The first essential and limiting step is to ensure that only doctors can become members. It is somewhat difficult to explain the reason for this to all the rest of humankind and especially to the other healthcare professions, but to most doctors it is self evident. If you’re a small town doctor, to give one example, the town comes to you, undresses, and places their trust in you. You, on the other hand, can’t talk to anyone about what you yourself go through during the day. You can’t talk to anyone about patients. You can’t talk about your own personal stuff, except perhaps with your spouse. Being a physician puts you in a unique and isolated position and there is a need, a very great need, to have a room of your own, a space exclusive to your own profession.
How do the various forums measure up? There are two parts to this question: who can sign up and who else can see your posts.
Let’s look at several forums and see how they’re doing. Since I started this blog by critiquing Sermo.com, I’ll start with them.
I believe they have done a good job in ensuring their participants are indeed physicians only, despite a few glitches in their authentication process along the way. Initially this created what felt like a safe and secure environment to talk to colleagues about anything and everything, from medical cases to personal stories.
Sermo is a private for profit company and was created with the concept of ‘information arbitrage’, i.e. selling information gleaned from physicians to outsiders, these being investors and Pharma. Some physicians found the concept “creepy” and avoided Sermo for this reason. I myself believe that the owner, Dan Palestrant, did a good job at selling this info in such a way that physician privacy was maintained. As far as I can tell the ability of paying clients to view the discussions was limited to the specific discussion they paid to see. At times concerns were raised about just how much these clients could see, as some were listed as members, so this specific question was not completely settled. That aside, data was sold in aggregate and no personal information was revealed. Dan’s attention to this issue was clearly due to his being a physician himself and his intimate understanding of doctors need for privacy from prying eyes.
There is one huge problem with all this, which I’ll get to in later posts.
Let’s look at a small forum I discovered just today called doctorshangout.com. They could serve as an example of what not to do. I won’t even bother to critique their noisy layout or any other issue, as these are moot. They state they are open to doctors worldwide and medical students. The presence of students is a no-no. Their authentication process is non existent. These two problems render them unusable as a safe gathering place. They could rethink this and redo, though having a forum open to physicians worldwide requires a much more complicated authentication process.
Let’s move on to the second of the two big players in the market: Madscape. Oops, Medscape, sorry. Judging by what I see there, and without looking into their financial records, Medscape, a part of WebMD, is owned by Pharma, lock, stock and barrel. How does Medscape fare on these two issues?
In the beginning their forums were open to everyone and anyone who could utter the words “I’m a doctor”. Also, since they cater to other healthcare professions, the boards were not physicians only. About two years ago they did start an authentication process, so one can assume I suppose that now they are indeed doctor only.
What is Pharma’s involvement in these discussions? What can they see and what do they know about the participants?
Curiously, this has been much more a topic of concern on Sermo, which is doctor owned and which has been upfront about client involvement, than on Medscape – which is owned by Pharma. The answer to these questions is: who knows? Medscape’s privacy policy promises that data will be used only in aggregate. The problem is that they are so corporate and impersonal that I trust them about as much as I trust any large corporation to “care” about anyones best interest. But, hey, that’s what they say.
Medscape’s saving grace in this regard is, ironically, that it is so corporate, impersonal and off-putting in every respect (I’ll get to them later in detail) that I can’t imagine anyone wanting to read their discussions and gather any meaningful information from them.
Next post: what makes a physician forum work, part II. Stay tuned.
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