First Do No Harm: Find Your Voice

If you want to be a champion for ending medical debt, you need a compelling story to share.

We drilled down into what makes an effective narrative about the harms of medical debt and distilled these findings into a single story-arc champions can use to help decision-makers understand why acting on medical debt is so important.

Our Research Modes

Focus groups

Surveys

Interviews

What is the message Frame?

Clinicians are key messengers in the effort to end medical debt, well-positioned to drive the conversation and help decision-makers understand why this work is so crucial. The following message frame is meant to help you craft your own message and tailor it to a specific audience or setting.

The supporting evidence may shift based on the values of your audience – but the topline message remains the same: No on should go into debt for accessing the healthcare they need. In other words: first, do no harm.

Introduce the Problem

Medical debt is pervasive – it affects all of us, burdening people financially and emotionally.

Key Message

As a provider [doctor, nurse, community health worker, etc.] I believe that no one should go into debt for accessing the healthcare they need.

Supporting Evidence

My patients are struggling with the cost of care. Patients delay or forgo care or do not fill a prescription to avoid medical debt. Patients are anxious and stressed.

They look to me as a problem-solver to help them address complex bills and adjust their treatment plans to meet their budgets.

As a [doctor, nurse, community health worker, etc.], I am navigating conversations with patients about what affordable options exist given their insurance type or status.

Call to Action

As clinicians, we must intentionally engage and build trust with patients to keep them healthy – mentally, physically, and financially. The problem of medical debt is complex, but we can each do our part to move the system to prevent it from harming patients.

Who is your audience?

What power do they have to solve the problem?

The messages in this guide are NOT intended for a patient audience, rather they are intended to support the healthcare workforce in getting comfortable talking about medical debt with a wide range of stakeholders.

Champions for change must contend with multiple audiences, many of whom may have competing ideas as to the most important solution (e.g., a revenue cycle leader might be concerned with easier pathways to financial assistance, while a physician department chair might view lower cost pharmaceuticals as the most important solution for patients)— but the core issue remains the same. There is deep empathy and near universal acknowledgment that medical debt is harmful, unfair, and must be addressed.

As with any messaging exercise, physicians, and front-line healthcare workers should reflect on the audience they are trying to influence.

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Defining Your Audience

It is always valuable to frame your messages so that they connect with your audience.

There is no “general public.” Be specific—every group has different interests, values, and motivations. Adapt your language to meet people where they are.

Consider the following questions when tailoring your story:

Why should this stakeholder care about medical debt? Where do they fit in the landscape?
What does this stakeholder value? What is their mission, focus or mandate?
What are the barriers they face in advancing solutions? How can you acknowledge constraints?

The Message Box tool is a helpful guide

Video: Messaging Example from Dr. Crichlow

Raise Visibility

Conversations with colleagues and institutional partners (CFOs, Revenue Cycle leaders, and others in administration), as well as communicating with more public-facing stakeholders (like local and state policymakers, advocates, and other community partners) are great ways to raise visibility about the harms of medical debt.

Adapt Your Language

When pivoting across stakeholders, it is important to reflect on what matters most to those individuals or groups. Shifts in language matter and are often key factors in influencing people’s thinking about medical debt harms and their power to change it.

Journey of a Champion

Explore the Path of Engagement

Awareness

Research the issue, read about the issue in media, ask friends and family about the issue

Clinician Champions Might:

Read About Medical Debt

Endorsing

Clinician Champions Might:

Contributing

Send a letter to a decision maker, submit a letter to the editor, comment on social, bring people to an event, tell your story

Clinician Champions Might:

Letter to the Editor or Social Media Post

Owning

Join a leadership team/steering committee or coalition, meet with decision makers, develop a social presence, author op-eds or blogs, gather stories

Clinician Champions Might:

Write a Blog or Op-Ed

Leading

Lead meetings and drive planning and strategy, train others to own the issue, lead a donation campaign, build a following and become an influencer, work to become a policy change agent

Clinician Champions Might:

Testify to Congress, State Legislature or City Council

Learn More About the Research