense. Here's what you want to defend from getting up onto your hospital's Facebook page:

• A successful visit by the Joint Commission, while important in its own right, is of little or no interest or value to the average Facebook follower. Consumers expect that your hospital is up to code.


• Recipes abound online, so sharing them on Facebook, unless cooked by a physician for you while you're in your hospital bed, isn't really that cool. My first stop for a good meatloaf recipe is AllRecipes.com


• That one department that was recently accredited as a certified Whatever center will likely not elicit many comments or "Likes."


• Photos of the newest members of your hospital's medical staff (unless they're all very hot and dressed in provocative clothing and/or mud wrestling one another) aren't interesting. Consider that people well outside of your service area are following your hospital's page.

But you say, "Isn't making the internal audience happy important?" Thus, I sayest unto you: Indeed. That's why there's your employee newsletter. Everyone thinks their monkey is cute.

I was in a job interview a few years ago, and was caught off-guard when the person interviewing me commented, "I haven't been on a vacation in over 30 years in which I haven't taken a client call every day or had a conference call." (Later, this person offered the interview-ending remark, "Our clients don't give a crap about your daughter's birthday. They expect you to be available, regardless." This marked the first time ever that I de-selected myself from consideration right there on the spot.) What stuck with me, though, was the image of being on a beach somewhere and not playing with my daughter in the sand or not relaxing by a pool or generally not not thinking about work.

That just sucks.

The number of Americans who report working while on vacation can be as high as three-quarters, depending upon what survey you're consulting. Thank you, technology.

And in PR/health care communications, we all know that the work doesn't stop because we've retreated to the Hampton Inns. I have an impressive track record of surprise dignitary visits (and here) while my various directors have been on vacation.

So, a few simple tips for minimizing work and maximizing your sandcastle output while on vacation:

• Set your availability expectations before you leave: If you have to, set a time each day in which you will check email and respond to only urgent requests. (Define "urgent" for your staff, who may consider that to be something newsletter related.)


• Plan news releases in advance. Have a few topics for social media (use the National Health Observances calendar), and "timeless" releases that can go out during the week to keep things moving.


• Talk with your staff about who will be stepping up into the PR role while you're out. This can be a good opportunity because, inevitably, a U.S. Senator will show up while you're out. Or there may be a diesel spill, to choose a wild, completely random example. Something will happen that will require a colleague to step up, which can be a positive experience them and your department.


• Have a crisis communication plan in place, should the diesel spill or something else reach CNN proportions. This may involve having a consultant or other external support ready in the wings.


• Plan ahead, plan ahead, plan ahead. Common sense alert: The more you do in the office before your vacation, the better. Meet with the team before you leave and go over what projects you've been working on, their status, and any assistance you may need while you're out. The fewer surprises there are for those left behind while you're sipping mojitos, the better off everyone is.

Finally, forget all of the above if you're planning a Disney vacation--you'll probably welcome the opportunity to check email, hop on a conference call or just not stand in line for It's a Small World.

Employee newsletters definitely had their day--like Flock of Seagulls and Captain and Tennille (and around the same time period, too). I'm always suprised, though, by how many places rely on the "newsletter" as a primary means of communicating with employees.

Just look at how the average person gets their information today. According to Pew's State of the Media report: "Eight in ten who get news on smartphones or tablets, for instance, get news on conventional computers as well. People are taking advantage, in other words, of having easier access to news throughout the day--in their pocket, on their desks and in their laps."

In fact, there is an entire generation entering the work force that wouldn't know what to do if you gave them an actual newspaper. Think Cerie on 30 Rock. And the thought of a newsletter--the newspaper's ugly cousin, once-removed--doesn't even register in their world.

Even the word "newsletter" feels completely turn-of-the-last-century. So, why not consider some newer, more efficient alternatives to an employee newsletter?

Here are a few:

• An employee blog: The value of an employee blog is that for PR/Marketing department, this is a much quicker, more flexible way of pushing out information. If your hospital has an employee recognition event, you can write it up and upload photos/video that day.
• E-Newsletter: This isn't just a copy/paste job into the body of a house-wide newsletter. We're talking about a nicely designed HTML-based template that can link to the blog option. Wordpress offers plug-ins for e-newsletters that you can add to your blog.
• Intranet: This is a bigger option, but would transform the typical cluttered street kiosk-style intranet site into a more organized, functional communication tool. A lot of organizations are moving to using SharePoint for this, which isn't a terrible program. It also comes with blog options.
• Social Media: As a companion to some of the other digital options, you should all be engaging your employees on social media. Twitter, YouTube, Facebook and Flickr are solid stand-bys for all of your media needs.

I know that a lot of employees say things like, "It's nice to have something I can hold in my hands" when it comes to internal newsletters. You still can: It's called an iPad. And it will display your new employee communication modes with perfect resolution and clarity.

If you listen closely, you can hear the sizzle of Australian recruiting firm Salt & Shein's butts on the barbie. To release a study that characterizes the PR industry as a "Pink Ghetto" is probably bad enough. But then to wager the utterly aboriginal statement,

"Girls and gay blokes gravitate to PR," [Josh Shein] said. "It's always been that way. I suspect it's because PR and corporate affairs is seen as a softer skill set in terms of judgment. It's more creative. And the softer skills set is more about influencing as opposed to, say, the sales function."

Well, Mr. Shein, you've successfully undone all of the positive image work and credibility that ambassadors like Russel Crowe and Mel Gibson have garnered for your country.

As a man who is not just in PR--but healthcare PR--I can honestly say...really? I hadn't noticed. I'm neither a "gay bloke" or a "girl," so I guess I'm a bit of an outsider on the pink, frilly fringes of this ghetto.

So be it. I could think of worse ghettos to be in, I guess.

I don't see the value of this kind of study, aside from lining consultants' pockets and making a splash with a stupid sound byte. Look at the job market at large (in this country, anyway) and you see that women account for a majority of the workforce--not just in PR.

According to the U.S. Department of Labor, women accounted for 51.5 percent of all workers in the high-paying management, professional, and related occupations in 2011, including: Registered nurses (91.1 %), Medical and health services managers (72.5%), Tax examiners, collectors, and revenue agents (66.1%), Accountants & auditors (60.1%), Financial managers (53.2%), etc.

I wouldn't pretend to call those occupations "soft" or "creative." And I fail to see how these stats might be problematic, in terms of women (or an industry) being "taken seriously."

Maybe things Down Under are different. The toilet water does spin the opposite direction, after all. Let's just hope that it does so with enough force to carry off the remains of this worthless study.

Blogging can be such a fickle thing. My own blog has gone through winters of dormancy and then bloomed with post after post, only to fall off again when I realized I had nothing more to say. So it is with this poor, unfortunate health care blog--so lonely, so neglected.

Except there was good reason this time. A month ago, I made the jump from one of the last independent community hospitals in Chicagoland to a hospital that is part of a large, swanky system.

Now that orientations are winding down, and I've learned to associate at least a few names with a few faces, I'm ready to carry on with this health care blog experiment.

Some differences betweeen There and Here that I've noticed so far?

A.) Professionalism: I have a head shot that was done in a studio. It looks, I think, nothing like who I really am, but they wouldn't let me dress down in sweats and a concert t-shirt.

B.) Passwords & Usernames: At last count, I have about 14 discrete usernames/passwords for various systems. I have tried to memorize them, as I fancied myself Will Hunting. But what has happened instead is that I've become intimate with IT support, who keeps issuing me new passwords. I should probably should start writing them down.

C.) Flexibility. Among certain populations at the old hospital, the idea of a Big System (or Corporate) meant handing over your personhood at the door to your new Corporate Overlords. I have not found this to be the case. Everyone has been welcoming, helpful and willing to explore new ideas. (Still, let's keep this blog between you and me for now.)

D.) People. I am trying to break myself of the habit of tagging all of the new people in my head as all of the people I used to work with at the old hospital. (Like, "Oh, that's the new Marie Smith.") Everyone is an individual. However, I'm still referred to as "The new Vince" (the guy who was in this position before me).

E.) I'm now That Guy. At the old hospital, whenever a new leader came on board from another hospital, we would joke about how often they'd start a conversation with, "Well, at my old hospital, I used to..." This is what I've become. It's difficult not to say that, but I'm trying to break myself of that habit, too. Still... At my old hospital, I was in charge of all of the web marketing and social... Sorry, sorry.

So, hopefully, I can get back on a good schedule of random posting. And maybe even build an audience again. Until then, thank you, mom, for reading The Pulse.

For many years, the National Health Observances Calendar was the guide for health care communicator's yearly agendas. To some degree, it still is: We know that February is Heart Month and that October is Breast Cancer Awareness.

But recently, with the help of social media, new observances that aren't on the national calendar are becoming forces in the health observances game. November has been designated "Movember" for men's health awareness, and has resulted in a slew Facebook mustache contests (check out mine--it was disgusting) and more than $14 million raised in the U.S.

There are selection guidelines to obtain representation on the calendar, but based on some observances listed, I wonder how stringent these requirements are. I know, I know, the goal is to help raise awareness about certain serious issues, but does everybody get a spot on the calendar? Here is a list of observances your hospital could probably ignore in 2012:

• January is National Radon Action Month. Radon can be harmful, but so are many other noble gases. Krypton adversely affects many superheroes, and helium, when unintentionally sucked, can have insidiously comedic results.


• The American Dental Association gets selfish in February with both National Children's Dental Health Month and Give Kids a Smile Day.


• April is National Facial Protection Month, which perhaps incorrectly coincides with baseball's spring training, rather than hockey season.


• June is a slow month, but features National Rip Current Awareness Week, which feels a little discriminatory for a "national" calendar. What is your average Nebraskan to do about this?


• September has both Whole Grains Month and National Celiac Awareness Day, while Irritable Bowel Syndrome Awareness Month is in April and GERD Awareness Week is in November.


• While October belongs to Breast Cancer Awareness, it's also National Medical Librarians Month. Ssshhhh.


• Drowsy Driving Prevention Week happens in November, while National Distracted Driving Awareness Month is April and Drive Safely to Work Week is in October.

I hope that 2012 finds you and your organization safe, happy and rabies-free (assuming you've recognized World Rabies Day on November 29).

It was only a matter of time before something like this happened. In this case, a patient wrote a negative review of their dentist on Yelp, and the dentist is now threatening to sue, claiming that the patient was in violation of a signed 'Mutual Agreement to Maintain Privacy'--a document that apparently prohibits patients from publishing/writing anything negative about the dentist.

There would be your first red flag, as a patient. But that aside, I've talked to numerous physicians on staff at our hospital about the issue of handling negative reviews online. I listen to commercials on the radio for Reputation.com, which promises to help lawyers, doctors and other professionals manage their online reputations.

"Should we do this?" the physicians ask.

"Do you need to?" I reply.

If the answer is "yes," then maybe you need to look at your practice and assess if there's something you could be doing better. This needs to be done with the clear-headed acknowledgement that EVERYTHING IN THE DIGITAL AGE IS TRANSPARENT. Realize that you can't open a bakery, a sporting goods store, or a Tarot shop (I'm reading great things about Delphina's psychic abilities) without assuming you will be reviewed online.

Take heart, doctors: According to the Pew Internet & American Life Project, "Hospital and doctor review sites have not yet become health care decision-making tools for most consumers." Check out the full report here, but for all of the people that use the Internet for health care-related things, the number of people who are using it to make key decisions about whether or not to go to a particular physician is still small.

Finally: Bad reviews sting. It doesn't matter if you're Dr. Oz or an astrologist who isn't Delphina, it hurts to read something negative about yourself online. Especially if the reviews are warranted. But you have to put it in the context of the number of patients you see every year who keep returning. People complain with their keyboards, but they vote with their feet. If you, as a physician, are losing patients each year AND reading a lot of negative reviews, you will definitely want to consult Delphina on what you should do. From what I've read on Yelp, she gives pretty good advice.

In the few years I've been preaching the gospel of healthcare social media, the hospital audiences have gone from skeptical to curious to (more recently) preaching to the choir. Hospitals get that the Internet has wheels and might stick around for a while, as will social media.

But then there are the physicians.

Many of the physicians (at least on our medical staff) aren't just late adopters of web marketing and social media--they are still unplugging office phones to plug in and use the facsimile transmitter. Last month, though, skepticism gave way to tentative curiosity. We did our first physician/office staff seminar about web marketing & social media.

Initially, I'd prepared a presentation bulky with Twitter/Facebook/YouTube tips, and our Physician Services director warned, "Too advanced. Most are just now getting around to thinking about getting a web site." Okay. So then I got basic. Here's some of the "basics"
that you can use to help physicians understand why having a web presence should matter to them:

• Because nobody searches the Yellow Pages anymore--pull your ads from the YP and take a look at ZocDoc.com. Then look at all of physician finder apps available for consumers (The Little Blue Book, BCBS, etc.)
• Because Sprint is now offering the iPhone--and the iPhone 4S has Siri, which will find a doctor, schedule an appointment, and make the perfect latte for you with the touch of one button
• Because no web presence=old, out of touch. Believe it or not, many people wouldn't cross the street to use a service that doesn't have a web presence. People want to see what they're getting--whether it's a meal or a physician
• Because your target patient demographic is now the fastest growing segment using social media: "Among the Boomer-aged segment of internet users ages 50-64, social networking site usage on a typical day grew a significant 60% (from 20% to 32%)." At about 78 million strong, if the Boomers are going online, so too should your practice.

Anyway, the case for physicians having a web presence gets stronger every day. While there were some naysayers at the meetings, there were quite a few other (admittedly younger) physicians who were asking good questions and taking notes. One of them commented to me after, "If the rest of these guys don't want to be online, I say 'great.' More [patients] for me."

Our new hospital had only been open for a month (still had that "new hospital" smell) when we received our first negative experience post on our Facebook page. In fact, it wasn't just a post about the experience, but it also included a link to a blog that the patient created just to write more extensively about her negative experience.

Ouch. So, what to do?

Some members of our executive team wanted the comment deleted immediately. Some wanted Facebook taken down immediately. Some wanted Internet access taken down immediately.

One voice of reason suggested a radical alternative: Let's respond to her and figure out what happened. (Crickets chirping.)

Here's the deal: Social media etiquette dictates that you DO NOT delete negative comments on Facebook (unless they use abusive language with specific employee names, etc.). You DO NOT wait to respond. You DO NOT EVER ignore it completely.

What you should do is both reasonable and simple:
1. Comment immediately with an apology and ask if it would be okay for someone to follow up personally with them within the next 24 hours. This should never be "canned" material, by the way
2. Identify/notify the care team involved with the experience. If you have a patient experience representative or team (as more hospitals do now and yours definitely should), they should be notified to get the ball rolling
3. Keep the patient informed on Facebook with any updates ("Hey Frank, I've passed along your comment to our Patient Experience representative/team. Would it be okay for them to contact you directly?")
4. Make sure that the loop is closed--usually our CNO follows up personally with all patient complaints that are clinical in nature; or our ER Director if it's ER-related; etc.
5. Do this process every time, for every complaint. It isn't rocket science. It's just good customer service in the social media age

Negative experiences happen at your hospital. They happen at every hospital. What's different now is that patients and visitors have instantaneous access to wide audiences, via social media. In the past, they may have sat down after the fact and composed a letter to your hospital. Now, they sit with their iPhones in your ER and post on your Facebook wall that they've been waiting for three hours and haven't been seen. (Eeep.)

Our experience has been that a lot of upset patients who post negative comments are pleasantly surprised by a quick response, with an offer to listen to what happened. They usually take us up on those offers, and are usually very appreciative. (You can't please everyone, no matter how hard you try.)

Our first (and certainly not our last--our latest happened just two weeks ago) negative experience on Facebook ended positively when the patient posted a note of thanks and appreciation for the resolution on our wall. And I was happy to see that, to this day, there are no further posts about our hospital on her blog.

My daughter and I like to play with Legos. We can spend hours constructing, playing, and then destroying, only to repeat the process over again ad nauseum. But among her hundreds of Lego pieces are a small number of generic Lego imposters, given to her as part of a birthday party goodie bag. Called "Best-Lock" blocks, they look similar-ish to Legos, but they don't fit with the actual Legos, despite a burst on the box that said "Works with other brands." This may be true, just not with Lego brand Legos. Anyway, it's frustrating for us when we reach for the imposters and they don't fit with the Legos. The imposters are pushed to the side, thrown at walls, and cursed.

The point?

Google+. It's not Facebook. But it's Facebook-y enough to appear to function like Facebook. But it's not Facebook, dig? You can import your Facebook news feed somehow to Google+. But it's not Facebook. I curse it as an imposter, and push it to the side.

I could (and probably should) write about the "good" of it--yet another way for your organization to boost its online presence! Yes, there is probably a way to integrate this into your social media portfolio so that it can be updated with your organization's latest stuff. But instead, I'm finding it hard not to roll my eyes and give you a really heart-felt recommendation: Go read a good book. Visit a museum. Play Legos with your kids. Or, professionally: Go visit a patient floor and watch your nursing staff do great things. Talk to a visitor and ask them how they are doing, or if they need any help.

In spite of my day job and the benefits of social media to our organization, I'm having a hard time seeing Google+ as anything other than another super-trumpet with which more noise can be made about whatever, personally or professionally.

My patience with these tools is growing thinner each day, and sounding a lot like: Yes, you can create your own noise maker, but does that automatically mean we need to use it? I say no. Professionally, with a good Facebook page, you're covered. Unless Google+ rises up and overthrows them. But that seems about as likely as Best-Lock overtaking Lego.