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The importance of tailoring the message to the audience was one of the lessons reinforced during the recent AAOS Board of Directors workshop on communications. According to keynote speaker Ronni Burns, adjunct assistant professor of management communication at the New York University Stern School of Business, an “audience-centered” approach is necessary to ensure that the message is received.


Published 6/1/2014
Frederick M. Azar, MD

Do You “Get It”? The Message, I Mean

I do a lot of talking to people. I talk to patients, residents, colleagues, other healthcare professionals, my family, and friends. And in each case, I tailor what I say. For example, in discussing a case with a colleague, I might say, “This patient has a large rotator cuff tear, chronic biceps tenosynovitis, and symptomatic osteoarthritis of the acromioclavicular joint.” When I sit down with the patient, however, I will start with, “I understand that your shoulder hurts.”

Your Academy speaks to many audiences: to you as members, to policymakers and regulators, to payers and device manufacturers, to media representatives, and to patients and members of the public. During the workshop, board members looked at each of these areas to see just how we currently communicate and how we could communicate better.

Member communications
is perhaps the Academy’s most obvious member communication vehicle. Currently ranked as the third most widely read orthopaedic publication (behind only The Journal of Bone and Joint Surgery and the Journal of the AAOS), AAOS Now is regularly reviewed to ensure that the content remains relevant. This year, a readership survey is being conducted; if you are invited to participate, I encourage you to take the time to complete the survey. We want to know what readers think so that we can continue to improve the publication.

E-newsletters are becoming increasingly popular, and the AAOS produces several, usually targeted to specific audiences. The e-newsletters known to most members include the thrice-weekly AAOS Headline News Now, which brings you information from the wider media relevant to orthopaedics, and the biweekly Advocacy Now, which covers legislative and regulatory information from our office of government relations. Targeted e-newsletters include the following:

  • AAOS in the States, a quarterly publication for state society executive directors
  • BOC/BOS Bulletin Board, a monthly mailing for members of the Board of Councilors (BOC) and Board of Specialty Societies (BOS)
  • BOS Washington Update, a regulatory and legislative update for leadership in the BOS
  • Orthopaedic PAC Report for donors to the Orthopaedic Political Action Committee (PAC)
  • AAOS Residents’ Newsletter, a monthly newsletter for residents
  • Specialty Speaks, a resident newsletter from the BOS featuring specialty societies

Web-based media, such as the AAOS website, Twitter, podcasts, Facebook, and YouTube, are also among the Academy’s armamentarium of communication vehicles. The Board also discussed increased use of these vehicles, not only to obtain and disseminate information, but also to understand the perspectives of various audiences. Twitter, in particular, may be useful in following happenings in Washington, D.C., and measuring the response to various legislative proposals.

It has been said that if you do NOT want orthopaedic surgeons to read something, you should mail (or email) it to them directly. There is a lot of “noise” out there and it is difficult to know what is important to read. Going forward, the Academy will be looking to fine tune that noise to better enable our members to know whether communications are “must reads” or “might reads.”

External communications
As diverse as the AAOS fellowship is, our external audiences are even more varied. Your Academy extends outreach efforts to all stakeholders, including policymakers, payers, industry, and the media. But the largest external audience is the American public, including our patients.

As surgeons, we have been trained to weigh the evidence before making a decision. Yet even we have some blind spots. As Ms. Burns told us, “Logic will make you think; emotion will make you act.” Charts and statistics provide intellectual fodder; stories and analogies enable the emotional connection.

The importance of tailoring the message to the audience was one of the lessons reinforced during the recent AAOS Board of Directors workshop on communications. According to keynote speaker Ronni Burns, adjunct assistant professor of management communication at the New York University Stern School of Business, an “audience-centered” approach is necessary to ensure that the message is received.
AAOS communicates with various audiences in different ways, tailoring the message to the recipient.

For this reason, external communications must operate on both levels. When we advocate in Washington, D.C., we need both the tallies—how many Americans are affected by musculoskeletal disorders and conditions—and the tales—the patient stories of the difference orthopaedic surgery makes in an individual’s life.

An example of how the AAOS combines tallies and tales can be found here, with the stories of patients, clinicians, and researchers who participated in the recent Research Capitol Hill Days. In fact, Sen. Mark Kirk of Illinois was so impressed by one patient’s story that he featured it on his website—a very visible way of showing the value of orthopaedics.

The AAOS engages external audiences on a daily basis, through public service announcements, press releases, op-ed editorials, letters to the editor, comment letters to federal agencies and Congressional representatives, advocacy ads, and relationships (such as the AAOS Key Contact Program, which connects AAOS members and their representatives in Washington). Some of these efforts are staff-driven, but all include input from AAOS members, and the most effective ones—like Research Capitol Hill Days—involve both our members and our patients.

Engaging patients
A key goal of the workshop was to identify ways to engage our patients to be our best advocates just as we physicians are their best advocates. Although not specifically advocacy-related, the AAOS campaign “A Nation in Motion” provides powerful patient stories that can help improve the image of orthopaedic surgeons, underscore the value of the services we provide, and help shift the conversation from “how much it costs” to “how much value it provides.” The campaign highlights personal stories from both surgeons and patients that capture the best of what orthopaedic care can provide to patients.

Although many AAOS members may feel uncomfortable discussing advocacy issues with patients, politics does not have to be a taboo subject. Many patients and their families are supportive of the same issues that concern us, but they may not have the facts or understand the impact that legislation can have on them personally.

We can provide that information and understanding by capitalizing on the audience we have in our offices each day. The Academy has a large array of materials that can be placed in our lobbies for patients to read. AAOS public service announcements and videos can also be played in our reception areas. We can educate our patients about injury prevention, about treatment alternatives for musculoskeletal problems, and about advocacy-related issues designed to preserve their access to our services.

Of course, the greatest potential vehicle to inform our patients about musculoskeletal issues and how to effectively communicate with their Congressional representatives is through the AAOS website. AAOS.org has recently undergone a usability study to determine how it can be improved. Going forward you can look for a more appealing and user-friendly website.

As we explain issues to patients, we must do so from their perspective. Maintaining our ability to offer in-office physical therapy services, for example, means that the patient makes only one trip (to the office), instead of two (to the office and the physical therapist). It means that questions (from the patient or the physical therapist) can be answered immediately instead of after a day or two. It means that treatment adjustments can be made in a matter of minutes instead of hours or days. It means that the patient does not have to rely on word-of-mouth, but can have confidence in the skill and knowledge of the physical therapist because the physician has already vetted the therapist. All of these concerns would matter to patients and may help mobilize and engage them.

To be effective, communication must be credible, authentic, and sincere. Our multiple audiences will understand our messages better if those messages are clearly directed, relevant, and meaningful to them. Whether the communication is a 1,400 word comment letter to a regulatory agency or a 140-character Tweet, the most important goal is that the recipient “gets” the message.