Hospitals' latest PR concern: The Netflix documentary

After the $261 million verdict against Johns Hopkins All Children's Hospital, health system public relations departments have a new concern: unwillingly becoming the subject of a streaming service documentary.

Released on Netflix in June, "Take Care of Maya" tells the story of Maya Kowalski, whose family brought her to the St. Petersburg, Fla., hospital's emergency department in 2016 with chronic pain. After physicians suspected child abuse, the then-10-year-old was kept there apart from her loved ones for nearly three months, during which time her mother killed herself.

Millions of viewers watched the documentary, which detailed the family's then-unsuccessful attempt to sue the hospital. In November, a Florida jury awarded the Kowalskis the nine-figure sum for damages on counts including medical negligence and false imprisonment.

"The level of global exposure and awareness of this case helped drive the interest, engagement and discussions in the community," Karen Freberg, PhD, professor of strategic communication at University of Louisville (Ky.), told Becker's. "This is a situation where hospitals across the board must evaluate their crisis communication plans from this experience and see how they would address this situation if it happened to them."

She said any reputation-fixing lessons for this case, then, will come not from hospitals that have lost big lawsuits, but from companies that have been the subject of unflattering documentaries.

The hospital's brand recovery will also depend on whether its appeal of the verdict is successful, said Pallavi Kumar, Hurst senior professorial lecturer of public communication at Washington, D.C.-based American University and a former public relations executive.

"Assuming they lose, it will be almost impossible to restore their reputation to the level it was previously at since the public will see the appeal as them not taking responsibility," she said.

That would then require cleaning house, with new leadership and a fresh board of directors, as well as instituting a new program to train staff on recognizing signs of child abuse, Ms. Kumar said. "If they really want to go the extra mile, they would partner with a reputable outside organization to develop the new training and then make it available for free to children's hospitals around the country," she said.

A spokesperson for Johns Hopkins All Children's declined to comment for this story, citing the active litigation.

Health systems have taken similar steps to repair their processes — and images — in the past. For instance, Los Angeles-based Cedars-Sinai instituted additional safety measures after giving the infant twins of actor Dennis Quaid 1,000 times the recommended dose of a blood thinner in 2007, noted Lisa Sparks, PhD, a professor of health and strategic communication at Orange, Calif.-based Chapman University.

"Prevention is always the best approach to medical crises," she said. "Hospitals can do very little to effectively handle a crisis if they don't invest in a crisis management team with planned-out scenarios before crises occur. It is crucial that hospitals invest in a prevention-first mindset as that is what will likely save the day when adverse events occur."

Dr. Sparks said if she was advising Johns Hopkins All Children's, she would put together a campaign showing that "specific and measurable" procedures have been implemented to prevent a case like this from ever happening again. "I would bring patient testimonials into the equation and repeat the message a million times until credibility and trust are restored in the community," she said.

The ability to bounce back from a public relations crisis also has to do with the size of the hospital or health system in question, said Eric Berkowitz, PhD, emeritus professor of marketing at University of Massachusetts at Amherst.

He pointed to University Community Hospital in Tampa, Fla., which in the 1990s had a string of problems, including removing the wrong leg of a patient, which it never recovered from; it was eventually absorbed by a larger system and rebranded. Conversely, Seattle Children's admitted in 2019 that mold in its operating rooms caused the deaths of multiple patients; it still ranks among the top children's hospitals across multiple specialties.

Beyond that will depend on parents' and caregivers' preferences and attitudes toward the hospital. "The key elements would be responses to questions such as: 'Would you trust John Hopkins All Children's Hospital as a place for your child should he or she need sophisticated medical care?'" Dr. Berkowitz said.

But, as Dr. Freberg noted, the new "precedent" here is being featured in the ever-popular streaming service documentary. "Take Care of Maya" spent two weeks in the global 10 most-watched English films on Netflix.

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