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Dealing With The Media

A Surgeon’s Guide to the Media

As a surgeon, your PR aim is to feature positively, as well as prominently, in the consumer press. The first action a member of the public will take when trying to find a cosmetic surgeon is turn to Google. Perhaps they have seen your name in a magazine or newspaper and decided you are worth further research. Whichever way they go about it, they are relying heavily on the media to assist them in their quest. So, how do you use the media pro-actively? What are the benefits and pitfalls of using social media to reach out to your client base? How do you hire a PR agency? All these questions, and more, will be answered in this guide.

How to Use the Media

Relationships. Relationships are the holy grail of pro-active media, which is based almost entirely on them. Taking time to court writers, editors and journalists will eventually pay dividends, and can even afford you ‘resident expert’ status with some outlets, meaning they will approach you when they need a voice about a particular subject. So, how do you place yourself in this situation? How do you burst onto the media scene with a bang?

Pro-active PR

Firstly, you must have something to say that is important, of interest and which you are ideally placed to discuss. But be aware, things that you may deem to be important and interesting may only be so to you and your colleagues – company news, launches, partnerships, new team members are generally only of interest to the local media, whereas innovation, such as new procedures, technology or techniques; statistics and trends; and human interest will almost always guarantee you media coverage.

Having some control over what is published is a huge part of pro-active PR and, in as much as is possible with the press, you call the shots. However, it is worth remembering that you will never be able to control everything that is written, even if you have provided the information and the case study. This is where an editorial differs from an advertorial, in which you have complete control over column width, content and who else is quoted alongside you. For example, it may be that you have developed an amazing new facelift technique, but another surgeon thinks it’s a bit ‘meh’. In the interest of balance, the journalist will quote both of you in order to provide an independent piece. There is no point feeling cross about this; it is their job and, as stated above, if you want complete control, it is worth considering placing an advert instead.

Any press is good press, or is it? If you wish to court the press using outrageous stunts or criticising bad practice, for example; you MUST ensure that you yourself are acting in line with your brand, ethos and the image you wish to project. Naming and shaming may get you coverage, but will come back to bite you if your own practices are not whiter than white.

Pro-active PR takes time, dedication and effort. A PR ‘mini-campaign’, running for one, two or three months to ‘see what happens’ is unlikely to yield immediate results; magazines have a lead-time, for example, a monthly magazine such as Cosmopolitan, Glamour, Harper’s Bazaar and Tatler may take a piece in January and not publish it until the May/June issue. If you want to know EXACTLY when a piece is coming out, book an advert!

Reactive PR

Reactive press involves remaining like a tightly coiled spring, ready to leap into action whenever something relevant happens, either in the industry, world/local news, or even just a piece that a journalist is working on and wants expert input. You, as an expert, will be put forward to comment on a topical subject, such as the PIP implant crisis, the decline in cosmetic surgery procedures, or even your input on why selfies are causing increasing numbers of men to consider Botox procedures. Your PR agency, if you have one, will be subscribed to numerous relevant media request alerts on your behalf. When a journalist is requesting say, an expert on the risks of cosmetic surgery tourism, your agency will contact you to provide comment or expertise on this subject. If there is a high-profile case or development, you may again be called to ‘react’ to this (hence ‘reactive’ PR).

In the case of reactive PR, the media decides what they want you to cover, you just have to be available when they need you to be. Reactive PR often provides valuable opportunities to impart your knowledge and expertise.

Alternatively, your comment may be requested by the media because of involvement with a high-profile case, perhaps one which used groundbreaking technology, or maybe you performed aesthetic treatments on a celebrity. It might even be that you had an unfavourable outcome. In many instances, you may not even want the attention, but it is essential that you know how to deal with the media, just in case.

Note to remember: Clarke’s 4^th Law: For every expert, there is an equal and opposite expert!

Advertisements versus PR

The differences between advertising and PR often cause much confusion, mostly because the aim is similar – exposure, your name in print, your quote in a newspaper or magazine, and ultimately some new clients. It is the way this is achieved that differs. An advert is booked and paid for by you. You control the copy, the date it is published and you get to approve the final proof. Logos and photos are provided by you. The only expert quoted is you, and the only clinic mentioned is yours. The downsides are the high cost and the lack of credibility; adverts are often viewed with suspicion as the public know they have been directly paid for. Editorial (PR) is free, other than the comparably low cost of retaining a PR agency. One well-thought-out press release can generate hundreds of articles, reaching hundreds of thousands of people, a height that advertising cannot reach. The downside of editorials is the lack of control you have over the copy; you won’t have the final say on what is written, when it appears, who else is quoted alongside you, or its context. If you need to have full control and your budget allows, advertising is the best choice for you, but for its incredible reach and potential there is no option other than a PR agency. An example of this is as follows. During the PIP implant crisis in December 2011 – January 2012, the British Association of Aesthetic Plastic Surgeons issued approximately ten press releases. These ten releases resulted in over 1500 media clippings, which, if purchased as advertising, would have cost around £5m. Put simply: the cost of retaining a PR agency versus booking numerous expensive adverts in newspapers and magazines is incredibly low. There is no contest.

Some print outlets will attempt to sell you what is called an advertorial. This sits comfortably between an advertisement and an editorial. It gives you a chance to write a bit about you, your clinic and/or your products, and is often the only way you will get into the publication. However, the advertorial will have ‘PROMOTION’ plastered across the top, a word that often results in readers quickly turning to the next page.

To conclude: In PR, you do not have control over the finished product. Want control? Book an advert!

Crisis Management

If used well, the media can be a surgeon’s most valuable mouthpiece. However, sometimes a story in the media may reflect unfavourably on you, your practice or even cosmetic surgery in general, such as during the PIP breast implant crisis. So, how do you deal with unfavourable media? First call: contact your PR company, if you have one. This is when the benefits of retaining a PR company TRULY outweigh those of booking the occasional advert! Crisis management is an essential part of PR, and a PR company will be able to handle the day-to-day media enquiries (if you or your practice have come into question), arranging interviews, advising you on how to respond to particular questions and scenarios, and pretty much keeping the baying masses at the gates. Anytime there is damaging information, publicists weigh up the options. They may decide to approach one specific outlet and trust that they will print your side of the story, or they may choose to wait to see what gets printed before asking you for a statement, or writing one on your behalf, which they will offer to media outlets. It could be that you have social media channels that will take a battering; they will be able to advise how to handle these also.

But what if you don’t have a PR agency? Now might be the time to hire one! If that is not a possibility, you will be forced to handle the storm alone, hopefully with the support of your practice and team. It is not a time to stick your head in the sand – you need to act fast to limit damage as crises rarely just disappear. Of course, in the case of alleged misconduct or negligence, you will need to seek legal advice; advice which you must heed when planning your crisis strategy. It is always a good idea to have a crisis strategy in place before you need it, which should consist of a basic plan outlining what steps you will take and in which order.

Firstly, you need to face up to the media and they need to hear your voice – you will hopefully have ‘courted’ them in the past and will have a few contacts; now is the time to use them to your advantage. Prepare a written statement that you can disseminate to journalists, which can also be used when the inevitable queries are flooding in. Even if you are not clear on all the details at first, you still need to react. Your initial statement could simply state that you are addressing the situation and will release a full statement in due course. This shows the media, and the public, that you have control over the situation. Delegate query-responding duties to just one or two people; this makes sure that the message is consistent and not dependant on whoever happens to pick up the phone. Take responsibility; if you must appear to make a statement, don’t send someone on your behalf; it’ll appear as though you are hiding away. Head up, straight back, approach the crisis head-on and respond professionally and with dignity.

The good news? Today’s news is, on the whole, tomorrow’s chip paper. Drown it in positivity – do not let bad claims go unchallenged. Negative story? Suppress it with happy case studies until it gets pushed to the graveyard that is Google pages 2 and 3.

In the scenario in which the cosmetic surgery industry is taking a media battering, your PR company will strive to place you as an expert, if appropriate, meaning you get extra exposure and the pleasure of perhaps helping to reassure people and put out metaphorical fires. If this is the case, it is not the time to try to push your practice or techniques, it is a time to stand up for your industry.

Implement a holistic approach to your crisis management strategy by following the tips below:

• Prepare a skeleton crisis management strategy in advance
• Ascertain exactly what you are dealing with – a disgruntled patient, although should be dealt with sensitively and with professionalism, is different to a full-blown national media storm
• When crisis breaks, brief all staff on the situation, and what, if anything, they should say if approached
• Ensure all methods of communication are covered and can be responded to in a timely manner (email, phone, social media, in person, good old Royal Mail)
• Be accessible and available should the media wish to speak to you
• Keep abreast of what is being printed/made available online. Google search your name/your practice’s name every day, just to ensure you are fully aware of what is out there. In fact, it is a good rule in general to have a Google Alert set up that contains your name and practice’s name.
• There are three key approaches to dealing with bad reviews: Remove (prove that it is false); Address (tackle head on, in a polite manner); and Suppress (drown in positive comments)

In the Firing Line

You’ve agreed to be interviewed on a difficult topic. Perhaps it is a scenario similar to that of the PIP crisis, or perhaps you are appearing in front of the press to answer questions about your own practice. Whatever the situation, the following will ensure you are primed prior to the interview.

How to deal with difficult questions:

Some people seem to thrive on difficult questions, answering eloquently and coherently, perhaps with an air of satisfaction. Others will struggle when answering the simplest of queries. Journalists can smell fear, but they are not out for the kill; they just want clear answers. Manage difficult questions by using the following tools:

Reflecting: If you know that a statement a journalist has outlined is not true or is inaccurate, reflect it back at them. For example, they may say, “We understand that you have X, Y or Z…” – you respond, “You have? Where did you hear this?”

Deflecting: This involves answering carefully so as to guide their line of questioning into more secure territory. For example, they may say, “The public are concerned that X, Y, Z” – you respond, “Actually, in my experience and in my practice, I have found that what patients really want to know is…”

No Comment: This is rarely advised as it smacks of guilt, and appears like you are trying to hide something. However, it is unavoidable in some situations, such as if legalities dictate that you can’t speak about a particular case, but most journalists will know this in advance and will not interview on such subjects. Whenever possible, try to structure a statement prior to the interview and stick to it.

The 3 Ps: This strategy is often used, particularly when tragic events are covered by the media: Pity, Praise and Promise. Firstly, show sympathy: “Our thoughts are with the families,” followed by praise: “We would like to praise the efforts of the services involved who have worked tirelessly…” concluding with a promise that things will be improved: “We will be reviewing all practices and procedures to ensure that nothing like this ever happens again…”

Over-talking: this is self-explanatory – just keep talking! Don’t give them a chance to interject. Keep to the point of the interview, but just keep going…and going…and going.

Practice: As with any skill, being interviewed takes practice. So, do just that. Rope in friends, family, kids, the family dog. You will get better with time.

Listen to others: watch tricky interviews with politicians and company CEOs. Watch how they deftly handle and/or sidestep tricky questions. Watch how they physically hold themselves and remain composed, and learn from their techniques.

But be aware: you can only deploy avoidance techniques for so long. Eventually, you will need to address the issue(s) and queries head-on. And finally, NEVER lie to a reporter!

First Impressions During Interviews

First impressions last. If you are called for an interview, the last thing you want to happen is to annoy viewers with your ill-thought-out choice of attire, or appearance in general. Here are a few tips to make sure you appear professional and composed.

• Don’t wear green – if the studio has a ‘green screen’ to display its background images, you will appear like a disembodied head
• Avoid wearing items with thin stripes; the stripes can ‘strobe’, making for an uncomfortable viewing experience for the audience at home
• Don’t slouch! Sit up straight, but don’t tensely perch on the edge of the seat; you’ll make the viewers feel anxious
• Don’t get too comfortable – an expert slouched with their feet curled up on the sofa won’t fill anyone with any confidence
• Watch your hand movements – you want to appear lively and friendly, but not as though you’re engaging in semaphore signals
• Tone down the flashy jewellery and watch. The less jewellery you wear, the less you will have to uncomfortably fiddle with
• It is unusual to be asked to speak directly to camera but, if you do, make sure you listen to their instructions as to the spot (usually to the side of the camera) you need to focus on during the interview
• With radio interviews, the vast majority will be in studio. However, on the occasion that you are asked to contribute via telephone, try to do this using a landline rather than mobile phone to ensure decent signal quality
• Smile when you are speaking during a radio interview. This may feel daft if you are in an empty room, but it does make a difference as to how you sound
• Stand up during the interview. You will sound a lot more animated than if you are interviewed whilst sat slumped in your favourite armchair
• The best option if you do a lot of interviews, whether television or radio, is to play them back and observe how you come across, or ask friends and family for (constructive) feedback. You could even ask someone to film or record you in preparation, drawing attention to how you come across on playback
• Ascertain whether an interview is to be live or pre-recorded. This will avoid any potentially embarrassing (or damaging), ‘I thought we were off-air’ gaffes
• Lastly (but not least importantly), consider having some formal media training

How to Hire a PR/Social Media Agency

We keep talking about this PR agency you can rely on to spread/protect your good name, and lead you if you are in a crisis situation, so how do you go about hiring one?

Firstly, before you even consider hiring a PR agency, you need to ensure you are ready for PR. Make sure that your practice offers reputable services, and that, overall, previous patients are happy enough with their treatment that they are willing to talk positively about it. All the PR in the world is not going to change an awful reputation, and once your name is loose on the web, it will unearth disgruntled former patients. Apply a similar process when considering hiring a social media agency – your reputation needs to be as positive as possible before you start on your mission to become known. The process is as follows: the potential patient sees your tweet/Facebook post/Linked post and it interests them, they want to know who posted such a gem of a post, they see your name, they Google you and bam…that’s where they form their opinion of you. If there is any adverse press; forum posts from less-than-satisfied patients; posts about you on social media, this is where they are buried, just waiting to be dug up. A presence on social media can be very helpful in pushing old news down the Google page rankings, as can new website content and new press, but it rarely disappears altogether.

It’s worth putting in a little time to do some homework before you hire a PR agency and/or social media agency Set up a web presence. Hire a decent website developer who can make sure that all those potential clients who will be led to your site have a pleasant experience. A dated website with royal blue Times New Roman font is not an aesthetically pleasing experience. Keep it simple, but make sure you exist on the web; it is pretty much everyone’s first port of call when researching treatments, surgeons and practices. 

Have a presence on social media. Set up a combination of Twitter, Facebook, a LinkedIn company page and perhaps even Instagram, but make sure you will have time, or can find someone who does have time, to run the platforms you commit to. No feed is better than a dead feed. Many PR agencies now offer social media management as part of a package.

Prime happy patients to talk about their experiences. The media loves human interest stories: post-divorce makeovers, new-found confidence of 87-year-olds, surgery changed our lives…etc. For each of these, the patient, or case study, will need to be interviewed and for this, and they need to give their express permission for their words, image and name to be included in articles. Make sure they are aware of what the process involves. Get back-stories from your patients – why are they having this surgery, how will it enhance their lives? Handing over a file of potential case studies complete with notes will make any publicist smile, particularly if the case study really is happy to be included in press and won’t just back out at the last minute!

Traditionally, word of mouth and reputation have sufficed to drive referrals to surgeons’ practices, but we are now in a digital age. People will automatically turn to Google; you need to make sure Google loves you so that when your PR agency place a story, potential patients can see that you can be found on the internet, something that is immediately reassuring. Your website developer will be well-versed in using keywords to push your site up the Google rankings (a technique known as SEO). To assist with this process, make sure you share relevant and popular stories from reliable sources, such as BBC, The Telegraph, Daily Mail etc, on your social media feeds. Google trusts these sites and therefore will prioritise content linking to them over that of lesser-known sources.

When you are ready to hire your PR firm, do your research, both on the internet and by asking around. If any peers have had successful media campaigns, find out who was behind them. Look at your peers’ social media accounts and followers/likes/connections; did they get any help with this? If so, who was behind it? Some PR agencies offer social media services, essentially killing two birds with one stone. This has many advantages, not least that it saves you time. The social media agency will already know when there is press about to break and will be primed and ready for any publicity, whether good or bad. This saves you having to go back and forth, liaising with PR and social in an attempt to get the two running simultaneously and cohesively.

Finally, it is critical that you hire a PR agency with extensive experience in medical PR – it is a sensitive sector like no other and needs a specialised and gentle hand. The cheapest will not be the best. You need a PR company that is on the ball and has your best interests at heart. Have a face-to-face (or Skype-to-Skype) meeting with them prior to committing to anything and remember, if they promise the earth, they are almost certainly lying. Don’t get tied into a ridiculously long-term contract, but equally, don’t expect that a month’s PR work is going to make you famous.

Social Media for Surgeons

A 2013 survey published in JPRAS An International Journal of Surgical Reconstruction revealed that 82% of surgeons used social media[1]. A good few years later, that already impressive ratio is bound to be higher considering the snowball that is Twitter, Facebook et al has gathered such monumental pace. Be warned though, although a social media presence has many positives, it also comes with its own drawbacks, some of which are detailed below.

Positives:

• Increased exposure of practice
• Low-cost means of advertising
• Effective as a patient educator
• Patients can easily leave positive feedback
• Stay in-the-loop with industry news from comfort of own phone

Negatives:

• It is easy for patients to leave negative feedback
• It is a 24/7 business – you could check your accounts at 10pm and all be quiet, only to wake up to a disgruntled patient having posted twenty times on your Facebook wall
• Time spent on social media is time away from patient care
• Unwanted solicitations from advertisers

Social media can function as a tremendous PR tool, enhancing your credibility and visibility, and making you accessible and approachable. A word of warning – keep your personal and professional lives separate; there are policies published by both the AMA[2] and BMA[3] that outline the guidelines for running social media accounts as a surgeon. The general guidance is as follows:

• Always maintain patient confidentiality
• Be aware of your own online image
• Maintain appropriate boundaries in the event of contact with a patient
• Keep personal and professional profiles separate – nobody wants to see their surgeon under the table after drinking ten shots of tequila

The three main social media sites have very different aims, and what is expected of you, as a user, differs from platform to platform.

Facebook

Facebook is a slow-moving, visually interesting, informative platform. It should be fed with posts once or twice a day, and thrives on videos and imagery. It is not as needy as Twitter in that it moves more slowly, and therefore your posts hang around for longer, meaning there is less requirement to post every few hours in order to maintain a presence. People will most likely look to Facebook for your business info, such as phone number, address, directions, links to website etc. Make sure this is all up to date. A dead link is incredibly off-putting. It is likely that Facebook will be the place your patients end up, before even your website, as it is easy to find. If you view it as being equally or more important than your website, you will be appreciating its value.

Heeding AMA and BMA advice regarding keeping personal and professional accounts separate, it is essential that you use a Facebook ‘Page’ for your practice, rather than your personal Facebook account. Keep your personal account for photographs of family and friend, memes and pictures of your dinner. Your Facebook business Page, on the other hand, could well be the first thing a patient happens upon when they research you. With this in mind, keep images and posts professional and in the tone of your practice and its ethos. Post relevant industry news and articles, along with information about you and your practice/treatments. Patients and journalists often find Facebook the easiest way to find and interact with you, so consider your page to be one of your shop fronts, and treat it with care. Keep your timeline colourful and stocked up – nobody likes to look at a bare window!

Twitter

Twitter is Facebook’s younger, cooler and more anarchic sibling. It should be cautiously treated like an ongoing, water-cooler-side conversation, which you can dip in and out of. It very much thrives on trending content, although as a surgeon, you will find a huge pool of social media-savvy peers who use it to chat and share research and news on surgical innovation. They tend to use hashtags (any word typed with the symbol # in front of it automatically becomes searchable; all you need to do to find this content – and who posted it – is to type, for example #PlasticSurgery in the Twitter search bar), so searching for relevant hashtags will throw up a huge pool of tweeters you can follow and interact with.

LinkedIn

LinkedIn is the most sensible of all the platforms. It is a place to connect with people in the industry, usually those you already know, and post content – either on your own timeline or that of a group – relevant to your industry. It is not generally used to chat and interact, although does have a messaging feature. Treat this platform like an online résumé/CV, and connect with those you are aware of in a professional capacity. This builds up a circle of connections relevant to your industry, and can facilitate the formation of interesting groups and discussions.

Instagram

For surgeons, Instagram – a social network based entirely on visuals – is a tricky one. Unless you want to share a lot of before-and-after photos, which may well become a little repetitive over time, it is best left as a personal account.

Social media can be an incredible tool for interaction, sharing and discussing research and articles, and communicating with potential patients whilst having a little fun along the way. However, as with any playground, bullies abound. If your feeds are managed efficiently, negative experiences should be extremely rare. In the event that you receive a negative public post, immediately seek to take the poster offline, ie. ask them to follow you (Twitter) so you can DM (direct message) them, meaning the conversation is out of view, or PM (private message) them (Facebook). If the negative comment is on Facebook it can be hidden, but be warned – although the poster and their friends will not see that you have hidden the comment, this is only a temporary solution – whatever issue they have raised usually needs to be dealt with directly. In most cases, a courteous response and an offer of help will usually make you look good, and leave the detractors appearing rude or uncompromising. Failing that, or if things start snowballing, you will need to implement a crisis strategy, following the advice covered earlier in this guide.

Social Media Checklist

• Make time in your daily schedule to post content on the platforms you have chosen to use. If you don’t have time, consider using management software, such as Hootsuite, which allows you to pre-schedule content, meaning you don’t have to be ‘live’ at the helm. If you STILL don’t have time, consider hiring a social media management agency to do it for you
• Download social media management apps on your smartphone. This makes posting and responding on the move incredibly easy
• Engage engage engage. Every day. Simply posting content about your practice and services will make you look like a spammer
• Add a profile picture to all platforms. Leaving the anonymous Twitter ‘egg’ is a surefire way of limiting your followers; nobody trusts an anonymous profile
• Monitor your sites as often as is possible – empty pages and feeds will attract spammers
• If someone interacts with you – respond.
• Do not criticise peers
• Once you have pressed ‘Enter’ and released something onto the internet, assume it is there forever. You may be able to delete an ill-thought out post or comment, but people can easily screenshot it before you get a chance to delete it, meaning it exists forever
• Remember –  each and every post you make reflects on your brand. Have fun with social, but make sure it is in line with the image you wish to project.

This might all sound terrifying and beg the question, WHY should I get involved with social media when so much can go wrong? The simple answer is that if you don’t form your own web presence, others will do it for you. Just because you are not on Twitter or Facebook does not mean people aren’t talking about you on Twitter and Facebook! Knowledge is power and by being present you can manage negativity efficiently and effectively.
 

This e-book has been adapted from “How to Cut it in the Media: A PR Manual for Plastic Surgeons and Professionals in Cosmetic Medicine” by Tingy Simoes