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The purpose of this paper is to identify image restoration strategies which the military can use to prevent crises from harming and/or damaging the organizational image

Image Repair 26

Running head: IMAGE REPAIR TAXONOMY FOR U.S. MILITARY HEALTHCARE












U. S. Military Healthcare: A proactive adaptation of


Benoit’s Image Repair Taxonomy


Tracie Adams

Bruce Moody

Michele Papakie

Tim White

Jon Youngdahl



DoD Joint Program in Communication

University of Oklahoma

Abstract

The purpose of this research project is to apply Benoit’s image repair taxonomy to formulate a plan that will restore credibility to the U.S. Military’s healthcare system. This system is currently under attack for its inability to provide quality care to its members. Many unqualified doctors have jeopardized, and in some cases, taken the lives of patients due to gross negligence or malpractice. An investigative report revealed that many doctors were licensed through substandard means. This report has been widely publicized through mass media, thus tainting the public’s perception of how the military cares for the health of its members. Image restoration theories and proactive reputation damage control strategies will be applied to analyze initial responses to these allegations and lay the groundwork for a plan to restore confidence in the military’s medical facilities. The recommended solution will be specific communicative messages that employ the strategies of image repair. These messages will be disseminated to internal and external audiences through the application of mass communication theories.









Introduction

The U.S. Military operates one of the nation’s largest healthcare systems, with nearly 600 hospitals and clinics employing 147,000 medical professionals – about 13,000 of them doctors (Carollo & Nesmith, 1997). The military’s system offers free, or nearly free medical care to 8.2 million military members, their families and retirees -- that means military doctors treat approximately one out of every 50 patients in the United States. In the past year, military doctors cared for 460,000 hospitalized and 36 million ambulatory patients (Guidance from OSD/PA, 1997), yet they operate in virtual secrecy.

Federal law prohibits the release of military doctors’ records to the public. Their training, certification and complaints filed against them are locked in a military data base. This shelter from scrutiny is not enjoyed by civilian doctors (Appendix A).

All physicians with malpractice suits, civilian and military, are required by law to register with the National Practitioner Databank (NPDB). This databank was designed to enable the public to look up information on a particular physician. However, more than 75 military medical facilities have never reported a doctor for medical malpractice to the NPDB. Even worse, those same facilities were the targets of claims alleging more than 1,000 incidents of medical malpractice (Appendix B).

In 1986, the military required physicians to obtain state licenses. But in 1996, more than 1,100 military doctors -- one of every 11 -- had not yet obtained licensure (Appendix B).

A Supreme Court ruling in 1950 resulted in the Feres Doctrine, which prohibits members of the Armed Forces from suing the federal government or its employees for medical malpractice. (Feres v. U.S., 1950). Today, the Supreme Court is considering several cases which are challenging the Feres Doctrine on behalf of military members (Appendix C).

Medical Malpractice: An Investigative Report

The elimination of military physicians from public scrutiny were the basis of a seven-day series of articles written by investigative reporters Russ Carollo and Jeff Nesmith of the Dayton Daily News and Cox Newspapers. The series featured numerous, graphic accounts of gross negligence suffered by military members and their families at the hands of unqualified physicians. It was published recently in Cox-owned newspapers around the country and also in both local and national television newscasts. Additionally, the Times Publishing Company, which publishes the Army Times, Navy Times and Air Force Times, carried extensive portions of the report in their publications simultaneously.

Despite knowing well in advance that the series of articles would appear and the nature of what the report would discuss, the Office of the Secretary of Defense, Public Affairs, (OSD/PA) did not build a public affairs plan to restore the image of military medicine. However, guidance for responses to queries regarding the investigative report were provided to field public affairs offices shortly before the report appeared, and the surgeon generals issued a response letter to Times Publishing Company. Both of these actions were reactive in nature when a proactive approach was needed.

Carollo’s investigative report is just the tip of the iceberg. Even after the Dayton Daily News published the disturbing series on the inadequacies of military healthcare, another expose is scheduled to appear in this week’s issue of the Air Force Times. The four-page piece, available on newsstands December 15, outlines the case of an airman first class who is believed to have injected lidocaine into 22 infants and one adult over a period of months in 1988. Effects of the injections included sudden drops in heart rate, loss of breath and blueness due to lack of oxygen, as well as a rise in blood-acid and blood-sugar levels. The airman, who worked in the nursery of the Maxwell Air Force Base Hospital in Alabama, deliberately harmed patients so that he may appear heroic in attempting to save them. However, lidocaine causes irreversible damage to the central nervous system, and many of the children now suffer from cerebral palsy and varying degrees of mental and physical retardation. The Air Force never charged the airman with any crimes. He was eventually removed from the nursery and later court-martialed on unrelated personal charges of child and spouse abuse. While a number of the families members have sued the government, and some have even been awarded settlements, the money is slow to come. Government lawyers are appealing to have the awards set aside.



Discussion

Image Repair Background

What has come to be known as image repair in communication, traces its roots to a sociological and psychological birthplace. Though the terminology may vary throughout time, the theme remains the same: When someone or something’s reputation is on the line, there is always a very strategic route to take to preserve a good image, despite unfavorable circumstances. Crisis management skills are critical; but, image repair strategies are paramount to individual and corporate success. Image repair goes beyond crisis survival. It is the skillful manipulation of the messages to the public, which make or break the offender’s reputation.

How does an individual or a corporation know that its image is being threatened? Maybe the crisis is not of such magnitude to threaten the public’s perception of an individual or a corporation. Benoit and Czerwinski (1997) state there are two criteria to establish that: “(a) The accused is held responsible for an act; and (b) the act is portrayed as offensive – and image repair strategies are organized accordingly” (p. 39).

While readers still find image repair strategies relating to individuals, such as Richard Nixon, Adlai Stevenson, Harry Truman and Edward Kennedy (Ware & Linkugel, 1973), most current research shows how image repair strategies relate to corporate culture (Benoit, 1995). Corporations can use Benoit’s model of image restoration discourse to understand crisis situations. Practitioners can use it as a guide to develop messages before or during crises. By applying Benoit’s theory to how the military has responded to the attack on its healthcare system, it becomes quickly apparent that image problems are imminent.

Methods of Analysis

The authors of this paper performed a content analysis of many articles which have appeared in various media since October regarding the military’s healthcare system. It was determined through this analysis that the military’s medical care image was definitely in jeopardy. When OSD/PA was contacted for comment December 3, it was discovered that the organization did not agree with the analytical findings presented in this paper. OSD/PA had sent guidance out to the field containing canned responses to anticipated media queries, as well as to specific questions asked by investigative reporter Russ Carollo, but no formal plan had been strategized to repair the already tainted image of the medical healthcare system. OSD/PA was not convinced that any damage had been done, since it had not received many calls concerning the issue. The researchers of this project disagree. By applying Benoit’s theory of image restoration discourse, the authors of this paper have analyzed the scope of the attack on the military’s healthcare system, applied the theory to the military’s response to show its inadequacies and recommend a strategic plan to improve the image of the military healthcare system.

Since neither form of denial (simple denial or shifting blame) was employed through the military responses, it was safe to assume that the accused -- the military – was responsible for the acts; and, loss of life due to incompetence is obviously considered offensive. Benoit’s two conditions were said to have been clearly met, which indicated the need for image repair, so the next step was to evaluate the potency and nature of the attack.

Carollo’s seven-part series uncovered many disturbing and damaging cases of military doctor’s malpractice, improper licensing and lack of repercussions to these offenders. Due to the fact that Cox Newspapers is the fourteenth largest news service in the United States, Carollo’s articles achieved some far-reaching results. His series was published simultaneously in the Air Force Times, the Army Times and the Navy Times, and also appeared in many civilian newspapers owned by Cox. The story was also picked up by 20/20 and run on the national television news program.

Benoit says that the response must match the attack. The Department of Defense (DoD) has the resources to effectively launch a counter attack of the same magnitude or at least a response to Carollo’s series, but it did no such thing. At its disposal, the military has hundreds of newspapers, television news programs for each branch of the service, web sites, and the ability of commanders to speak directly to their subordinates to reinforce media messages. None of these channels were used to disseminate the military’s message using mass communication theories such as two-step flow or diffusion. Conversely, the messages, weak at best, were sent only to Russ Carollo and the Times Wire, reaching the same internal audience, and the external audience that Carollo had already penetrated was completely ignored. Military internal media focused on the DoD’s transition to a new family care program, medical command feature profiles and patient satisfaction surveys. It failed to specifically address any of the components of Carollo’s attack.

Although Dod minimizes the existence of an image problem, Benoit argues that image is always a central concept to the field of public relations. He contends that firms can take preventative and restorative steps to solve problems initiated by crises. His theory of image restoration discourse proves useful in developing and understanding messages that respond to crises.

Benoit’s taxonomy has five major components: (a) Denial. This is when an organization flat out denies that the problem exists or that it does, but it is not hurting anyone. Another variation of denial is shifting blame; (b) Evasion of responsibility. This allows an entity to manipulate public perception so as to relinquish responsibility; (c) Reduce offensiveness. This strategy seeks to offer an alternative perspective to the problem, attempting to make it appear less offensive, which may include stressing only good points, or focusing on more important issues than the events at hand; (d) Corrective action. The organization attempts to repair the damage by taking action to prevent recurrence; and (e) Mortification. The offender apologizes and asks for forgiveness (Appendix D).

Benoit contends that an organization may employ a combination of image repair tactics to solve a problem, but it must be done carefully so that messages do not contradict and senders do not appear to be back-peddling, which only worsens the credibility of the offender. Appendix E demonstrates how the military’s responses fit into almost every one of Benoit’s strategies, yet a proactive plan was not in place to spare the organization’s image and reputation. Had a plan been in place, conflicting messages would not have been released, and credibility would not have been compromised.

Application of taxonomy

Public affairs officials should choose appropriate image repair strategies carefully.

Denial, in both forms, would do more harm than good in this situation. Even in cases where the military is without blame, Benoit argues that, perceptions are more important than reality. It is not as important that the military is not responsible for the offensive act if the military is thought to be responsible for it. As long as the audience thinks the military is at fault, its image is at risk.

Under evasion of responsibility, provocation would not be a fruitful tactic. There is absolutely no excuse for allowing unqualified physicians to practice. The next tactic is defeasibility. By applying this strategy, the military would allege a lack of control over important elements of the situation. For example, as a result of downsizing, the military’s healthcare system is under pressure from federal officials to do “more with less.” Hospitals and clinics are understaffed and under budgeted thus hampering military doctors to provide the utmost quality healthcare.

In other cases, the military would use defeasibility by explaining how the healthcare system is bound by law to conduct itself in a particular way. For example, should a settlement be reached before a malpractice claim goes to trial, the Justice Department will reach the settlement regardless of the merits of the case. As a result, a claim can be paid when there is no malpractice, and the military’s standard of care has been determined to have been met by the practicing physician (OSD/PA, 1997). In these cases, the physician’s name is not reported to the NPDB.

Another example of defeasability is claiming a lack of information. It is common for public affairs officials to be first informed of a situation by reporters. It would be perfectly reasonable to explain that DoD is a huge organization with bureaucratic obstacles to be negotiated. That challenge is further complicated by the transient nature of the military’s troops and family members (Benoit, 1997).

A third option is to claim an offensive action was an accident. If the military can convince the audience that the act in question happened accidentally, it should be held less accountable, and the damage to that military's image should be reduced (Benoit, 1997). This would not be an appropriate strategy due to the overwhelming number of cases currently being held against the military.

Fourth, the military can suggest that an offensive behavior was performed with good intentions. For example, the military is reluctant to report its physicians to the National Practitioners Data Bank, because they may consider leaving the service, rather than continuing a career stalled by an adverse report.

If the military is at fault, the military should admit it immediately. This is the most effective tactic for evading responsibility. Not only is this the morally correct thing to do, but attempting to deny true accusations can backfire. If the military falsely denies responsibility, it risks substantially damaged credibility if the truth emerges.

When the military is accused of an offensive act, it may try to reduce the perceived offensiveness of that act. There are six versions to this strategy. First, the military may use bolstering to strengthen the internal and external audiences’ positive feelings toward the military. For example, the military could boast results of customer satisfaction surveys, heroic success stories in its healthcare system or results of studies which point out excellence in the system. The military’s means for bolstering would be: newspapers, radio and television. Bolstering is also possible through public assemblies. Medals and awards presented to healthcare workers would be done on as high profile a scale as possible. These efforts would offset the negative feelings connected with the perceived problems in the healthcare system.

Another option is to try to minimize the negative feelings associated with a wrongful act. Though uniformed active-duty service members cannot sue in court and win settlements for their injuries, public affairs officials should stress the fact that they can be compensated through financial assistance and free medical care from the Department of Veterans Affairs. Public affairs officials should use this option with caution; minimization cannot always improve one's image.

The military should employ differentiation, meaning it would distinguish the offensive act from other similar, but more offensive actions. Relating to this tactic is transcendence, which is placing the act in a more favorable context. Public affairs officials would point out that while approximately ten percent of the military’s physicians are not state licensed, it is important to remember that a decade ago, the military did not require state licenses at all for its physicians. This would open the opportunity to portray this as a period of transition for the military’s healthcare system and explain that conditions are improving each year.

Another tactic for reducing offensiveness is for the accused to attack its accusers. This strategy is not appropriate for the military. It is likely that such an attack would backfire as a result of public distrust in the military and other federal institutions.

Corrective action is another general image restoration strategy. The military would pledge to correct a problem. Public affairs officials should publicize plans to correct a problem and prevent its recurrence. This publicity is extremely important. Members of both the internal and external audience will want to know whom to blame, and it is more reassuring to know that the military is taking steps to eliminate or avoid future problems. The military’s commitment to corrective action can be a very important component of image restoration discourse, especially important when the military admits responsibility.

The final general strategy for image restoration is mortification -- to confess and beg forgiveness. This strategy is not appropriate for the military. The healthcare system is worldwide. The bad in this organization is far outnumbered by the good. While it is morally right to take responsibility for mistakes, it is not necessary to beg forgiveness -- an act which would negatively impact the internal and external audience’s credibility in military healthcare.

This paper presents many examples of specifically applying Benoit’s theory to the military’s healthcare system. Public affairs practitioners should carefully decide how to pick and choose the most effective combination of strategies and messages based on an analysis of the crisis (Appendix F).

Incorporating Strategies into a Plan

Public affairs practitioners are advised to take a proactive approach to Benoit’s image repair strategies with regard to the military’s healthcare system. The first step to building a proactive strategy is to identify crises which will damage the healthcare system’s image. As explained earlier in this paper, public affairs officials should anticipate high press interest in medical malpractice incidents.

Planning before a crisis occurs will reduce response time and help to prevent missteps in the initial response. Contingency plans should be prepared, even though actual crises will invariably differ from textbook crises. These contingencies should be incorporated into base-wide exercises. This would reap two benefits: realistic training for public affairs officials and an opportunity implement image repair strategies, evaluate their effectiveness and modify them accordingly.

It is imperative that public affairs officials take charge in the development of these strategies. Too often, military healthcare officials make very public and damaging comments, such as this Navy commander’s quote in a 1994 military medical journal: "As military officers and federal employees, one of the benefits we enjoy is the relative freedom from being sued personally as a result of job performance. In this litigious society, that is no small thing" (Carollo, 1997).

Since image restoration rhetoric is derived from persuasive discourse, the development of a strategy should be based upon the basic principles of persuasion: avoid making false claims, provide adequate support for claims, develop themes throughout a campaign, avoid arguments that may backfire (Benoit, 1997).

The second step to disseminate image repair strategies is to prioritize the target audiences (Benoit, 1997). The military addresses multiple audiences, each with its own interests, concerns and goals. The military’s audience can be divided among three categories: internal audiences (active duty, reservists, family members, civilian employees), external audiences (local community, national public opinion) and policy makers (local and federal officials, interest and lobbying groups). Public affairs officials should consider their most important audience to be the military’s internal audience, for three reasons. Members of the internal audience accomplish the mission of the military. First, their faith in the healthcare system has a significant influence on troop morale. Second, in taking the two-step flow view toward the internal audience, it is apparent that they are opinion leaders to the civilian public. The “horror stories” of a military member can have a strong influence on the public’s opinion of the healthcare system and the military as a whole. The third reason to consider the internal audience is the available means of reaching this audience. Public affairs officials have the military’s internal media at their disposal.

The next audience to consider would be the military’s external audience. The general public makes little distinction between the various branches and organizations within the military. It is essential that each crisis be handled individually so that public does not generalize its opinion to the entire military. The damaged image of one unit or command is often perceived as a reflection of the state of the entire military.

In addition to considering the salient audience for a crisis, it is important to understand the nature of the crisis itself. Public affairs officials should identify potential accusations and suspicions. Knowing the nature of the crisis allows for an appropriate response by image repair strategists. The response will also be tailored according to the anticipated severity of the crisis.

Once a corporation gets itself into a situation where image repair is imminent, it is important to note that while many of the strategies may seem feasible and logical, there are times when legal or political issues prevent a company from employing a seemingly appropriate strategy (Benoit, 1995).

Conclusion

This research paper discusses a serious and disturbing problem facing the U.S. Armed Forces today and outlines a way to help restore the public’s faith in how the military cares for its members. Benoit’s image repair taxonomy is applied and identifies inadequacies in the way public affairs and other official military spokespeople responded to this life-threatening crisis. Tables are presented to outline image restoration strategy and offer specific responses for use during events such as this.

The implications for future research in the area of image repair are limitless. Countless taxonomies can evolve from these models and be applied to any number of corporate crises. Utilizing these guidelines, public affairs practitioners can help the United States Military and other corporations take a proactive, long-term approach toward improving their images.

Appendix A

Military Medicine: Sheltered from Litigation

The U.S. government has historically been immune from lawsuits without its consent. That changed in 1946 with the Federal Tort Claims Act which initiated a limited waiver of sovereign immunity allowing itself to be sued in the same manner and extent as a private individual would in acts of negligence against a government employee.

Four years later, however, the U.S. Supreme Court re-examined the Federal Tort Claims Act as it pertained to military malpractice. Resulting from this case was the Feres Doctrine, prohibiting members of the armed forces from suing the federal government or its employees for medical malpractice. (United States Reports). Today, the Supreme Court is considering two separate cases challenging the Feres Doctrine on behalf of military members.

Appendix B

A Reluctance to Report Substandard Care

Federal law prohibits the release of military doctors’ records to the public. In 1986 Congress passed a law prohibiting the release of any information about the quality of military doctors in spite of the fact that the information on civilian doctors is available from state medical boards. This data, including schools attended by the military’s physician, board certifications, and complaints filed against them, is kept in a military database, board certifications and residency training (Carollo 1997).

In 1990 Congress established the National Practitioner Data Bank (NPDB), a database containing all cases of medical malpractice filed against physicians, and designed to allow the public to look up information on a particular physician. When the NPDB was established, the military agreed to report its physicians when a “standard of care” had not been met. However, more than 75 military medical facilities have never reported a doctor for medical malpractice to the NPDB, yet those same facilities were the targets of claims alleging more than 1,000 incidents of medical malpractice (Carollo, 1997).

In 1986, the military required physicians to obtain a state license. They could register in any state and those on active duty had until 1986 to comply. But in 1996, more than 1,100 military doctors, one of every 11, had not obtained a license (Carollo, 1997).

Appendix C

Feres Doctrine Appeals

On February 4, 1997 three federal judges with the Ninth U. S. Circuit Court of Appeals in San Francisco ruled that government negligence could have led to the 1991 death of Army Specialist Ronald E. Dreier who fell into a concrete water-drainage channel near a picnic area of Fort Lewis, Washington and drowned (Corollo, 1997). Defense attorney William J. Carlson of Bellevue, Washington said “Dreier’s death had absolutely nothing to do with his active-duty status. It could have happened to anyone, military or not military, at the site of his death” (p. 1). Government attorneys built their case around the heretofore impenetrable Feres Doctrine, but with the judges ruling, other service members may now have an avenue to sue the government for negligence.

The Supreme Court will consider two separate cases challenging the Feres Doctrine on behalf of military members. In the first case, a promising track star hoping to qualify for the 1992 Olympics was permanently injured when military doctors improperly applied pressurized stockings to his legs during a seven-hour surgical procedure. He awoke from surgery to find his lower legs swollen to the size of his upper legs. Doctors diagnosed Jones’ leg condition as compartment syndrome requiring an immediate operation to relieve the pressure. Defense attorney Burton I. Weinstein filed a federal lawsuit on Jones’ behalf in late 1995. A judge for the U. S. District Court for the Northern District of Illinois ruled against Jones, upholding the Feres Doctrine. The decision was appealed to the Seventh District Court of Appeals in Chicago and was again decided in favor of the Feres Doctrine. Weinstein plans to file a request for reconsideration before the Supreme Court in time for the July 23rd deadline.

In the second case, Darrel Clark, who served with the 18th Airborne Corps during the Gulf War, claims the Army failed to inform him that possible exposure to chemical-warfare agents in the combat theater might cause him to father a child with birth defects. He filed a federal lawsuit in the spring of 1996 on behalf of his daughter who was born in1992 with severe birth defects. Both the federal district court and the U.S. Court of Appeals for the Fifth Circuit, ruled against Clark and upheld the Feres Doctrine even though the child was an unwitting victim of the negligence. Clark’s attorneys, Carol Lomax and Scott Roberts, filed a new complaint before the Supreme Court on September 9, 1997 urging the court to rule on their clients’ behalf, and to reconcile two earlier cases in which U. S. Circuit Courts reached opposite conclusions concerning the government’s liability for birth defects of military children.

Appendix D

Benoit’s Image Repair Strategies

Denial


Simple Denial

act did not occur; I did not do act; act is harmless

Shifting Blame

another did the act

Evade Responsibility


Provocation

act responded to prior offense from victim

Defeasibility

can not control situation

Accident

unforeseen consequence

Good Intentions

meant well in doing act

Reduce Offensiveness


Bolster

stress own good points

Minimize

act is less offensive than it appears

Differentiate

act is less offensive than similar acts

Transcend

more important issue

Attack Accuser

reduce credibility of attacker or claim victim deserved it

Compensate

offer money, goods or services

Corrective Action

repair damage; prevent recurrence

Mortification

apologize; ask for forgiveness



Appendix E


Applying Benoit’s Image Repair Strategies

to How the U.S. Military Has Responded to Attacks


Denial


Simple Denial


Shifting Blame


Evade Responsibility


Provocation

“If I had known the severity of her asthma, or her history, I might have given her steroids, I might have done things differently.”

Defeasibility

“Our initial review has confirmed your report that some military physicians hold a special license from the state of Oklahoma. We appreciate your calling this to our attention.”

Accident

“In any medical system there will be unfortunate medical incidents.”

Good Intentions

“The nature of military service has its physicians moving frequently as their duties require; Obtaining a new state license in each state to which a physician is assigned would not be feasible.”

Reduce Offensiveness


Bolster

“The military system employs some of the country’s finest physicians.”

“Consistently, these reviews have found that healthcare in the military meets or exceeds civilian standards.”

Minimize

“In any medical system there will be unfortunate medical incidents.”

Differentiate

“The point here is that one cannot measure a physician’s capability or quality by looking at the number of malpractice claims.”

Transcend

“Amid all this, however, Pentagon officials say they want to avoid a witch hunt and still balance patient safety with physician due process.”

“The most important thing to us in military medicine is concern for the health and well-being of our patients.”

Attack Accuser

“You did a disservice to the thousands of dedicated and professional men and women who serve in day in and day out medical commands worldwide providing high quality healthcare for our service members, retirees and family members.”

Compensate

“Within the military system of healthcare delivery, we have a number of processes in place to examine the circumstances when adverse patient outcomes occur, whether or not the standard of care was met. One rating system determines the monetary amount the individual will receive tax-free for the rest of his or her life.”

Corrective Action

“We have initiated action to correct this situation. In addition, I have requested that the Surgeons General inquire as to the licenses held by all physicians on active duty and to ensure that they are in keeping with our policy.”

Mortification

“Lt. Gen. (Dr.) Ronald R. Blanck, the Army Surgeon General, said privacy laws prevented him from talking about specifics of the Clark case. But he said he sympathized with the family, and he added, ‘My heart goes out to her,’ he said.”

“It is a considerable embarrassment to me that someone had to point out these special licenses out,” the Army’s top doctor said.

“I have no excuse for that. That’s an error or a failure on our part,” he said.



A limitation of this analysis is that some of the responses may have been tailored to meet legal requirements, which usually forces a company to decide what is more important: repairing its image or avoiding litigation. Although the Feres Doctrine protects military doctors from being sued by uniformed members of the service, some details of cases, which would boost the credibility of the message responses, may not be disclosable due to the privacy act, for example.



Appendix F


IRG Consultants’ Strategic Plan To Apply

Benoit’s image repair strategies


Denial


Simple Denial


Shifting Blame


Evade Responsibility


Provocation


Defeasibility

Oklahoma lessened the standards required for military doctors to obtain a license. Federal law allows military doctors to practice in states other than where they obtained their licenses.

Accident


Good Intentions

Federal law had good intentions by not holding Dod to civilian requirements when it allowed military doctors to obtain a license in one state and practice in another in response to the transient nature of their careers. More efficient.

Reduce Offensiveness


Bolster

Boasting the results of customer satisfaction surveys.

Minimize

The doctors involved in the malpractice cases are only a small percentage of the 13,000 employed by the military.

Differentiate


Transcend

Ten years ago, we required that doctors be licensed.

Attack Accuser


Compensate

Disability pensions

Corrective Action

Military is taking steps to eliminate and avoid future problems

Mortification




References

Benoit, W. L. (1997). Image repair discourse and crisis communication. Public Relations Review, 23, 177-185.

Benoit, W. L., & Drew, S. (1997). Appropriateness and effectiveness of image repair strategies. Communication Reports, 10, 153-163.

Defense and Public Opinion Polls, Air Force Magazine, 79, February 1996 (pp. 87-89).

Feres v. United States, 340 U.S. 135 (1950)

Marconi, J. (1992). Crisis marketing: When bad things happen to good companies. (pp. 118-122). Chicago: Probus Publishing Co.

Young, D. (1995). Looking at your company’s fragile reputation. Public Relations Quarterly, 40, 7-15.

Carollo, R. (1997, October 7). Some staffers underqualified at alcohol rehab clinic, some counselors were kept on the job while mentally ill themselves. The Dayton Daily News, p. 1.

Carollo, R. (1997, October 10). Mistake ends veteran’s bond with military. . The Dayton Daily News, p.

Carollo, R., & Nesmith, J. (1997, October 5). Military medicine, flawed and sometimes deadly. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 5). Private contractors, questionable doctors hired. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 6). The needle went wrong. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 8). Special licenses for doctors. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 9). Double standards of care. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 9). Military labs not subject to federal standards. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 10). The man in the white coat was no doctor. The Dayton Daily News, p. 1.

Carollo, R., & Nesmith, J. (1997, October 11). Laws and rulings shield doctors. The Dayton Daily News, p. 1.

DeBrosse, J. (1997, October 7). Doctors change, records go astray. The Dayton Daily News, p. 1.

Hills, W. (1997, October 5). Newspaper sued to see records. The Dayton Daily News, p.

Mathews, W. (1997, December 15), Who hurts the babies?/A federal judge is absolutely certain it was an airman the Air Force never charged. Air Force Times.

Nesmith, J., & Carollo, R. (1997, October 5). Officials defend military medicine system. The Dayton Daily News, p.

Nesmith, J., & Carollo, R. (1997, October 7). Too many patients, too little time. The Dayton Daily News, p. 1.


15 WORD COUNT 3040 IMAGERY AND SPORT PERFORMANCE BRUCE
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