In the spotlight

HEALTH stories are big business for the media industry, with a seemingly never-ending supply of sensational headlines appearing every week.

From positive stories about medical miracles to more damaging tales about deaths caused by malpractice, there are many reasons why your medical or dental practice might attract a reporter’s attention. And as a former national newspaper journalist, I have seen first-hand how the media machine works and the lengths to which they will go to get their story.

As practice managers, you are likely to find yourselves at the sharp end of media enquiries, so it is important to know what reporters want and what you can tell them. It is useful to bear in mind that a journalist who questions you may not be in search of large chunks of information. Even the slightest nugget of data – like confirming a particular GP is on duty that day – will fill gaps in their story. Always be careful about what you say.

Practice managers are also bound by strict confidentiality rules which limit what they can say. Patients have the freedom to talk freely about their healthcare to a reporter, but there is very little you will be allowed to say in return. And while the media all pledge to abide by the voluntary code of conduct set out by the Press Complaints Commission, it is not surprising to hear that these rules on privacy, harassment and underhand tactics are not always strictly adhered to. In all cases, members should contact MDDUS for advice.

To explore some of the risk areas surrounding media enquiries, it is useful to analyse common scenarios that practice managers might find themselves in.

COLD CALLING

Imagine a practice manager receives a phone call from a newspaper reporter who seems to know all about one of her patients. That patient is a high-profile politician with a known health problem and the reporter says he knows the person is a patient and asks how the practice staff have coped in treating the person recently. How should the manager respond?

The important thing about this scenario is that the reporter is very likely fishing for information in the hope that they will catch the manager off-guard. But patient confidentiality means you can’t confirm or deny if anyone is a patient – so be careful not to imply anything. You should be polite and avoid being drawn into a conversation. A response like: "I’m sorry but we have a duty of confidentiality and cannot comment about any patientrelated matters" should suffice. And avoid blurting out "no comment" as this can sound abrupt and rude.

The journalist may sound friendly but remember there is no such thing as "off the record", so don’t say anything that you would not be happy seeing in print. It may be frustrating not being able to defend yourself, but the media is not the place to deal with patient issues and any statement you do make could be printed inaccurately or out of context.

The GMC has published guidance on this issue: Confidentiality: responding to criticism in the press. It explains clearly what can and can’t be said and acknowledges that while criticism about your practice in the press can be frustrating, "it does not relieve you of your duty to respect your patient’s confidentiality... You must not put information you have learned in confidence about a patient in the public domain without that patient’s express consent."

ON YOUR DOORSTEP

High profile cases tend to attract even greater attention from the press. It may be that one of your GPs has made a controversial statement, for example, on assisted suicide. You turn up at work to find a large group of reporters and photographers gathered outside the practice. They ask you what you think about the GP’s remarks and you notice some of your patients are being questioned as they approach the surgery.

So how should you handle the situation?

It’s not advisable to speak there and then when you have been caught off-guard. Take the reporters’ details and tell them you will call back. If they enter your practice you can ask them politely to leave but they are allowed to stand outside on the pavement provided they are not causing an obstruction.

They are also entitled to speak to your patients, but you should make it clear they must not harass patients and respect their privacy by not photographing them entering or leaving the practice without their consent. If they attempt to photograph you or your practice staff, you should resist the urge to run away and hide your face as this creates a negative image. It is good to have a clear policy in place for dealing with the media which has been approved and understood by the practice partners. In some practices a senior or administrative GP would take an active role. Once a policy is in place make sure practice staff are familiar with it.

AN UNHAPPY PATIENT

Patients who have a complaint about their medical or dental treatment can often phone a newspaper or broadcaster directly to talk about their case. So it is likely that the practice manager would in turn receive a call from the reporter to get the other side of the story.

Imagine a scenario where a newspaper has been contacted by the daughter of an elderly patient. The woman tells the reporter that one of your GPs missed a fracture in her mother’s ankle causing weeks of suffering. The lady now needs surgery and plans to sue the GP. Two days later a negative story appears in the paper with the headline: "GP left me with broken ankle for two months". A picture appears alongside of the GP covering his face with his briefcase. What do you do?

The first move is to buy time by taking the reporter’s details and calling her back. Don’t be tempted to ignore the call as reporters will just keep trying. Call back even if all you are doing is reminding the reporter of your duty of confidentiality. You should not be tempted to try to justify the actions of your staff as this will breach confidentiality.

It is unwise to phone up the newspaper to complain because there is little you can do unless the story is significantly inaccurate. As the GMC’s guidance explains: "Disputes between patients and doctors conducted in the media often serve no practical purpose; they can prolong or intensify conflict". If you deny allegations that appear in the press, the GMC warns: "You must be careful not to reveal personal information about a patient or to give an account of their care without their consent".

In some circumstances it can be helpful to contact the patient to make them aware of the practice complaints procedure and perhaps offer to meet with them to discuss their concerns further.

DIRTY TRICKS

Reporters have been known to go to extreme lengths to get their story, including pretending to be someone else on the telephone or by not identifying themselves in the hope of catching you off-guard. For this reason, you should always ask callers to identify themselves and, if in doubt, don’t give out patient information. Genuine callers will not mind if you offer to call them back once you have verified who they are.

KEY POINTS

There are some basic points about handling media enquiries that practice managers should bear in mind:

• Always respect confidentiality
• Be polite and avoid an abrupt "no comment"
• Have a practice policy that all staff members are familiar with
• Always ask callers to identify themselves
• Don’t ignore media calls
• If in doubt, do not comment and seek advice from MDDUS.

Joanne Curran is an associate editor of Practice Manager