All right. Good morning or good afternoon, everyone, depending on which time zone you are. Welcome to Critical Cross Talks. My name is Dr. Saras Chandra Vallabha Josila. I'm a cardiologist, an intensivist, and an interventional cardiologist at Wake Forest. I've had the pleasure of working with the SACM for many years and had the pleasure of hosting these sessions in multiple capacities, and currently I'm here in my capacity as the chair of the training section. I'm very grateful to have two wonderful experts with us today who'll be discussing how to approach a media interview. Our two experts are Dr. Laura Evans. Dr. Evans is a professor in the Division of Pulmonary Critical Care and Sleep Medicine and the Medical Director of the Critical Care Unit at the University of Washington Medical Center in Seattle. She trained at the University of Washington and before that Columbia Presbyterian in New York. She's a Presidential Citation Awardee for many years running now from the SACM and richly deserving from what I understand. She's worked with the CDC in the past. She's been a physician of the year in the past, and we are very grateful to have her here today with us. Thank you, Dr. Evans. I also have with me Dr. Leo Rotello. Dr. Rotello is the section chief of the hospital-based medicine at Johns Hopkins Community Physicians. He's an assistant professor with the Department of Critical Care Medicine, Pulmonary Medicine. He's the chief elect of the chief of staff at the Suburban Hospital in Bethesda, Maryland. He's a member of the Physicians of Academy of Clinical Excellence at Johns Hopkins. Dr. Rotello, thank you for your time and thank you for being here with us. Happy to be here. Thanks. All right, so maybe I'll just have both of you share a few initial leading thoughts about how you personally or as a system prepare for media interviews, what you say, like to say, don't say, and your opinion based on your wisdom. Leo, you want me to? I'll give it a start. Yeah, get us started, Laura. Thanks, Sash, for the very kind introduction. It's nice to be here with everybody. So I should preface this by saying media interviews are not something that I seek out doing, and I think before I did my first media interview, I was actually extremely hesitant about it. I just stylistically, I'm somebody, I think, who generally prefers to be sort of behind the scenes rather than out in front of the cameras for that. So it may be worth sort of a brief detour into the backstory behind the first press conference that I did because I think I found it helpful in terms of thinking about how to approach them afterwards from that. So the first time I did a media interview or a press conference was actually on the discharge press conference associated with the only person who was treated for Ebola virus disease in New York City, and that was really a very intense experience, I think, for everybody involved in that person's care, but it also was a very intense experience from the public relations standpoint. So those who were in practice or even can remember back to that was sort of the end of 2014 when patients in the U.S. were treated for Ebola virus disease, they were like basically lineups of media trucks and television trucks outside of the medical centers that had persons with Ebola virus disease hospitalized there. So I was at Bellevue Hospital at that point, which is on First Avenue in New York, and I think three of the lanes of traffic were closed with satellite trucks from the media from that, and I was the lead physician sort of helping manage this patient's care with a huge team from that, and one of the moments I remember is that nobody actually knew who I was, and so I was coming into the hospital each morning and sort of climbing over these wires and around these media trucks, and there were people broadcasting out there, and they were sort of stopping anybody with a hospital badge on to ask for information about what was going on, and nobody knew who I was, and I kind of enjoyed that anonymity of like just sneaking through them from that, but I was forced into doing a press conference upon this person's discharge from that, and so I got a little crash course in media training from our PIO or public information officer at that time because I hadn't done it before, and some of the quick pearls that were very useful at that time to me were think about what message you want to send ahead of time, don't speak off the cuff, and keep your message very simple, and keep coming back to it. So you really want to reiterate that message. You want to think about it ahead of time, and as physicians or as health care workers, I think we, when we're asked questions by families or colleagues, our inclination is to be very thorough, right, and to be very forthright, and that's not necessarily the right approach to answering questions from the media, is you really want to think about what your message is and not get too complicated, not get too far into the weeds, but to come back to a clear and simple message, and they also quoted the same thing that I think you'll read if you look at sort of the CDC guidance on crisis communication. Some of the really central principles around this are, you know, get the information out there, so be first, be credible, and be correct, so don't imply certainty when we don't have it, be upfront about what we do or do not know, but keep it kind of simple, and those, I think, are really good tenets to approach a media interview with. I think the approach may differ, and I don't know if, Leo, you'll want to comment on this or not, is sort of if it's an interview that you are being kind of asked to do because it's of the public interest, or if it's a media, if it's an interview you've sort of sought out doing to provide a message to the public that you think is important from that. I think probably those principles apply in either circumstance, right, in terms of keep it simple, have your message identified ahead of time, and keep on message. Let me stop there. Yeah, I agree with a lot of what you said, Laura. From my standpoint, most of my media things have been on public interest topics, heat stroke, different things, and there have been not anything so elaborate as the Ebola issue, but with public interest topics, so I think step one is try to see if somebody else can do it instead of you, which is usually not the case, but in all reality, you're going to be nervous. I think that's a natural thing. You're going to be nervous in these interviews, so if you have the opportunity where it's something that's going to be scheduled and it's not right then and there, prepare the best you can. Know your information. Make sure what you want to say is what comes out of your mouth because, again, you do get nervous and you tend to kind of ramble on. I know if you're doing it on behalf of a hospital, if you're contacted by people from the media, which is not uncommon to happen, you should always get your chief information officer or whoever it is that does publicity for your hospital, you should always make sure that they are involved and administration is involved. You should not be doing press conferences about your institution without them knowing about it, so I think it's important that you always make sure the right people are involved because we get people calling into the ICU reporters wanting to know this or that or set things up, and we always kind of divert that to the correct people in administration and let them set the process up. They know how to do it. The other thing is, Laura's used that, how much do you give? And you kind of put this somewhere between a trial where they tell you only answer the question and just a casual conversation. They want more than you just to answer yes or no, so you need to be able to give them information on the topic that they want, but try and stay on task. Know what your message is. Don't go rambling on about things off topic because that takes you down paths that you may want to know, and a lot of that goes back to preparation if you have the opportunity to do it again because you are going to be nervous and you're going to start talking about things, and then you're going to look back at the clip later and say, oh my god, what was I thinking? What was I doing? And it's just from personal experience, so I think those things help. And the media, again, as Laura said, don't overstate your case. They want you to be honest, but remember, this is going out on public broadcasting, so you don't want to say things that are not correct or that you're not fully invested in, and don't give declarative statements on things that you're not sure, no matter how much they may press you for you to do that. So those are the main things. They're kind of fun to do once you've got a few of them under your belt, but it does take some getting used to. Thank you, both of you. Those were just tremendous points. I mean, I can already think of a million questions that our audience might have just preemptively, but I wanted to pick your brains a little bit about Laura's point about simplifying the message. That's a very powerful point, and as you, both of you alluded to at different points in your talk, is as physicians, we are taught to be holistic. We are taught to be all-encompassing. We are taught to appreciate uncertainty or differential diagnosis, going back and forth. Nothing is ever black and white. It's almost always shades of gray. So in such a situation, when you are facing questions from a larger pool of reporters or from the lay public, how do you address this? How do you go back to that message? How do you simplify? What strategies do you use? I think that's a great question, and that's where I think Leo made the point about taking a little bit of time to prepare. So not walking in cold, not picking up the phone cold, I think makes a big difference. And preparation probably doesn't need to be, you know, hugely long, but really taking the time to write down, for me it's writing, to write down a couple bullet points of what I want the take-home message to be, right? And so if it's giving, you know, Leo mentioned, you know, giving out public information about heat stroke. So like, if you use that as the case example here and say, what do I want that take-home message to be? If somebody listens to this interview or reads it, if it's in print media, what do I want them to walk away from? This knowing. And so those, that's what I kind of use as the framework for what's my message here. And so if my message is, you know, stay indoors because it's going to be very hot out, or if you're a vulnerable population, I'm going to come back to that again and again throughout that, because we know people don't hear and don't learn things necessarily the first time they hear them. So if there's a really central take-home point, I want to make sure that I mention that a couple times from that, and stay away from, well, you know, heat stroke is very complicated medically, here's what happens, and getting, you know, getting deep into the, doing a deep dive in the pathophys, but rather if my central message is around safety, really coming back to that again and again, and avoiding some of the stuff we can kind of go down a rabbit hole about in terms of, well, this is what happens, and this is why we're so worried about it, and going from there. So I personally find writing it out as a couple of bullet points to be very useful. Yeah, and I think that's right. That's what I'll do. I'll just have a little index card where I've written things, and if I'm on desk, it'll be on the desk in front of me, where I know these are the things I want to stick to and try not to go too far off topic. And like you said, keep it simple. I mean, you remember your audience and who your audience is, and they're not going to be physicians or medical students or anything like that. It's going to be the general public, and they're going to have a much more basic knowledge of the things that you're talking about, and things that you're talking about. So don't go deep into physiology or things like that. Really keep it at a conversational level. I think you raise a good point, Leo, about making sure that you know who the audience is. So if it's someone from the lay press newspaper, that's very different than somebody from even a trade journal, right? So if you have a high profile abstract that's being presented at SCCM, for example, you may get approached by folks from trade journals to say, you know, can you break this down? We want to report on your abstract in one of the medical trade journals, and how do you break that down? And that'll be a little bit more technical, but I still think keeping it quite simple is probably a good approach. And to bring it back to, you can always reference people to the primary paper, your primary abstract, right, for a more technical reader. But what you're trying to provide is sort of an overview lay summary, I think, even to a trade journal. Those are great points. Your point about knowing your audience is very, very important. Leo, I wanted to touch upon a point that you had mentioned, and we kind of talked about briefly here, is the preparation timeline. Somebody who is, you know, an expert or a senior intensivist like you probably just needs a flashcard. But for some of our early career or in-training folks who might get approached for the odd interview, especially, like Laura said, if they're presenting a really good abstract and that gets taken up or is of timely or, you know, educational value to the lay press, what recommendations do you have for a preparation timeline? How should they stack up towards the interview? Yeah, and it doesn't have to be a lot. Remember, most of the interviews that you're going to be giving are probably going to be three to five minutes for the most part. I mean, you may get into a longer one for a specific topic, but they may interview you for five to ten minutes and then use sound bites from you for a few minutes or even shorter than that. I've done some and all they took was one sentence that I said. So, it doesn't have to be a lot of preparation. If you are going to be presenting facts or data or whatnot, just make sure they're correct and that you validated that number because people will go and do that after the fact. So, if you're presenting a study about cooling or whatnot and talking about that, you say what percentage of people recover on it, just make sure that whatever you're quoting, there's data that you can identify identify behind the scenes if you need to. But yeah, I mean, I don't think it needs to be depends on your topic, but I don't usually, I don't see you having to prepare more than a day or two in advance to do that. Again, most of them are going to be pretty short and they're going to want just a few tidbits of information from you. And often you're not going to get a lot of notice ahead of time about it being requested or arranged, right? They may, oftentimes the writer may be or the interviewer may be on deadline. And so, being timely in your response to a request is really important. If you want to follow through on the opportunity to give the interview or, you know, then I think you need to be quite timely in your response to it because often the writers or the interviewers are on a deadline. So, they'll say, you know, can you do this today or, you know, before 2 p.m. today, that's when I have to get it to my editor. So, you may not have a lot of notice from that. So, it's sort of an imposed deadline, but it also takes the end up because then you don't have three days to stew over what you're going to say. You just keep it simple and, you know, be and then get it over with. Yeah, for sure. Maybe a tangential but related question. This came up to me when I was thinking of Laura's Ebola discussion. How has your individual experience been or your institute's collective experience with COVID and all the, you know, requests for interviews or requests for information that comes to your hospitals? how do you guys deal with it? What are your policies and protocols and your individual or collective experience? I think Leo already mentioned a lot of it, which is certainly if you're being requested to speak on behalf of the institution, that always needs to go through the institutional PR, whether it be the public information officer or the correct institutional person for that. I can tell you at UW, it's been sort of, many of the requests do come through the media relations group, and then they have, so they may reach out to me or colleagues and others to give comment on a particular topic from that. And then if I get requests separately, through my own email account at the university, I always clear those with media relations before I accept or decline them and just say, here's what has been requested to them. Similarly, if you get asked by SCCM to give comment on something, they need to know that, or if it's related to one of your, if you're a volunteer on a committee at SCCM and you're going to make comment about those committee activities, SCCM should know about it from that. And there's a media relations staff member at SCCM to help guide you through that process as well. So I think the requests can come in via multiple pathways, but the key is always, as with everything we do, right, is communication, communication, communication. So make sure that the relevant parties are all aware because nobody wants to be surprised that, oh, Laura went on TV and she said, what? No, and I think that's very true. And the media people, don't get us wrong, the media people are very helpful for your media services. They are very helpful and they can really guide you through a lot of these things. But even if it's something that you don't think is going to be related to your institution, like Hopkins or wherever you are, it's probably still a good idea to let them know you're doing this. Number one, they can help you. And number two, it's never good to catch them off, catch your parent institution off guard. So I think there's a lot of benefit to engaging media services from your own institution, regardless of what you're being asked. And they'll tell you what you need to do and whether this needs to be vetted through a certain part of the organization or not. So they're very helpful when it comes to it. Many of them are also former journalists. And so they'll have a lot of experience in this. So you can always ask them for a five minute, 10 minute tutorial before you do it to kind of refresh your memory about what you wanna say and to do that. I think you don't, they're there to support you as you do this as well. So don't be shy about asking for guidance sort of right before you go in as a just-in-time training. Now, these are great points. Another related question that came up was, what are young guys who starts about physicians, especially those in administrative and leadership roles, taking on formal or professional training for these kinds of endeavors? Are there options out there in your knowledge or do you think it's beneficial or what should be the approach for leaders and administrators? I'm not sure. I assume there probably is some media training. It depends about how, it depends really how much of this you're gonna be doing. If this is once or twice, probably pointers from your media services would be more than adequate. If this is gonna be an ongoing part of your job going forward, you're the head ICU doc who's gonna be making statements for all ICU care or issues going forward. If you're gonna be in that role as part of your job and you're gonna be doing it more frequently, then it's probably worthwhile to kind of get yourself a little bit more official training. I'm not sure what the resources are for that, but your media services people can certainly guide you in the right direction. Yeah, I agree with that. I did a little bit of it just for sort of interest sake. I found it useful. The concepts are not especially complicated. The one that I did was through a professional society and it was interesting because they actually brought in some media consultants. They did a little bit of like the role play that everybody kind of hates, right? But they did some role play with video and then you had to watch yourself on video. And I find that kind of thing excruciating to watch, like to watch myself on video. Like I find it so painful, but it was informative because it sort of tells you like, oh, here's what my body language looks like. And so it was useful in that, even though I didn't find it fun in the moment. No, that's refreshing to hear that somebody as senior as you still doesn't like doing these things. That's good to hear. Now, the other specific question, specific to critical care that I had was, it's a very rapidly evolving place in the hospital. Things happen in very short notice and especially with COVID, especially specifically with COVID, a lot of our information has evolved as the disease process played out. So how do you guys deal with that uncertainty? How do you approach contradicting pieces of information, either misinformation or disinformation as it's currently called? How do you guys approach these sticky situations? That's just really hard. I'll be really interested to see what Leo has to say about it. I kind of think there's two elements to your question. One is, how do you manage conveying uncertainty in a way that still gets a message across and builds a relationship of trust with whomever you're communicating with, right? And then the second element is, I think a really important one, which is what is our obligation as healthcare workers to speak out or to try to correct disinformation or misinformation? And so I think the first one is, I actually think people can handle uncertainty. People like certainty, but I think to me implying certainty when there is uncertainty probably does more harm than good. And I think people actually have the strength and resiliency most of the time to handle uncertainty. So I think being very forthright about where we are, what we believe we know, what are still the unknowns and what do we hope to learn, right? And that things may change and evolve. I think that's a message people can generally handle. I think it's then important to make sure that that loop gets closed when we do learn additional items or things has changed to go back and say, this has changed and here's why. So I think there is a sort of a loopback process that's necessary for that. I think the piece about misinformation and disinformation I think is so complicated, right? And there are some very loud voices that are spreading bad quality information out there. And it's sort of funny as somebody who doesn't really like doing media all that much, I also think that we collectively probably have not done enough as a specialty, as a field and as a profession to collectively speak out about misinformation and disinformation. Because I think that our voices are often being sort of drowned out by bad information. Yeah, and I think, remember you're not on trial, so it's okay to put some qualifying statements in there. And you should do something when you're not sure. Not everything you say shouldn't have a qualifying statement on it, but if you're not sure or if we don't know the answer to that yet, that's what you should say. Don't try and make more of a case than there is just because that's a topic you're being asked about. So I think it's very important when the facts aren't clear or when it's an evolving process, which COVID has been for the past years, it's okay to say that and you should say it. Again, don't say it for every point you make, but for the ones where we really don't know, I think that's the prudent way to go so that you're not spreading information that may or may not be true a week or a month from now. Absolutely. No, these are great points. And the other, maybe not directly relevant to a media interview, but the other piece that I wanted to ask you both is your principles or policies when you behave and interact on social media platforms. It's not directly relevant to this, but it's oftentimes a window into how the professional societies or professional opinions are playing out. I guess the main thing is don't put anything out there that you don't want everybody to read or see. I mean, I think that we've all learned that over the years that once it's out there, it's out there forever. So I think even if it's your own personal account, you need to be cautious of that because people will look at it. I know that medical staff offices or when they're doing credentials and whatnot, routinely mine the social media to see if there are any red flags out there. So I think you're certainly allowed to have your own voice and your own opinion. There are ways to do that that are more acceptable than others. So I think just be careful and just know that whatever you put out there is there probably forever and can be discovered. But I think that's the main thing that people forget. Well, it's my own Facebook account. I can do what I want. And yes, you certainly can do what you want, but it may impact on you later on as well. Yeah, I think that's a really good point is I assume we're talking about personal accounts, not sort of professional or work accounts on social media with that. We all have the right to express our opinions and we should feel comfortable doing so. I often remind myself that things can get taken out of context as well. So we all know that we've all sent an email that we thought was really clear, but somebody read it and interpreted it in a different way or the tone that we intended wasn't how it was received. And I think social media is very vulnerable to that. We may intend a certain tone, levity, joking, and that may not come across from that. So I think we need to be, I try to pay particular attention to the tone by which I'm saying something and be aware that other people might interpret it differently than I do. And it does live on forever for sure. And there are definitely employers out there. If you're looking for a position or your fellowship match, there are programs that will look at social media accounts and take that into account when you're looking at that. And one mistake that I have seen people make numerous times, all too many times is posting things that contain patient identifiable information, which we all know not to do that, but it still ends up out there. And so I think just being especially cautious that if you're posting anything that could potentially be identified by any fluke, don't do it. Yeah, I think that may, and you'd be surprised how patients can be identified. You're talking about somebody in your ICU who you don't mention their name or anything was in an accident two days ago and blah, blah, blah. That is still identifiable and people can come back. The other thing that I tell all my team is don't post or write or send anything when you're mad. If you're mad about something, I tell them write the email, get it all out, put it in your save box for 24 hours, and then go back and look at it and see if that's really what you still wanna say. Most of the time it won't be or you'll tone it down, but try and information is immediately accessible now to everybody. So if you're upset about something, what it is a temptation to either go on your social media page right away or write an email, just take a minute, especially if you're in a leadership position, just take a minute and think about it before you post it. Like I said, go ahead, write the email, put it in your save box for 24 hours and send it out the next day. That's saved me plenty of time. It feels good to write it when you're mad, but don't send it. So you- It feels good, just don't push send. Just hold on the send button for 24 hours. And I approach social media with the presumption that even though it's my personal account, it reflects on me professionally. Yeah, definitely. These are just tremendous tips. Leo, I especially like your tip about sitting on it for 24 hours. And more than me, I suspect my wife will like that more considering how many ranting sessions I'm saved with every night. But that's all in jest, but these are tremendous tips. So let me summarize maybe six or eight bullet points that I have taken home personally in the last 15, sorry, last 20, 30 minutes of conversation. One, never walk into something that you are not prepared for. Always have a plan. However brief, however abbreviated a plan, but have a plan. Number two, stick to your message. Try to make it consistent, simple, and emphasize it repeatedly so that the right points are highlighted. Number three, be genuine, be honest. Don't either overstate or understate your cause. Try to be objective, but also simplify the message so that there's not an ordeal of numbers and inferences to be made from what's being presented. Number four, in public, all forms of public life, be it on social media, in print, or TV media, try to present the same consistent professional image of yourself. Try not letting your personal biases, personal thoughts, influence how you project a situation. Protect, next point, protect patient privacy in multiple ways, not just known HIPAA violations, but also unintended ways of violating HIPAA which can lead to unfortunate situations of patient recognition or whatnot. And finally, never write anything in extremes of emotion of whatever kind is what I've come to understand. So try to sit on it, try to think about it, re-address it in 24 hours. And I think this is something that both of you emphasize, but never really said as much, but somebody else told me this is never write something that your parents will be ashamed to read. And I think those are all phenomenal tips and I'm really grateful that at least, if not for everybody else in SACM, at least the three of us had the session because I've certainly learned a lot. So maybe before we wrap up, final closing thoughts from both of you for our audience and across SACM Crosstalk. I think your summary was far more eloquent than I was. I can't speak for Leo. Yeah, no, I agree with everything you said. And I just say, when you get the opportunity, just go out there, have fun with it because it can be fun too. Agreed. Wonderful, wonderful. Again, Dr. Laura Evans, Dr. Leo Rotello, thank you both for spending your time with us. Thank you for this wonderful conversation. My name is Dr. Saras Chandra Vallabha Josula. Thank you all for attending this talk and we look forward to many more from both of you. Thank you. Thanks.

media interview

simplifying the message

honesty in communication

addressing uncertainty

spreading misinformation

social media impact

building trust