The most important ethics priority for healthcare communicators – Kena Lewis

Joining me on this week’s episode is Kena Lewis APR, Fellow PRSA. She is the Senior Director of Public Affairs and Media Relations at Orlando Health. Kena discusses several important ethics issues, including:

 Please tell me a little bit more about your career and yourself.

I’m one of those very lucky people who is fortunate to love the job that they do, and I landed in the right place at the right time. I started in radio as a reporter and made the jump to PR about 35 years ago. I’ve worked in the PR business ever since. Always on the corporate side, never on the agency side, but in multiple industries. I started in cable television. Then of course, like any good Orlandoan, I worked in travel and tourism. It’s a prerequisite here. I did a stint in the nonprofit sector, which I want to say, if you really want to get to know a community, the nonprofit sector is something you should do. Now I’ve been in healthcare now for almost 15 years.

Looking over your career, what is the most difficult ethical challenge you ever confronted?

It’s tough for I’ve worked for some really great organizations.

I’m from the school of, you don’t go over your boss’s head when you see that things are not right in an organization. But what if the thing that’s not right in the organization is the boss? I faced that dilemma earlier in my career. Ultimately I decided that to not say something was a disservice to the organization, to its clients and to the industry. And so I did. I went to the chairman of the board. Lucky for me, he also was aware that something was out of sync, but he was not there day to day. My account just served as confirmation to him that something was not as it should be. Soon after that, the boss decided to pursue other interests. That really was the best thing for the organization and for everyone involved.

That’s a great example and it’s a challenge a lot of people face. Where does your duty lie? When you’re deciding to go over your boss’s head, what’s the triggering factor? How do you know when the little thing becomes a big thing?

It wasn’t just me who was seeing this. There was a lot of chatter within the organization and it was affecting the morale of the entire team of the entire organization. So much so that people were just throwing their hands up and giving up. If it gets to the point where it is impacting the organization on a broader level, then something needs to be done. Presidents and executives come and go but if your organization has any longevity, then it’s the organization that has to stay. I think that’s one thing to look at. Is it damaging the organization long term or short term and if so, you have a responsibility to say something.

How do you make sure your voice is heard and you’re not dismissed as being the one outlier or that people understand the severity and the need to act now?

I would say document. Have specific examples that you can relay and if you can, time and location. The more information and the more facts that you have to substantiate your claims and your account, the more seriously you are taken. Then whoever you’re speaking with, they may want to reinforce what you’ve said by interviewing other people and that’s fine because the information that you give is accurate, timely and fair.

A lot of people say you should bring these concerns to HR. What’s the deciding factor for you in terms of where you go to raise the issues?

In that particular example, the HR executive was having the same problem. Maybe I was just the one with the loudest mouth and the one who said this is crazy. The HR executive was also aware of the situation, but for whatever reason and maybe it was one of loyalty, they didn’t want to say anything either. In that instance, that’s what was going on. It wasn’t just HR. It was also the finance executive and the sales executive. We all knew what was happening. I think I was just the one either elected or who volunteered to go to the board of directors chairman and say something.

Beyond your personal experience, what are you seeing as some of the key ethics challenges for today and tomorrow?

Oh goodness. I think that it probably resides somewhere in the online space. I see a number of people who post about brands, either for them or against them, positive or negative, and they’re using pseudonyms. In actuality, it appears that they may be spokespeople for these brands or opponents for them. One of the values of the PRSA Code of Ethics is honesty. That means being honest about who you are and who you represent as well as what you’re saying about whatever brand you’re speaking about. I understand these individuals may be concerned about being identified. If you’re that concerned about being identified, then maybe that’s not something you should be talking about.

I see that and it bothers me as a spokesperson, and I’ve been a spokesperson for almost four decades now. It bothers me that there are spokespeople who are not living up to the ethics and the realities of what it is to serve as a spokesperson for an organization.

I spoke with Greg Bailey recently and he was talking about it from the disclosure point of view and the use of pseudonyms in terms of, you need to say who you are to make the case also otherwise there’s the issues.

Absolutely agree with him. Absolutely agree.

Brands also come under attack from people using pseudonyms. How do you recommend responding when you find you can’t identify who the stakeholders with whom you want to really address the concerns?

Social media for all of its good points, has plenty of negative ones. Sometimes it’s a cesspool and I don’t think that you can realistically respond without being attacked further. When that happens, if you’re a brand that is under attack by an unnamed someone, I’m not sure responding, especially on social media, is the smart thing to do. Most of the time I would counsel do not respond.

If there are blatant facts that are being presented as untruths, you can respond to those facts, but don’t take it personally. I know that’s hard for people who love their brands to do, but you can’t take it personally and you have to stand aside and look at exactly what’s being said. If there are any facts that you can provide, that’s okay. But anything else I think will just open up you and your brand for more attacks unfortunately.

What are some of the ethical issues that healthcare professionals in general need to think about?

Our first priority and our first responsibility is always to the patient. I don’t care who that patient is. If that patient is a celebrity, if that patient is someone who is an elected official, it is our responsibility to maintain their privacy. To not do that is a violation not only of the PRSA Code of Ethics but also, it’s a federal violation. You’re in healthcare. You know of times when a celebrity or someone of known has entered your facility and someone will take a picture or tweet it out or Facebook it out and it’s not allowed. It’s simply not allowed. We also get a lot of requests for when that happens, somehow the press always finds out. I absolutely respect the first amendment and love it. I’m a former journalist so I have huge respect for what journalists do, but we have rules that we have to live by.

When we cannot provide your information to journalists because it is a privacy violation. It doesn’t mean that we’re withholding information. It means we’re abiding by the laws that we’re required to abide by. We get that quite a bit. We’ll have a journalist say, “Well, I know so and so is there.”

“I’m sorry, there’s nothing I can do. I can’t respond to that because according to HIPAA, that person, that name is not in our system and is not in our system.” That’s probably the biggest thing.

When we have medical errors, like any other healthcare organization, our policy is to be transparent with the patient and with the patient’s family. I know our doctors do and our administration does, and we’ll even meet with people depending on the circumstances to hear their concerns and offer assurance and guidance.

I want to drill down with a tactical question. You are asked a question and you can’t disclose it. The PRSA Code of Ethics talks about safeguarding confidences. Is your approach, “according to HIPAA guidelines we can’t release names of any patients” or is it “we can neither confirm nor deny.” How do you handle that?

Here’s an example. We have a lot of visitors who are down here in Orlando of course and from time to time, we’ll have serious accidents on the roadways. Especially if there are children are involved, we’ll get requests and the reporter will say, “Hey, I understand there was the four-year-old who was in the wreck on the interstate was brought to your hospital. Can you tell me their condition?” And our first response is, “You have to give me a name. I just can’t give you the condition of any four-year-old in the hospital.”

They said, “Well, I don’t have the name, but it’s the four-year-old who was in the accident.” And our response is, “I’m sorry. You’ve got to provide me the name.”

Take another example. Sometimes law enforcement will bring in someone who has been attacked or shot and they will ask that that person be entered into the hospital under a pseudonym and it’s for their safety because that means they don’t know where the perp is, whoever the perpetrator was who did this attack in the first place. If a reporter calls me and says, “Hey, can I get a condition on John Smith who was brought in?” That name may not be in the system because law enforcement has asked it to be changed.

When we say, “I’m sorry, that name is not in the system”, of course, then they get angry because, “Well, I know the name’s in the system because we know he was brought here. We know he was brought here.” That may be the case, but the name is not in the system and then we’ll give an example of why. We’ll say, “For example, it may not be in the system because law enforcement has requested a change. It may not be in the system because let’s say a celebrity comes in or you yourself, Mr. Reporter, you come in and you don’t want to be found. You could request to be put under a pseudonym. We have quite a bit of that especially if there’s a bad accident or there’s a high profile person or there’s a child. That’s very concerning to people. We don’t mean to stand in your way, journalist. We just have to abide by the laws that we’re bound by.

That’s one of the things I’ve talked to several folks about. When you talk about disclosure for information, it doesn’t mean you need to disclose all information.


Disclosure can be saying, I’m not going to tell you and here’s why, so I understand that. I had a fun conversation with the former head of the TSA communications about that very thing, when they wanted information. And it’s like, “No, it’s a national security issue. This is why I’m not going to tell you.”

You should respond, don’t ghost, but be clear there.

What is the best piece of ethics advice you ever received?

The best piece of ethics advice I ever received came from my grandmother who had about a sixth-grade education. She knew nothing about public relations, had probably never heard of the word, but she would always say to me, “Kena Lynn”, that’s my middle name, “Kena Lynn, if it doesn’t feel right, it probably isn’t.”

Use your judgment, listen to your inner voice. We, as humans, don’t necessarily have antenna, but we do have sensors that tell us when things don’t feel right. Trust those sensors.


Listen to the full interview, with bonus content, here


Mark McClennan, APR, Fellow PRSA
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Mark W. McClennan, APR, Fellow PRSA, is the general manager of C+C's Boston office. C+C is a communications agency all about the good and purpose-driven brands. He has more than 20 years of tech and fintech agency experience, served as the 2016 National Chair of PRSA, drove the creation of the PRSA Ethics App and is the host of


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