Tuesday, January 25, 2011

Who Should Manage Your Social Media Strategy [Accepted for publication in The Physician Executive]

By Kent Bottles, M.D., and Tom Sherlock

Hospital and medical group leaders are facing the most challenging healthcare environment in recent memory. The need to decrease per-capita cost and increase quality to respond to federal healthcare reform and the global economy is a daunting task that requires two-way communication with a broad range of stakeholders. As reform unfolds, hospitals and medical groups of all sizes are embracing social media tools as soon as they realize that they're no longer optional.

At least since the first quarter of 2010, analysts have been reporting that websites and search engines no longer dominate online communication.[i] Deloitte's Social Networks in Health Care[ii] recently concluded that healthcare executives “who do not consider how to incorporate social networks into their future strategies risk being run over on the super-highway of health information sharing.”

Your social media strategy will work more smoothly when no one department has control, because it's likely that before long employees in many of your departments will be using social media to do their jobs. It's time for your Internet strategy to be managed by a qualified person definitely one of your best-and-brightest who reports directly to senior management and works with all department heads as an equal colleague.[iii]

You no longer have the opportunity to be an early adopter, but you can give yourself a big advantage by having people in every department who've been trained how to use social media intelligently, and who follow the lead of your social media manager. It's essential that you understand that each of these tools is designed to nurture personal relationships and thereby strengthen loyalty to your institution:

  • We use Twitter as our principal example because it's a more important business tool for hospitals and medical groups than Facebook.
  • If your organization isn't already on Facebook, you should wait until you have a specific strategic reason for using it.
  • Blogs can be particularly effective business tools if they let readers get to know and understand the blogger. Paul Levy’s "Running a Hospital" blog[iv] has shown how a CEO blog can be a powerful communication and branding tool.
  • Many of your people should be listed on LinkedIn. Each person's profile will be unique, but a certain amount of coordination is necessary to make sure your institution is identified accurately and consistently, for example.
  • Your YouTube channel can present videos that let people get to know some of your key physicians and nurses, for example. Your social media manager can see to it that the content, style, and production values of your videos will send the right message about your organization.

You might conclude that you need to hire someone new to manage your website and your social media strategy. But don't rush into a decision to bring in someone new to be your social media manager just because they have experience with these tools. It would be far better to find someone who is already thoroughly familiar with and personally committed to your institution.[v]

Note right away that social media is not something you use for advertising or marketing, and that it doesn't duplicate or replace any of the functions of your website. When you reduce it to its fundamentals, social media strategy isn't complicated. It's social. It's about establishing and nurturing authentic relationships in ways that will build loyalty to your institution. Your social media manager will:

  • Listen to what's being said about you anywhere on the Internet, with special attention to your own social media channels.
  • Respond by engaging those who are talking to or about your organization.
  • Establish relationships by showing people respect, honesty, and enthusiasm, and then nurture those relationships by authentic personal interaction. Your social media manager will gradually get a feel for how much time to put into each of the relationships that are established.
  • Bring to your attention the insights and opinions he's hearing and the facts he's learning so that with his help, you can evaluate any implications for what you do and how you do it. Not all feedback is valuable, but some of it certainly will be. Senior management should balance a healthy skepticism with openness to input from people who use social media to tell you something.

There really are no social media experts, because we're all still trying to find the best ways to use these tools.[vi] One of us has been on Twitter since June 2008, and one of us is among the most influential physician twitters according to several metrics. We each spend at least two hours a day on Twitter, and yet we cannot claim to be an expert on how you should use Twitter or the other tools — because your social media strategy will have to take into account a unique combination of goals, strengths, target audiences, and local concerns.

Adopting an effective social media strategy involves a challenging but rewarding process of discovery that must be done in-house. A smart, creative consultant with significant experience in healthcare social media can fast-track the process by explaining the basics and best practices, and by helping your social media manager learn how to consistently create content that interests your target audiences.

Social Media Does Not Belong in the IT Department

It's surprising that anything that has to do with the Internet is sometimes still assigned to the IT department. Websites and social media aren't primarily technical matters, and social media may eventually take 50% or more of your social media manager's time (your social media manager should have responsibility for your website too). The rest of his or her time might be spent on content development for your website and keeping up with the literature.

While some IT people may enjoy doing web design, website maintenance, and now social media, one may presume that they were hired to do something quite different. The skills required for IT are a world away from those needed for social media.

Nearly a decade ago, a technical headhunting firm was trying to determine why the Web developers they sent to their clients were striking out so often. The problem turned out to be that they were requiring that a web developer have at least three years' experience with the C++ programming language. They were sending programmers to do a communicator's job. Programmers (and graphic designers) aren't usually the people who have the combination of writing, communication, and relationship skills that are needed to ensure that your Internet strategy supports your overall business strategy.

Social Media Does Not Belong in the Marketing Department

One of your marketing people may be best qualified to be your social media manager:

  • if she's a creative, energetic, and enthusiastic person who is not the least bit cynical or world-weary;
  • if she's enthusiastic about social media, is already using it on her own, and talks about it every day to anyone who will listen; and
  • if she understands that Twitter and Facebook are not marketing platforms. As recently as just a couple of years ago we spoke of “social media marketing” but no more, because that phrase sends the wrong message.

Because developing and nurturing relationships is the whole point, social media can't be effective if it's automated in any way, and for the same reason outsourcing your social media strategy and execution to a marketing agency or other vendor is almost always a bad idea. Agencies may try to persuade you to entrust social media to them, but that's calculated to meet their needs, not yours.

Studies suggest that people like brands with an authentic personality, and your social media manager is going to be out there on the front lines every day, using his or her own name, showing people who you are and doing and saying things that give people reasons to be loyal to your organization. That's got to be done in-house by someone who understands your organization and is personally committed to it.

You might find that someone in your marketing department is the person best qualified to be your social media manager. If that's the case, that person should begin reporting directly to senior management, and should be relieved of his or her duties in the department. As already mentioned, many people in your organization are going to be using social media as part of their jobs, and you can eliminate potential obstacles by keeping responsibility for your Internet strategy independent of any one department.

What to Look for When You're Selecting a Social Media Manager

Your social media manager should have easy, informal access to senior management, and should attend top-level meetings at least once a month. The position is that important, and you do need to be personally involved at least to this extent.[vii] If the person you're considering as your social media manager is not someone you would look forward to meeting with, then he or she isn't the right person.

Many hospitals and larger medical groups will already have a person with the qualifications to be social media manager somewhere on staff, but he or she may not immediately come to mind. Don't assume that social media is something that's best suited for women — or that it's just something the kids are doing these days.

You're looking for a remarkably intelligent person with the following qualifications and characteristics, a person who might be male or female, younger or older:

1. Someone You Can Trust. You want someone you can trust without hesitation, someone to whom you're willing to give everything — including confidential information about current challenges and future plans — that will enable him or her to do the job. Social media tools can be used to build trust in your institution, but the process must begin with your trusting your social media manager.

2. An Accomplished Writer. You want someone who welcomes the opportunity to write all day every day. This rules out many of your people, but it's essential. You might even initiate your search by asking everyone who works for you to identify themselves if they really enjoy writing.

3. Creative Imagination. A successful social media manager will have the ability to see possibilities and connections in everything he sees, hears, and reads. To build a list of followers, he has to give them a reason to follow — and interesting, informative tweets are what that's about.

4. Organizational Skills. Twitter's constant barrage of facts, opinions, and ideas must be tamed if it's going to benefit your organization. Managing social media for an organization involves coordinating social media strategy throughout the departments, and it means keeping databases or lists of followers, people being followed, and contacts made, for example. These can take Twitter's free-flowing stream and turn it into an organized system.

5. A Charming Personality. You want a genuinely nice person with an outgoing personality — a good listener who finds it easy to establish professional relationships with people, and who can respond to people who are annoying or idiotic without becoming hostile or sarcastic.

6. Generosity. You want someone who can tweet generously about other healthcare institutions and organizations in your community, including your competitors when they do something worth noting or congratulating. This is social media, and promoting your community in this way will enhance your reputation (and confound your competitors).

7. Empathetic Listening Skills. You want someone who can interact honestly and ask and answer questions with genuine empathy — because if people feel that their concerns have been validated, their respect for your organization will grow.

8. Honesty and Diplomacy. You want someone who will speak truthfully because she feels a deep sense of responsibility to the people who follow her on Twitter. You need someone who will be able — after consultation with senior management when that's called for — to deal unflinchingly with controversial matters, as part of crisis management, for example, or when a hot topic that might impact your organization — like the role of the physician vis-à-vis the role of the nurse — is being discussed.

9. Good Judgment. Look for a person who will not embarrass your institution, his colleagues, or himself — or reveal confidential information of any kind. Interesting tweets will sometimes be provocative, but you want someone who understands the critical distinction between being intelligently provocative and being irresponsible — someone who is aware of the line and doesn't cross it.

Hiring the right person to be your first social media manager will ensure that your hospital or medical group will use these essential tools to compete effectively. Hiring the wrong person, or not embracing social media at all, is a recipe for failure in a rapidly changing healthcare environment.

Kent Bottles, M.D., is a former medical school professor, president and ceo, chief medical officer, and chief knowledge officer who is now an independent health care consultant, keynote speaker, and writer.

kentbottles@gmail.com and http://twitter.com/KentBottles

Tom Sherlock is an Internet strategist, Website producer, and content developer who has worked with businesses and healthcare professionals since 1994. tom@aicolorado.com and http://twitter.com/ColoradoHealth
Sidebar: Some Major Social Media Tools

Facebook — a social networking community originally for college students, then expanded to include high school students, and since September 2006 available to everyone; founded by Harvard student Mark Zuckerberg and friends in February 2004; in October 2007 Microsoft bought a 1.6% share of Facebook for about $240 million.

Jumo a new social network for “people who want to change the world”; launched in a beta version on November 30, 2010; founded by Facebook co-founder Chris Hughes, who designed and managed the social networking systems used by the Obama campaign.[viii]

Linkedin — a business-oriented social network of more than 75 million professionals from around the world; founded by Reid Hoffman and former employees of Paypal and Socialnet.com; launched in May 2003.

Twitter — a social networking and micro-blogging service where updates are displayed on the user's profile page and instantly delivered to other users ("followers") who have signed up to receive them; founded by Jack Dorsey and Biz Stone; launched in October 2006.

YouTube — a video-sharing service founded in February 2005 by former PayPal employees Chad Hurley, Steve Chen and Jawed Karim; bought in November 2006 by Google for $1.65 billion in Google stock.

[i] Jim Tobin notes in Mashable/Business that some major websites are starting to get more traffic from social networks than from Google http://mashable.com/2010/10/22/social-media-optimization/ Also see Justin Kistner: “Social is now dominating time spent online and brands aren’t keeping up,” Useful Social Media Blog, Nov 2, 2010 http://bit.ly/cRG0HM

[ii] https://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/US_CHS_2010SocialNetworks_070710.pdf

[iii] Because of the focus of this article, we'll call this person your "social media manager," but you will actually want him or her to be your Internet strategy manager, with responsibility for coordinating all aspects of your institution's use of the Internet.

[iv] http://runningahospital.blogspot.com/

[v] During the 2008 political campaigns, many candidates simply hired to a college kid to "take care of" social media for the campaign. The results were often pathetic, and the campaigns were unable then or now to evaluate the lost opportunity. Many of these kids knew how to communicate with their friends, but actually interacting with voters and activists was not even on their radar. We strongly recommend that you reject suggestions that you hire an intern to "take care of" social media for your hospital or medical group.

[vi] Bill Sweetland at ragan.com is a teacher who knows how to use humor to make his points by poking fun at social media "experts," for example. See “A short guide to the clichés of social-media speak” http://bit.ly/cfEeT5 and “The Don Draper guide to social media marketing” http://bit.ly/atBmQe

If you decide to hire a consultant to guide your organization, ask first to see a resume that includes information about his or her personal experience with blogs, Twitter accounts, Facebook pages, and other social media tools. Have one of your people follow applicants' Twitter timelines long enough to determine whether they're worth your time and money.

[vii] See Joe Stanganelli: “C-Suiters Out of Touch With Social Media,” Internet Evolution Oct 27, 2010 http://bit.ly/drrdIz and Leslie Gaines-Ross: “Why So Few Tweets from the C-Suite?” Harvard Business Review blog,” Oct 12, 2010 http://bit.ly/cF9NHu

[viii] “We’ll be matching people based on their skills and interests with organizations around the world that need their input,” Hughes said. “It’s a discovery process that first matches, then helps people build relationships, then lets people share their resources.” http://www.fastcompany.com/1587959/facebook-chris-hughes-jumocom See http://jumo.com and http://blog.jumo.com/


  1. Thank you for sharing. I wonder why you see Twitter as more important than Facebook which has greater penetration (for now). The Mayo Clinic Twitter account has 113K followers (but I suspect many are spam) whilst the Facebook page has 37K fans who are probably genuine people. If I look at the Facebook page I can see testimonials (although I have concerns that Mayo doesn't give any direction about protecting privacy/confidentiality- instead suggesting that remarks should be 'respectful') which might give me a better sense of what Mayo is about. A FB page can act as a newstream just as a Twitter feed. If I search Twitter for @mayoclinic I can see what the Twitter community thinks to a certain extent but it doesn't feel very 'social'. So, I'm wondering how you drew your conclusions.
    Anne Marie

  2. Hi, Kent and Tom.

    Thanks for citing my article about C-levels' adoption of social media and online engagement.

    I agree wholeheartedly that the position of social media manager is very important. My article posted today on Internet Evolution discusses that very point -- that the role of social media manager should not be diffused or decentralized. You may care to read it here: http://www.internetevolution.com/author.asp?section_id=1087&doc_id=203486&

    Take care,

    Joe Stanganelli

  3. Kent and Tom:

    Thanks for spelling out in plain terms what skills a social media manager should bring to the health care organization (and any business, really). Many firms make the errors you pointed out, so your guidance should be shared among firms considering such a hire.

    I tend to agree with you about Twitter's utility, as I find Facebook is simply another webpage with added functionality. The lack of real privacy control on Facebook and its penchant for selling user data are clear downsides. You might consider putting together a best practices top ten list in using Twitter, as you gather more anecdotes in using it.

    In my own niche on the clinical research side of things, I am finding that more and more clinical sites are looking for how-tos in getting started with all manner of social media. Figuring out where their patient base goes to on social media is a first start, but unless the site is comfortable with the medium, proof of audience alignment will not help them champion that hurdle. Thanks for writing this very thoughtful post.

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