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By Michelle Perron
When Facebook logged its first likes in 2004, no one was predicting that social networking would become a tool in the practice of medicine. Yet it has. From the revered Mayo Clinic to little-known regional specialty centers, the health care industry is finding that social media helps attract new appointments, generate revenue, and build relationships.
Research published in the Journal of Medical Internet Research in 2014 shows that virtually all hospitals in the United States are now using social media in some way.1 This is not an overstatement: 94.4 percent of the 3,371 hospitals reviewed operated a Facebook page, and 50.82 percent had a Twitter account. This study found that private nonprofit and teaching hospitals, typically in large urban areas, are the highest users of social media.
Its expertise in using socia
Although individual physicians aren’t using social media at the same rate as hospitals, they are finding it useful. In fact, another 2014 study, this one by MedData Group, found that more than 50 percent of the physicians using social media for work purposes are engaging with peers, marketing the practice, or providing thought leadership for patients.2
Leading the Way
The Mayo Clinic system is a recognized leader in health care industry use of social media. Tweet this
Lee Aase, Mayo ClinicIts expertise in using social platforms to connect with patients and build business is so valued that other health care organizations lean on the Mayo Clinic Social Media Network (MCSMN; #Mayo Clinic SMN) for collaborative help. In partnership with Hootsuite, the MCSMN even developed a continuing medical education course to teach medical providers how to create an online presence.3
Lee Aase is the director of Mayo’s Social and Digital Innovation Team, which is staffed by eight media professionals who orchestrate the system’s posts on Facebook, Twitter, Google+, Pinterest, and You Tube. Activity on each outlet is unique, as shown below in the Facebook, Twitter, and Google+ feeds one afternoon in mid-January 2017.
Each of the posts focuses on a particular subject area, ensuring a different experience for each media outlet user. The day’s topic selections can be influenced by the request of a Mayo department seeking more publicity (the sports medicine department in the Twitter feed), relevant national news stories (cervical cancer awareness month in the Google+ post), or the opening of a new hospital wing (the fifth floor of the Luther Building in the Facebook post). No matter the content decision, its goal is the same: to instill appreciation for Mayo Clinic and its resources.
In an interview, Aase pointed out that today’s widespread use of social media by Mayo Clinic is in keeping with its history. “Our reputation was made through word of mouth,” he said, “and that is just as true today as it was 100-plus years ago. Patients would come to Mayo Clinic because a friend recommended us. Now, social media provides ways for people to share the same types of recommendations.”
“Just Like Talking to a Patient”
Perhaps the most vivid examples of such recommendations are found on the Mayo Clinic’s YouTube channel, which features videos capturing everything from a patient’s first reaction to his restored sight via a bionic eye to the precise symptom presentation of a baby with whooping cough. No doubt thousands of that video’s million-plus views were by frantic parents trying to determine whether their infant’s bark-like sounds warranted a trip to the local ER.
One of the most powerful applications of Mayo Clinic’s YouTube channel is its line of videos for patients that feature staff physicians and other clinicians. These videos can offer information and encouragement to a patient trying to understand his or her rare diagnosis, reinforce the education provided during a complex office visit, or calm a patient’s unease before a surgical procedure by providing a step-by-step visual explanation of it.
Take, for example, the diagnosis of ventricular tachycardia, a condition that causes the heart to beat faster than normal. It can be treated with medication, surgery, or both. To a patient receiving this diagnosis after experiencing rapid heart activity, the term alone sounds ominous. By directing a newly diagnosed patient to a YouTube video accessible in the comfort of home, Mayo Clinic can repeat the information presented at the treating physician’s office. The video presentation is likely to be better understood because it is more digestible. The Mayo Clinic’s YouTube channel features videos on ventricular tachycardia and many other topics.
The educational application of social media is particularly appealing to busy physicians. They typically don’t have the time to prepare lengthy written material — but they’re more than happy to talk about what they know and what they can do for patients.
“For many doctors, it all comes down to time. That’s where the capturing of video is so helpful,” Aase said. “We [the communications team] take care of everything. They are happy to share their expertise in a manner that is just like talking to a patient.
“In the videos, we’re looking for them to say the things they say to patients several times a day, only to a broader audience,” Aase continued. “They’re demonstrating their expertise and showing empathy. We book a 15- to 30-minute timeframe and make them at ease. It’s a much more efficient use of time, and it is more impactful and genuine.”
Mayo’s Social and Digital Innovation staff uses smartphones and consumer-grade cameras to shoot video, then edits and loads to appropriate channels. As physicians and other Mayo Clinic staff members have been exposed to the value of social media via these video sessions, more are requesting that the team help them “take control of their identity” on LinkedIn and Twitter, Aase said. He and his staff regularly coach interested physicians in how to beef up their profiles across platforms.
Setting Ground Rules
In an age when a Twitter rant can get you fired, it’s important for all employers to have clear policies for social media usage. This is especially true in the health care industry, where privacy of information is sacrosanct. The Mayo Clinic developed guidelines for employees’ social media activity, and many other hospitals have followed suit.
The document boils down to common sense and the practice of established medical ethics. “The main thing is that they should stick to talking about what they know and what they do,” Aase said.
“No one should practice medicine online. We advise them to elevate it out to general terms, such as ‘a patient with these symptoms may have this condition, and these are the standard options for treatment.’ This highlights their understanding and avoids looking like they are giving a prescription to a patient.”
Granted, most hospitals don’t have the size or patient reach of the Mayo Clinic. So what about hospital use of social media in smaller settings and markets?
In a mid-sized or small city, the approach can be more streamlined and personal. The emphasis may also be on community relationships and trust more than branding on a large scale.
Lafayette Surgical Specialty Hospital (LSSH) in Lafayette, La., is a surgery center owned by 34 physicians in various surgical specialties. The mid-sized city of Lafayette is a competitive market for health care services (nine freestanding hospitals for a population of 124,000), and LSSH distinguishes itself by creating a facility where health care meets hospitality. Liz Hebert is the director of marketing and business development for Lafayette Surgical Specialty Hospital. Since she was hired in January 2015, she has focused the facility’s social media outreach on Facebook, where she works to build a sense of trust. She automatically feeds the LSSH Facebook posts to the hospital’s Twitter feed.
“I want to show people that we are involved in the community,” she said. “We use Facebook to inform the public about things we are involved in, and to show that we are a trusted resource for information.”
As shown above, Hebert recently used the LSSH Facebook page to promote a community event she organized in conjunction with a new fitness facility. Anyone who saw the page was invited to a free class at a new indoor cycling facility near the hospital.
One of the most effective uses of social media at LSSH is highlighting the community-oriented activities its staff is involved in, Hebert said. The hospital uses its social platforms to feature events like its “31 Days of Giving Back” campaign during the month of December that encouraged random acts of kindness and a spring scavenger hunt that raises money for the local United Way chapter. Other posts report on patient satisfaction surveys and honors received by staff members.
“For me, the most important reason for our hospital to use social media is to develop a level of trust,” Hebert explained. “Even when you are confident in your choice of a surgeon and hospital, you’re still nervous. With our posts, and our day-to-day activities, we try to reduce those fears. We care about the community. We are dedicated to your care. Social media is one important way for us to get that across.”
- Griffis HM, Kilaru AS, Werner RM, et al. Use of Social Media Across US Hospitals: Descriptive Analysis of Adoption and Utilization. Journal of Medical Internet Research. 2014;16(11):1-11.
- Silas R. How Are Physicians Using Social Media? MDigital Life.com. http://mdigitallife.com/how-are-physicians-using-social-media/ Citing work contained in the following report by Med Data Group: https://www.meddatagroup.com/wp-content/uploads/MedDataGroup-Physician-Adoption-of-Social-Media-Q22014.pdf
- Mayo Clinic Social Media Network. Social for Healthcare Certificate from Mayo Clinic and Hootsuite. https://socialmedia.mayoclinic.org/social-media-basics-certification/
By Victoria Cayce
Linda was feeling bad. Really bad. She had been overly tired for a week, but since her kids had just gotten over a bug they picked up at school she assumed that the nausea and fatigue were related and went back to plowing through her busy day. Then her upper back began to ache. The dull pain in her chest was making it hard to breathe and she was sweating. She ignored it and kept on going. Three hours later, Linda was dead at the age of 45.
Remember back in high school when your teacher was telling you that knowing how to diagram a sentence would be important later in life? While a dangling participle is not a likely cause of death, she may have been on to something. Good communication, or the lack of it, is directly linked to the outcomes of cardiac patient care. And that is a matter of life and death.
In the story above, the hypothetical Linda ignores her symptoms because she simply doesn’t know that heart attacks often present differently in females than they do in males. If she had been aware, she would have been more likely to seek emergency treatment that might have saved her life. Sadly, the story of Linda plays out in real life every day.
Leading Cause of Death in Women
While more and more people have become aware of the dangers of breast cancer and the need for self-examination, many more women are completely uninformed about their heart health. The case for informing women of the dangers of breast cancer is laudable; however, these same women are at greater risk of dying from a heart attack or stroke. According to the Center for Disease Control 1 in 31 women die from some form of cancer each year while one in every four women die from heart disease. The key to improving these numbers is at the local level; healthcare professionals are on the front lines and must do a better job of educating their patients about the risks and symptoms of heart disease in women.
Perceptions are Everything
Studies have shown that the public has a perception that heart attacks happen more frequently in men. The great disconnect for women is not helped by the media, which tends to portray the dramatic “Hollywood heart attack” of someone (often a male) who is gripping their chest before they collapse. In reality, many women experience either no symptoms or a dull pain or discomfort that may radiate to the throat, arm, or jaw.
Medical providers can do a lot to break this myth by simply talking to their patients about the differences and making information more accessible for them. For example, doctors could start by adding a few questions to the forms that new patients fill out regarding their family history of heart disease. They would follow up by briefly explaining the warning signs for female patients. The questionnaire might include targeted keywords related to the symptoms such as:
- Have you been feeling excessively tired in the last few weeks?
- Have you experienced pain in your neck, back or jaw?
- Have you been having stomach pain?
- Have you been having chest discomfort or pain?
When patients leave, a nurse, technician, or a member of the office staff could hand them a packet that contains small laminated poster with a magnetized back that can hang on a refrigerator door. Medical offices can also display colorful informational posters that clearly explain things that female patients and their families should know including:
- How minutes count when someone is having a heart attack
- How they should give someone with the symptoms of a heart attack an aspirin
- The differences in male and female heart symptoms
Another reason that female patients tend to press on and ignore heart related symptoms is that they do not feel emotionally comfortable seeking medical care. They may also regard their own symptoms as trivial. Doctors and nurses need to create an environment in which female patients especially feel comfortable reporting their symptoms. To address this issue, medical providers must create an atmosphere of trust.
Open Doors Save Lives
For instance, when discussing issues related to cardiac care, physicians and their staff need to stress the fact that they have an open door policy, and that symptoms should never, ever be ignored. Explaining that it is OK to seek medical care (and that they will not be dismissed out of hand) will go a long way in removing the emotional barriers to care and alleviating fears of being dismissed or labeled a hypochondriac.
Unfortunately, the fear of being labeled may not be that far off of the mark as a study published in the New England Journal of Medicine involving more than 10,000 cardiac patients (48% were women) demonstrated that females under the age of 55 were seven times more likely to be turned away than male patients while they were actually experiencing a heart attack. The most common misdiagnosis assigned was listed as “anxiety.”
Women Say it Differently
In part, this problem may be related to the fact that women often use different verbal clues to express their symptoms. For instance, female patients are much more likely to complain of “discomfort” while male patients use the word “pain.” When combined with the more subtle symptoms of heart attacks in women, this tendency can easily lead to a misdiagnosis.
Furthermore, in an American Medical Association study that included more than one million patients, females were found to be twice as likely to die while hospitalized when their symptoms (including changes in an EKG) were not expressed in the classic way that males do when experiencing in a heart attack.
Communication is therefore even more critical to providing appropriate care to female patients. Medical providers must go beyond the basics and employ active listening that allow for the inherent differences of male versus female speech patterns and word usage. They must then apply more aggressive treatment strategies when a heart attack is suspected. In other words, they must be willing to dig deeper when females present with less specific and immediate heart related symptoms.
Communicating in a Social World
Marketing campaigns have had a significant impact on breast cancer awareness. The Susan G Komen Foundation, for instance, uses social media, blogs, touching real-life stories and marathons to help raise funds and awareness. Doctors and nurses can use the same approaches to educate women about heart attack symptoms. They can get their message on social media. They can write engaging blog posts with relatable stories and critical information about heart attack symptoms in men and women. Their posts can include valuable resources, too, including tools for heart health such as the Heart Attack Risk Calculator.
Local health care providers also can incorporate national awareness campaigns into their grassroots efforts. The American Heart Association has created a short film to educate women called Just a Little Heart Attack that is very sharable and could be embedded in social media. Additionally, medical personnel can spread information by holding heart health awareness events that offer free cholesterol checks and heart health screenings. Volunteers could hand out:
- Red bracelets ( The American Heart Association has designated red as the color for heart awareness)
- T-shirts with heart health slogans and information
- Red balloons
- Memorabilia such as cups, magnets and bumper stickers aimed at increasing awareness
Doctors and hospitals also can team up with professional writers and marketers to create slogans and messages that the public can understand and respond to. They can connect with local news stations to get the word out about events.
Anyone working in a busy practice understands that time is extremely limited. But bolstering medical practice’s heart attack awareness efforts with a social medial campaign, as well as a blog aimed at a lay audience, gives you the ability to get your critical message across to far more people. The point is to get the word out as often and as clearly as possible, and ultimately, to save lives.
Having to choose between that and which is one of those tricky little grammar rules that used to trip me up constantly as I wrote.
To spare you the same aggravation, I’m sharing the words’ definitive usage guidelines:
That is used solely in restrictive clauses, meaning it introduces specific, essential information in a sentence. As a general rule of thumb, that is usually used in sentences without commas. For example:
The cat that was on the porch slept all day.
The shoes that she bought yesterday were very expensive.
Both of these sentences contain restrictive dependent clauses, giving us specific information about what is happening. The first sentence “restricts” the subject “cat.” It is used to separate the cat on the porch from other cats that may be in the bedroom or on top of the refrigerator. Put another way, you could say that “only the cat on the porch slept all day.”
Same scenario in the second sentence, where that restricts the shoes she bought to yesterday only, and doesn’t include any of the shoes she may have bought on any other day.
Which is used to introduce a non-restrictive clause, a clause that gives us extra information that may be interesting or incidental but does not define the subject. A fun way to remember this: which clauses can “fly away like a witch,” meaning they can be cut from the sentence without changing the meaning. In order to form a restrictive clause, use which and insert two commas around the clause.
The cat, which was on the porch, slept all day.
This sentence tells us essentially the same thing, a cat is sleeping, with one key difference: the cat just happened to be on the porch. Adding the non-restrictive clause gives us extra information about the cat – that he was on the porch – but it does not alter the meaning of the sentence, “The cat slept all day.” Notice the commas that bracket off this new information.
And you can reconstruct the form in the second example in the same way:
The shoes, which she bought yesterday, were very expensive.
The reader knows that someone bought shoes; the fact that she bought the shoes yesterday is just an extra piece of information bracketed off from the rest of the sentence. Again, we have commas separating the non-restrictive clause from the rest of the sentence.
As a general note, that can NEVER be used in a non-restrictive clause. To say “The cat, that was on the porch, slept all day,” is incorrect because of the comma usage.
Also, when speaking of people, always use who rather than that or which.
3. Combining the Two
Don’t be afraid to combine that and which once you have the correct usage down. For example:
The shoes that she bought yesterday, which cost more than $500, were very chic.