Today’s health care communications lesson is brought to you courtesy of Whole Foods … I mean John Mackey.

John Mackey’s stepped in it again. Last week, Mackey, the libertarian CEO of natural-foods behemoth Whole Foods, wrote an op-ed piece on health reform for The Wall Street Journal. But Mackey felt it necessary to republish it on his blog because the Journal editors lightly edited it, Journal headline writers wrote a catchy headline for it, and Mackey was concerned that folks might attribute some of the sentiment in the piece to the company, not just to the CEO.

The gist of the piece: health care is not a right, everyone needs to take more personal responsibility for their own health (including, utilizing health savings accounts, exercise, eating well … shopping at Whole Foods, perhaps?) and if you want to do something more, make a donation via your tax return to fund public health insurance programs like Medicare, Medicaid or SCHIP. And he opened with a Margaret Thatcher quote: “The problem with socialism is that eventually you run out of other people’s money.”

Setting aside the question of whether one agrees with Mackey’s views on health care reform, one has to question the man’s judgment. He is apparently pretty good at running a Fortune 500 company. However, his op-ed has resulted in an avalanche of reaction, much of it negative, from comments on the WSJ site, to comments on his own blog (where he republished the piece with its “original” title — “Health Care Reform” — which the Journal had replaced with “The Whole Foods Alternative to ObamaCare”), to the blogosphere, to mainstream media.

So, what’s wrong with this picture? Mackey should know by now that (a) many, if not most, folks will identify a very public CEO with the major corporation he leads and (b) if he espouses views contrary to those embraced by his company’s historical, largely liberal activist, customer base he will get the boycott messages that have been posted online, and more customers than those who post will join the boycott. As my kids would say, insisting that the op-ed views are his and not his company’s is lame. A couple more on-line missteps, and perhaps Mackey and his company will not be able to so easily recover.

What can a business leader — in health care as well as in natural foods retailing — learn from this experience? That, no matter how forward-thinking one may be, on-line communications must follow a few simple rules, including the following tenets of social media:

* Authenticity is key, but if your authentic self is likely to alienate core constituencies, think again about what you’re trying to do. If you need a cleanup squad maybe you shouldn’t be the public face of your organization.

* Remember that you do not control the message; all on-line communications may be read by anyone and referred to anywhere (even if not initially published in a leading national newspaper).

* Be prepared to engage with your constituencies on their terms, not yours.

* If you have a big megaphone, be sure you use it to enhance, not detract from, your brand.

David Harlow is a health care lawyer and consultant who blogs at HealthBlawg.

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