Communication is the bedrock of cooperation, teamwork, and progress. Think about it: If you’re trying to work with others to accomplish a large goal (as we so often do in this hyper-connected world), everyone must be on the same page in order to successfully work together. A baseline understanding must exist—one that includes the group’s overall goals, the methods being used to get there, how each individual’s work contributes to the goals, and any existing interdependencies. Without clear and detailed communication, it’s all too easy for the machine to fall apart—for people to step on each other’s toes or muddle forward into disaster.
The healthcare industry has a plethora of challenges facing it (and yes, I’m putting that lightly). It is a behemoth with a multitude of subspecialties that don’t often speak the same language or agree on an overarching goal. However, I think one of the continuum’s biggest issues—and one that’s often overlooked—is communication. We’re not good about communicating within our own professional spaces, and we’re not great about communicating our value proposition with patients or the general public (our future patients), either.
The CDC supplies the perfect example of “bad health care communication.”
Take the Centers for Disease Control and Prevention (CDC) and its communication strategy during the COVID-19 public health emergency. I have tremendous respect for the health officials who have the difficult job of navigating this pandemic on behalf of the entire country. I also understand that we are learning in real time, and new information is often released monthly, weekly, and sometimes even daily. But, I think it’s fair to point out that the national communication thus far leaves a lot to be desired. For that reason, I think it makes a great case study.
Let’s roll back to the beginning of the pandemic. The Secretary of Health and Human Services (HHS) declared a public health emergency due to COVID-19 on January 31, 2020. Eleven days later, state health officials were already complaining about a lack of communication. “I understand this is a rapidly evolving situation,” said a Nevada health official in a letter to the CDC, “however; I am concerned about the breakdown between the communication the states have received from the CDC, and information provided to the CDC DGMQ [Division of Global Migration and Quarantine].”
Rough Start Communication-Wise
We started out on a bad note—and in a time of crisis, that is never a good thing. Communication in a crisis must inspire confidence and trust, and it must be engaging to the audience. McKinsey and company said it best in this guide to communication for leaders: “COVID-19’s speed and scale breeds uncertainty and emotional disruption, communication from leadership must instill stability, demonstrate empathy and build resilience.”
Also, it’s worth noting that we regularly underestimate how frequently messages must be repeated and reinforced in order to be absorbed by listeners. The 2015 study, “Inverted U-shaped model: How frequent repetition affects perceived risk” showed that an audience needs to hear a health-risk-related message nine to 21 times to maximize its perception of that risk. The CDC did not establish a steady cadence with repetitive messaging—a missed opportunity that created an uphill battle regarding pandemic management. This underscores the need for organizations of all sizes to make communication a priority pillar in their disaster recovery plans.
The Current Omicron Debacle
Because we’ve faced a plethora of communication hiccups over the past two years, the resulting uncertainty has snowballed into lack of trust in the American majority. The next obvious example of a major communication fumble is what’s currently going on with Omicron. Confusion is at its peak, mostly due to a lack of clear, non-conflicting communication. This is noticeable within schools and large corporations, for example, who look to the CDC for guidelines to follow.
Recently, the CDC halved the official isolation window for those who tested positive with COVID-19, but were asymptomatic. But based on recent studies, it’s been implied that this variant is more contagious but less severe in terms of fatalities.
The CDC then said that an asymptomatic person who tested COVID-positive could wear a mask and return to work or school five days post-positive test. However, there was no recommendation about the type of mask that should be worn. (There is also an obvious side note that must be stated here as a sign of the current times: The reception of information, even of peer-reviewed, scientific research, is heard through a political filter. The general public is not objective about its information consumption.) Two weeks later, the CDC began recommending N95 and KN95 masks to the general public, admitting that cloth masks don’t really cut it anymore—which essentially fell on deaf ears as (rightfully) exasperated people threw their hands up in despair.
Even to date, despite clear trends observed in countries that experienced the Omicron wave before the US, the CDC says it still doesn’t know if Omicron is more infectious and less deadly than the Delta variant. The problem here is that there is no one specific source of truth (although the CDC has traditionally held that position in the US). In a time of crisis, leaders must establish a single source of truth in order to project confidence and dissipate misinformation. Obviously, that is difficult in our current world—especially when media outlets share conflicting information about what’s published on the CDC website—but prior to the pandemic, the CDC did hold a place of prominence. Unfortunately, due to a poor communication strategy while in crisis, the CDC has fallen in public opinion.
The general public has been left with a lot of questions—to the point where the CDC actually apologized this month. Information about the COVID variants is emerging quickly, yes—but with the creation of an accessible, intuitive, single-source informational resource as well as a more confident, consistent voice from the CDC, much of the public’s confusion could have been mitigated.
PTs must up their communication game.
Alright, I know you’re asking what this has to do with physical therapy. Well frankly, I think our profession has suffered from many similar communication problems regarding the value we provide patients, who we are, and what we do as physical therapy professionals. We struggle to communicate the benefits of our services to a wider population—and potentially even to our current patients. You can clearly see this demonstrated in high patient dropout rates and failure of plan of care completions as well as the 90% problem that you have heard me talk about before. (For the uninitiated, 90% of patients who could benefit from PT never receive it.)
The overall brand awareness for what PTs do and how we can help people has improved over the years, but continues to be very slow-moving. We know the research exists. We know that private equity has read that research as they are investing billions into the digital MSK space. We know that PTs are a big part of the solution to the opioid epidemic and can play a huge role in diminishing population health issues like diabetes and obesity. So, why don’t others know about all this? More importantly, why doesn’t the general public know? It all comes back to communication.
PTs aren’t great at communicating with each other.
Beyond our difficulties with spreading the knowledge of our value to a larger audience of consumers, I also believe that PTs struggle to communicate with each other—especially when it comes to updating our common clinical practices. I’m talking specifically about how long it takes us to adopt new, peer-reviewed scientific knowledge. We are not alone in this debacle. It can take up to 17 years before information from scientific studies makes it into mainstream clinical practice. That seems pretty ridiculous in 2022—especially when many of these studies examine our common, near-daily treatment practices. Our lack of treatment uniformity in addition to disparate state licensure rules, CEU requirements, and curriculum differences in PT schools makes new knowledge and treatment patterns difficult to disseminate—even within our relatively small profession. This variation in treatment and clinical outcomes, of course, does not help us communicate our value to patients.
In this day and age, despite our addition to digital services, communication is a lost art. In the past, communication was our differentiator as far as building rapport and relationships with patients. Frequent patient visits should allow physical therapists to become the provider with whom patients most often communicate. And for this reason, building strong communication skills must be an integral part of every PT school curriculum—including verbal, non-verbal, and written communication skills. We know how big of a role the patient-provider relationship plays in positive patient satisfaction and clinical outcomes. Building that communication muscle could potentially set us apart from other providers and strengthen our value proposition to patients.
We need uniform communication methods.
While it will be difficult to combat our poor information communication techniques, I do believe it’s possible—especially if we commit to solving this problem as a unit. With that in mind, I believe we can pursue the following four communication improvement goals.
- Accept that producing one more study proving the same results about the opioid epidemic will not change minds. Focus on promoting these studies instead. (This 2021 JAMA one heralding pre- and post-PT’s impact on lowering long-term opioid use is a great one to start with.) Ultimately, that means putting some serious money and investment toward public relations for the profession.
- Evaluate how we can easily disseminate knowledge throughout our profession and to patients. Perhaps we could set up a single directory or RSS feed that’s not behind a paywall, but is truly accessible to the public and incredibly digestible (and most importantly, search engine optimized).
- Commit to improving our PT curriculum so it includes a stronger emphasis on communication skills and business knowledge, like basic marketing techniques.
- Commit to unifying and standardizing our treatment methods—as well as our methods for educating clinicians.
- Continue to push for more autonomous practice and utilization of direct access. If we truly want to support a direct-to-consumer model, then the patient experience must be seamless.
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I am an enormous advocate for progress, change, and innovation. That’s why I want to not only talk about our communication problem—but attempt to solve it. I believe PTs have the potential to shape and improve the lives of countless people—now is the time for us to capitalize on it.
