Inside the Media Training for ER Docs to Learn to Talk About Ebola

It was toward the end of the second day of the largest conference in the country for emergency physicians, when the official Twitter account for the American College of Emergency Physicians (ACEP) sent out this little nugget of truth:

#Ebola is not the only topic at #ACEP14. It just feels that way.

The conference host was dead on. With over 7,000 emergency physicians flocking to ACEP’s annual Scientific Assembly in Chicago last week, talk of Ebola was impossible to avoid. It seemed questions such as “is your Emergency Department ready?”, “Are your protocols set?”, and “Is everyone properly trained?” seemed to permeate conversation.

On Day 2 of the conference, ACEP hosted a course called News Media Training 101, which, not surprisingly, used ebola as a test case to train hospital spokespeople on how to handle a television interview. Shelley Sims and Nan Tolbert, a pair of media consultants from The Communication Center, emulated moderately aggressive TV interviewers, as ER physicians from all over the country took turns going in front of their cameras.

Physicians learned to rely on a set of ebola talking points being distributed nationally by ACEP. The talking points lack drama, and that’s the point.  Designed to avoid or mitigate controversial issues, the talking points instead focus on conveying useful information and calming fears.

Some physicians were naturally adept at handling reporters, even when fielding tough leading questions. But others were failing to be clear and calm when pushed, especially when faced with the fear mongering and blame game types of questioning hurled at them by Sims and Tolbert.

The role playing exercises made for some cringeworthy exchanges*:

Interviewer: Ebola cases just seem to be popping up everywhere. Is it time for the public to start panicking? ER Physician: I think the public should be concerned, not panicked. Interviewer: But isn’t it true that there is no known cure for this disease? ER Physician: That is true. There is no actual cure. But we are working on vaccines, and hopefully those vaccines will be coming soon.

You couldn’t be blamed if your takeaway from the exchange was that ebola is indeed sweeping across the country, with no known cure, no vaccine, and no end in sight. The lesson from this exchange was to stop repeating the interviewer’s incendiary words and pivot to your core messages.

Yet, physicians often failed to respond to questions with any fear-assuaging information: that ebola is extremely difficult to catch, that only a small handful of people have been infected, and that the nation’s healthcare system is well-equipped to deal with the disease.

Nor did the doctors dole out information of value for anxious members of the general public, the so-called “what’s in it for me” stuff. In the case of ebola, it’s this: if you have recently traveled to an ebola-stricken country and are showing flu-like symptoms, you should immediately dial 911 or call your local health department. And, if you aren’t displaying flu-like symptoms, for God’s sake go get a flu shot – if there are fewer cases of the flu overall, the task of picking out ebola patients will be made that much easier.

Interviewers put the physicians on the defensive over past handling of flu cases. The questioners repeatedly offered them opportunities to throw Texas Presbyterian Hospital under the bus for its role in missing the first ever diagnosis of ebola in America. They opened up the CDC for criticism for its evolving guidelines to hospitals, which may or may not have contributed to early mistakes. Interviewees also faced multiple open-ended questions, like, “Is there anything else the public should know about this disease?” Assurances that “We have everything under control, don’t panic” fell flat.

Mistakes aside, a New York physician undergoing the excercise skillfully handled several difficult questions: “Do you agree with Governor Cuomo’s decision to quarantine certain travelers?” … “We are working very closely with the Governor’s office and local health offices. I’m not here to second-guess the Governor’s decision-making, but I’m sure he is trying, as we are, to protect the health of all New Yorkers.” … “How many ebola patients is your hospital prepared to see?” … “We are prepared to treat anyone who presents to our Emergency Department who has the symptoms and travel history consistent with a potential ebola diagnosis.”

Still, emergency physicians clearly feel defensive about the issue. ER docs do not want to criticize or blame one of their own, and they are quick to rise to the defense of fellow physicians or other departments when they’re being attacked, fairly or not. After his mock interview, the New York doctor explained one of his more defensive responses, saying he was sick of the media and the public demonizing Dr. Craig Spencer, the New York doctor recently diagnosed with ebola, who travelled around the city for six days after returning from Africa. Spencer, who is an authority on ebola, was monitoring his temperature every day after his return. When he found he had a 100.3 degree fever, he immediately contacted health authorities.

It’s that defensiveness which has seeped into many emergency physicians’ thinking as they ponder how, or even whether to respond to media requests about ebola. The ACEP media training, even if its prescriptions were a little obvious, clearly helped. Responding to a tough interview situation, and then reviewing your performance on TV, help immeasurably.

ER docs, by nature and training, are good at remaining calm and collected – but even the most level-headed physician can still freeze up when a camera is thrust in their face and they’re put on the spot with an accusatory question.  But as with other aspects of their roles as physicians, when that situation occurs, it is their responsibility to do what will benefit the health of society – and not to let fear and misinformation win the day.

*All exchanges and quotations in this story are paraphrased from my notes as I sat in on the training.