An article in The Economist (“Perfecting Pitches,” August 16, 2008) points out that marketing budgets are often cut first and hardest. Communications in general tends to follow this rule because, like other “shared services,” it does not generate a profit. The paradox, however, is that communications, and earned media coverage in particular, are more important than ever in a down economy.

Generally accepted economic theories tell us that expectations help drive economic growth. The way consumers, stakeholders and investors imagine companies will perform is a partial measure of how they will behave: positive publicity drives momentum which, in turn, shapes perception. The job of every PR professional is ultimately dependent on this dynamic – particularly when a company’s constituents are more concerned about their pocketbooks than new products.

By strict definition, PR is about getting the word out, disseminating valuable information to the right people so that the public can make more informed decisions. As communications professionals, we help generate awareness about new innovations and future possibilities. The more elusive and challenging aspect of PR is the actual shaping of perception, attitudes and behavior.

In a slow-moving, uncertain economy, maintaining a strong, positive image can differentiate your company (or client) from your competitors and send a strong message that you are not only weathering the storm but performing in spite of obstacles. A company that can do that is a company that people want to be associated with through thick and thin. The same Economist article suggested that “the downturn may even be a blessing in disguise,” as strong companies “can stand out more easily and steal market share.”

So despite the instinct to adopt a reactive foxhole approach during times of trouble, communicators should encourage their clients, business partners and leadership teams to be proactive; challenge the skeptics and rally the troops.

Economic slowdowns should signal business leaders to be more bullish with their PR efforts, which they can do without breaking the bank. For example, desk side briefings, executive speaking opportunities, rapid response media outreach, blogging and op-eds all offer inexpensive but valuable ways to promote overall thought leadership, products and executives.

Most communications professionals agree that showing ROI for PR is a challenge, even under the best of circumstances, but it is exactly in these difficult times that we have the opportunity to prove the value of PR to the companies we serve.

Budget cuts are often inevitable, but can be temporary. Use these cuts to make your group stronger and prove your worth as a PR professional. Be creative and proactive, and get back to the basics, back to strategic media relations that will position your company positively even in a downbeat economy.

The first trend is that the oldest of the 76 million millennials (experts disagree on the exact age range but many categorize this generation as those born approximately between 1982 and 2004) will turn 30. They will enter their middle management years intent on reshaping work into a more comfortable existence. I admit I am of this generation and we are comfortable coming to work in flip-flops, jeans, and headphones.

But for all that this generation has been maligned for trying to write its own workplace rules, its denizens also bring a very special quality to business and that is their need to connect their work to a higher purpose.

Consider this against another important business trend – a renewed emphasis on building strong, collegial cultures where teamwork can flourish. As organizations look for ways to refresh and reinvigorate their cultures, they have a tremendous opportunity to look for ways to integrate clients and projects that make work more meaningful. For PR firms, this may be targeting clients with similar sensibilities or embracing pro bono work. Corporations can make sure they engage their millennials in their philanthropic efforts.

The author John Stossel, who wrote “Myths, Lies and Downright Stupidity – Why Everything You Know is Wrong,” is quoted as saying that “happiness comes when we test our skills towards some meaningful purpose.” Maybe the millennials have it right – flip-flops, work-life balance, and a higher purpose.

Originally appeared in PRWeek Insider Blog

Apparently, at one of the sessions she attended, one of the faculty members said that in the past 100 or so years, three events have occurred that have made people feel as though the world was about to implode and they were standing on the precipice.

The first was the massive destruction of entire populations that happened with World War II. The second was the 1962 Cuban Missile Crisis with its threat of annihilation from a nuclear holocaust.

The third seismic shift is the impact of the factors that are shaping the world we live in today. The collapse of large financial institutions, entire countries poised for bankruptcy, the bailout of banks by national governments, evictions, foreclosures, and tremendous job losses have created a culture of fear and panic. Who will lose a job or a house next and can we really depend on government to save us?

Getting comfortable with change is the challenge of the 21st century. And PR can do more than nearly any other business discipline in making this happen. Organizations need to communicate honestly with their customers to explain change and its likely impact.

PR can help social institutions regain credibility by helping them form and articulate their obligation and responsibility to people. PR can help the healthcare industry explain that huge advances in medicine have actually made the world less scary. And, even consumer packaged goods organizations can explain to the public that our food and water are better protected and safer than ever.

PR professionals have an obligation to try and help their diverse publics grapple with and become comfortable with change. This may be our finest moment.

This post originally appeared on the PRWeek Insider blog.

It was an amazing trip – I was captivated from day one. Aside from spectacular scenery, amazing wildlife sightings and thrilling matches (the stadiums were all built in time), the people of South Africa could not have been nicer or more accommodating. Every interaction and conversation equaled making a new friend and learning something new.

But I was also struck by the various healthcare challenges facing the entire continent. It became apparent over the course of my four weeks of travels and interactions with people from all walks of life—from hotel owners and taxi drivers to other travelers from around the world and South Africans we met out on the town—that Africa had a myriad of technology problems, cultural sensitivities, prejudices and infrastructure challenges to overcome in order to enable better access to healthcare and education. Hopefully some of the transport upgrades put in place for the World Cup, such as more paved roads and newly purchased buses, will translate into more services for the underprivileged, but time will tell.

Traveling between cities like Johannesburg, Port Elizabeth, Durban and Cape Town revealed how expansive and underdeveloped many parts of the country are. Roads are luxuries in some parts, so we heard stories of people walking half a day to see a visiting doctor who examines patients and takes a blood sample for testing. However, when the doctor returned a few weeks later with test results some people didn’t or couldn’t make that same half-day walk to learn what the doctor had discovered.

Quite simply, without a robust and effective transportation infrastructure inhabitants of remote villages and even the townships, the slums that non-whites were forced to live in on the edge of towns during the Apartheid Era, have minimal means to access healthcare. It should also be noted that South Africa is probably the most developed country in Africa, so other nations on the continent are facing even more monumental infrastructure challenges to help their people.

Obviously, one of the major healthcare concerns facing South Africa, and the African continent as a whole, is educating the public about HIV and AIDS. Experts estimate that South Africa has one of the largest HIV/AIDS populations in the world, with around 5.7 million affected. Yet, old cultural prejudices and sensitivities about even discussing health topics, such as HIV/AIDS, hinder healthcare professionals from making inroads to combat this disease.

While walking through the Apartheid Museum in Johannesburg, I learned that Nelson Mandela criticized himself for not doing more to lessen the taboo of HIV/AIDS during his presidency. In 2005, the venerated Mandela announced that his son had died of complications from AIDS. He did this because he wanted all Africans to speak openly about a subject that affects too many people in Africa. This courageous gesture openly challenged the cultural sensitivities shared by most Africans. Of course entrenched social stigmas won’t change overnight, but Mandela’s frankness has begun to help individuals, families and communities from ostracizing patients, as often happen.

Our guide in the sprawling Soweto township outside of Johannesburg told us that the Chris Hani Baragwanath Hospital, the largest acute hospital in the world with 2,964 beds, is also trying to educate people. He said that healthcare workers at the hospitals were trying to put the disease in the proper context, noting that getting tested and treated for tuberculosis or other ailments is commonly accepted, so HIV/AIDS should be no different.

I must admit that I was slightly wary of the trip and intimidated by the prospect of traveling through Africa. I didn’t know what to expect, if I would be welcome, whether I needed to fear for my safety. Well, nothing even close to those scenarios happened to me.

Now, having been there, met the people and learned more about the cultures and uniquely African challenges, I can’t stop thinking about it. It is a great land, filled with tremendous people, and they deserve more from all of us—from business investments to healthcare innovations that help solve the obstacles facing the continent.

Simple investments in buses, mobile health clinics, and supply line solutions to rural parts of Africa will help bolster education, engage the population to get treated and promote healthier lifestyles. Advanced technologies that enable immediate blood test results would greatly help individuals learn about their HIV/AIDS status on the spot, and not require them to make a long return journey when the doctors come back to their area. These patients could then work with the healthcare professionals to manage and treat themselves, hopefully also sparing the spread of the disease by someone who doesn’t know their status. These are the types of steps needed to keep Africa great and propel it forward. I hope to one day see it happen.

After years of working in a service industry, it wasn’t until I looked at a crisis from the perspective of being “the client” that I truly understood what client service really means.

Top 5 SIMPLE Rules of Client Service:

1. Be a calming force—but not at the expense of accuracy. Our first instinct, when we hear the urgency in our client’s voice, is to have a solution—yesterday. But a quick answer could also be an inaccurate answer. Clients look to their agency to be a calming source of counsel and advice. Inaccuracies will only cause confusion and make an already stressful situation worse.
2. Be a sincere team player—your problem is my problem. Let’s face it, people can tell instantly when you are being sincere. While everyone knows that the most effective client and agency relationships are partnerships, we always have to make sure that we are holding up our end of the bargain. Simply put: view every budget as if it was your personal bank account, and your client’s success/challenges as your own.
3. Don’t overpromise and under-deliver. Doesn’t it feel great to see that glint of excitement in your client’s eye when you tell them that your team can deliver something in record time, or return astonishing results? There is nothing better. However, there is nothing worse than having to make a follow-up call explaining why, actually, things didn’t turn out as expected. Take the time to develop a point of view on what’s possible before you promise what’s awe-inspiring, but maybe not doable.
4. Be prepared. A wise person once said that when someone doesn’t know what they’re talking about, they use a lot more words. When an answer becomes a soliloquy there are usually problems. Short and sweet is usually also precise. If you are having trouble communicating something, it might mean that you have not wrapped your head around the situation. Clients appreciate candid and concise guidance.
5. Raise red flags—early. Not all crises can be avoided. However, many times there are little cracks that if ignored can turn into the San Andreas Fault. Being the bearer of bad news or flagging a possible problem can be uncomfortable. But clients need to be able to count on you to stay ahead of them and warn of impending problems. No one is perfect and sometimes crises can take everyone by surprise. But, life is a heck of a lot easier if we don’t ignore the signs.

Months ago, in a too-tiny dressing room surrounded by sample shoes and veils, a crisis was solved using all of these steps. Before the tears had made it to my chin, the sales associate rushed in a small, sturdy dynamo with a pin cushion. She gave me a hug, hit me with the truth, made sure I understood that to solve my problem she needed time, and said she’d get back to me with the answers she did not have. It wasn’t a quick fix – oddly, that reassured me. I met with this miniature miracle worker two times a week for three weeks and happily walked down the aisle in a dress with sleeves—normal sleeves.

"As I Am, Beautiful And Whole" - 2008 Oncology On Canvas Winner

No one ever wants to hear, or to utter, the words “you have cancer.” But so much progress on the clinical side may help take the sting out of some diagnoses. On the psychosocial side, however, the news is not as good: very little is being done to assess and treat the psychosocial needs of cancer survivors, which in many cases may be acute and long lasting.

The most significant impetus to step up efforts for increased access to psychosocial support services comes from an October 2007 Institute of Medicine (IOM) report: Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. The report concludes that quality psychosocial care is critical to cancer survivorship. According to National Coalition for Cancer Survivorship (NCCS) President and CEO Thomas P. Sellers, “cancer is more than a physical disease; it affects your emotions, your relationships, your spirituality…and much, much more.”

Six years ago –long before the IOM report saw the light of day– TogoRun created Oncology On Canvas^SM: Expressions of a Cancer Journey art competition and exhibition in response to Eli Lilly and Company’s desire to provide doctors and their patients with support that went beyond medicine. The biennial competition — presented in partnership with the National Coalition for Cancer Survivorship — invites individuals diagnosed with any type of cancer, their families, friends, caregivers and healthcare providers to express through art and narrative, “the life-affirming changes that give their cancer journeys meaning.”

My own experience with this program since its inception affirms the truth of the IOM Report – that the non-physical aspects of cancer can leave scars as long-lasting as any caused by surgery or radiation. Attention must be paid to the humanity of the experience and the wisdom that can be found there. Since 2004, more than 3,000 entries have arrived in our offices from patients, doctors, nurses, caregivers, families and friends. Hundreds of art exhibitions have been mounted and millions of lines of copy written about the program. Oncology on Canvas has given a voice – through words and images – to everyone touched by cancer.

As the entries continue to pour in for the 2010 competition, our fourth, I am reminded of the faces of cancer I’ve met along the way: John, whose daughter Jeannine discovered the healing powers of painting while undergoing breast cancer treatments; Anne, whose young daughter Katherine taught her that life “is not a dress rehearsal,” even when you’re battling lung cancer; and Ellen Stovall, past president of NCCS, a super star in the cancer community, a 37-year survivor and a real sweetheart. During the first Oncology On Canvas exhibition in 2005, I met a woman who desperately needed to talk to someone about her niece, a new mother with Stage IV breast cancer. Ellen had been a new mom when she was diagnosed with cancer 32 years prior. Could she give her some advice? “Give me a minute,” was Ellen’s reply as she quickly wrapped up her conversation with the event sponsor and turned her attention to the fearful woman. Ellen’s generosity in sharing her experience, and the woman’s profound relief, was powerful proof of the need for psychosocial support.

Let’s face it. I, like most people, am afraid of cancer. But I don’t think of it as “The Big C” anymore. I reserve the “C” for more deserving words, such as courage, compassion, and well…canvas.

To learn more about Oncology On Canvas, visit www.OncologyOnCanvas.com. You can also follow it on Twitter, Facebook and YouTube.

Susannah, Associate Director of Digital Strategy at the Pew Internet & American Life Project, was a panelist last month at TogoRun’s Digital Capital Week Event, Public Health: What’s Digital Got to Do With It? in D.C. She joins us again to speak with TogoRun Vice President Banks Willis on matters concerning the influence of the digital world on public health.

Listen in as Susannah and Banks discuss, among others issues, federal agencies’ increasing openness to social media, harnessing the power of social information, and a re-visit to our favorite subject, the ROI of social media.

If you missed our Public Health discussion featuring panelists Susannah Fox, Maya Linson and Erin Enke, click here!

Catching disease earlier should prevent the health care system from incurring astronomical costs down the road. However, the timing couldn’t be more ironic. A few months ago, many stakeholders were vocal in the press that diagnostic imaging is over prescribed and driving up the cost of health care. The problem is not the tests. Physicians are paid per procedure and patients ask for tests. As long as physician incentives are corrected, these necessary and potentially lifesaving tests shouldn’t be over prescribed. We should all try to be good patients and not ask for additional scans we don’t need.

For more on this issue, read this interesting article from Reuters’ Jon Lentz.

Trending topics, lists, Twitter clients, direct messages, “@ replies”, celebrities (something Facebook can only provide through Fan Pages), and ReTweets — the list of Twitter advantages goes on and on. While I love them all, I would like to focus in on one in particular: ReTweets.

What is a ReTweet?

For those not familiar with Twitter, a ReTweet is the act of taking someone’s Tweet and re-broadcasting it through your own feed, with attribution. There are two ways to ReTweet (RT) content:

Which style of ReTweeting is best?

These two styles are the fundamentals of ReTweeting, and also the subject of disagreement between “old skool” RT fans and those who prefer the new direct ReTweets. I love to ReTweet, and I do it quite frequently. The style of ReTweet I use is a conscious choice based on certain considerations: who am I  ReTweeting, am I adding to the post, who do I  want to read the ReTweet? 

If I am ReTweeting a distinguished news source or a thought leader, I usually use the direct style ReTweet for two reasons: I like the direct ReTweet icon, and I want to keep the post in its original form since Tweeps are more likely to read what the credible source has to say than my satirical comments.  However, if I am ReTweeting a friend or colleague, I usually want to add my opinion before re-posting it to my followers.  Something to consider: are your followers more likely to read the ReTweet if they see your avatar, or picture icon, next to the post (using old skool  RT) or if they see the avatar of the original tweeter (via direct style)? 

A very unscientific poll of @TogoRun’s followers

When TogoRun took a poll of ReTweet preferences, we found that the majority of respondents prefer the direct ReTweet function. . Said Twitter user Bryce Laumann, “[direct ReTweets are] easier to use and [I] don’t have to remember someone’s username.” (For an old-skool ReTweet you have to type in the original Tweet source).  Although direct ReTweets won in this poll, old-skool RT fans were more vocal about their choice. One user complained, “Don’t think I like the twitter Beta ‘Retweet’ feature- can’t comment on the tweet and I like the RT at the beginning, qualifies it from begin.” Another user expanded on this last idea: “RT makes it more clear at-a-glance that it’s a retweet.”

Twitter “clients,” –  third-party apps  that help users  navigate and update their  Twitter accounts from a desktop  computer, mobile phone and even iPad, give users the option of choosing the ReTweet  style they  prefer. Clients such as Tweetmeme and Echofon let users choose old-skool or direct ReTweet styles with every ReTweet.  Seesmic and Hootsuite make users choose an  option when they  first sign up.  This is not popular, as preferences change depending on the post. One disgruntled Hootsuite user complained in a post titled, ‘Allow us to choose which type of retweet on the fly rather than in settings,’  “It’s a pain having to go into Preferences each time.”

The ReTweet Effect

ReTweeting is a bit like the telephone game that we all played in the sixth grade; you pass along a message until it keeps spreading.  Same idea goes for Tweets: the more people spreading the message the better.  Below is an example of what I like to call the ReTweet Effect, the process of how ReTweeting can spread your message beyond your followers to the masses.

The main point of ReTweeting is to spread a message.  It doesn’t matter what style you choose to use or whether you have 5 followers or 5.2 million (like Ashton Kutcher): just one ReTweet can have a multiplier effect far beyond your original circle.

In a new journal article, I explain changes to the Medicaid drug rebate program and implications for drug makers, health plans, and states. The article appeared in the June 2010 issue of the peer-reviewed journal American Health & Drug Benefits.

The article provides a primer on the basics of the Medicaid drug rebate program, including Average Manufacturer Price (AMP), Best Price, federal rebate agreements with drug manufacturers, supplemental rebates, Preferred Drug Lists (PDLs), reporting of drug prices by pharma and biotech companies, and drug utilization reporting by state Medicaid agencies.

The article then summarizes the major changes effective for 2010, notably (1) increased minimum federal rebate percentages for brand and generic drugs and (2) extension of federally mandated minimum drug rebates to Medicaid drug utilization in Medicaid managed care organizations. It concludes with a brief discussion of implications for states, drug makers, and health plans.

This is the first post in our new Unleashed series called Health Reform Insights, in which expert TogoRunners outline the impact of the Patient Protection and Affordable Care Act (PPACA), the Health Care and Education Reconciliation Act (HCERA) and other health related legislation. From Medicaid prescription drug pricing to changes in coverage, reimbursement, and care delivery, we clearly demonstrate many of the complexities of health legislation and what it means for the healthcare community.

The first installment is from TogoRun senior counselor Kip Piper, a leading expert on Medicare, Medicaid, and health reform. Be sure to come back for future installments of this illuminating series.

This post also appeared on piperreport.com.