October 18, 2007

Doctors click to networking?

BY Dr. Keith J. Kaplan

I do not understand what Sermo.com really does or why it receives the amount of press it does.  Below is a recent story that appeared in Financial Times and reported by the Associated Press.  After sometime I was able to register on the site and use it infrequently.  For pathology I find it offers little more than Medscape or what use to be possible with Physicians Online (now Medscape).  However, the content, CME and related specialty stories on Medscape I find more interesting.  The pathology discussion rooms on Sermo have some interesting discussions and "What is your diagnosis?" type cases to reply to but overall, the content is lacking and uninformative.  It appears a core of about 2 dozen or so pathologists are regulars who post questions and answers.  Perhaps 150 or so pathologists are actually registered. 

What I find most intriguing is the average age of participants on this so-called social network site for physicians, particularly in pathology.  It is interesting to see "older" or, er, "more experienced" pathologists using online forums as a meeting and network place.  While I don’t have a Facebook or Myspace.com account, neither have I forayed into other social networking sites.  But perhaps amongst physicians these have their place among older physicians, particularly if they are in small groups or in rural areas or isolated from other colleagues.  See story below.

"US doctors may not have time to be out of the office with colleagues playing golf anymore, but they  might be found clicking away online (on a social networking site) instead.

And the demise of doctors’ weekday golf availability and their time on Sermo.com, the US social networking site for physicians, are very much related.

As the structure of medicine changes and more treatment is done in physician’s offices, allowing patients to avoid hospital stays – so-called outpatient treatment – doctors can spend more time there, and much less time than before interacting with peers.

Dr. Daniel Palestrant, founder and chief executive of Sermo, says doctors’ increasing sense of isolation was one of the most unexpected findings after launching his social networking site a year ago.

“Golf is a thing of the past; even doctors’ lounges are things of the past. What was shocking to me was these doctors described themselves as ‘lonely’.”

But that is changing as doctors are now linking themselves and their practice of medicine in new ways with technology more often associated with teenagers than surgeons.

This shift is highlighted in the current collective discussion among Sermo’s online community of more than 30,000 physician members on what to call themselves. So far, they prefer “Sermoans”.

The Sermoans are medicine in the MySpace age. And it’s not just the younger set fresh from medical school. The attraction of belonging and the ability to publish or broadcast personal professional pursuits to a distinct and interactive online social community and receive feedback is grabbing the older, busiest doctors the most.

Dr. Palestrant says he expected Sermo’s users to be dominated by younger doctors like himself at age 33. But instead, Sermo member doctors 45 years of age and older outnumber by three-to-one those under 45.

Sermo, which verifies each member’s credentials, is free to join for doctors, whose profiles can range from minimal biographical information to photos and personal details. Its business model rests on two fundamentals: no advertising and open, unedited interactions between members.

For instance, a doctor posts a medical case, and others help to work the problem. Other discussions can expose conflicts of interest in doctors, seek emotional support, or ask for guidance on hiring and firing office employees. “The wisdom of crowds dictates these things. It’s startling how effective this happens,” Dr Palestrant says.

Nevertheless, it was the prohibition of marketing and branding that at first left the pharmaceutical companies wondering how they could ever work on such a new frontier. Dr Palestrant estimates that nine months ago about 90 per cent of drugmakers he approached either thought Sermo was a joke, or looked for reasons why it would not work.

Pfizer was interested nine months ago, as the company struggling and in transition with Jeff Kindler, its new chief executive, sought fresh ideas.

Pfizer sees the technology as potentially helpful, efficient and a dynamic way of letting doctors obtain information on its drugs, learning more about its own drugs, improving relations with the medical community, and getting new ideas and feedback on clinical trials.

Dr. Michael Berelowitz, global medical chief at Pfizer, said: “The most interesting thing for us about Sermo is in many ways it represents a future direction for physician discourse.

“The physicians at Pfizer would like to become part of the social fabric and learn to work with the physicians’ social network in ways they feel comfortable working with us.

“We in turn learn from them and learn how best our medicines may be used, and how best that knowledge of our medicines may be generated.”

Timing is always important, and Pfizer’s interest coincides with the company’s rigorous self-examination and search for change to reignite growth and prepare for a changing drug market.

Similarly, physicians have been seen as fragmented, disorganised and resistant to new technology, thus making them a formidable obstacle to healthcare cost reform, particularly in the US. Uniting them with a technology platform could bring many more important changes in the future."

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