Despite the array of options, emergency physicians have been slow to utilize social networks for edcuational gain
What practice-changing medical research have you come across on Facebook? What amazing EM career opportunities did you discover on LinkedIn? What enlightening medical conversations have you had on Twitter? There’s a good chance the answers are none, none and none. When it comes to meaningful physician-physician interaction, online social networking has yet to really take off. Sure, doctors use Facebook like everyone else, but – by and large – they haven’t tapped into the educational potential that online social networks offer.
In a world where Facebook is valued at about $100 billion, and spends $1 billion on Instagram (a photo-sharing network that never made a dime) it’s a good idea to ask, what exactly is a social network? In the article “Social Network Sites: Definition, History, and Scholarship,” UC Berkeley’s Danah Boyd offers a useful definition: “a web-based service that allows individuals to (1) construct a public or semi-public profile within a bounded system, (2) articulate a list of other users with whom they share a connection, and (3) view and traverse their list of connections and those made by others within the system.” These criteria filter out a number of online media sites that simply allow physicians to create profiles and post contributions, such as Student Doctor Network and Medscape’s Physician Connect, as well as those that generate and display physician profiles for rating purposes, such as Vitals.com and HealthGrades.com.
While discussion forums and ratings sites have been with us since the early days of the web, social networks have exploded in recent years, driven both by users’ interest in connecting and sharing, and advertisers’ interest in more tailored information and more targeted ads. One would imagine that an online physician social network would be sought after, by both users looking to share practice information and advertisers looking to gauge, and sway, a physician’s influence.
The idea of physician networking goes back as far the 8th century AD, when a Tibetan King brought together physicians from India, Nepal, China, Kashmir, Afghanistan and Iran to share medical expertise. Whether by papyrus or pixels, physicians have always benefitted from comparing notes. Greg Henry, who is a speaker at the largest EM conferences in the world, recently noted that, “A lot of the learning that goes on [at EM conferences] is not just from listening to the speakers, it is interacting with other doctors, asking questions of each other. ‘Do you really do that? What’s happening at your institution?’” If this is the case, the educational potential for physician social networking online is great, if we can just find the right platform and get buy-in from physicians.
It’s not that groups aren’t trying. ACEP, SAEM and AAEM are on Facebook, as are dozens of departments and residencies, EM journals and interest groups (Disclosure: one of the authors was the first chair of SAEM’s social media committee). When you “Like” an organization on Facebook, you subscribe to its updates and can interact regularly with the institution. The problem on Facebook is buy-in and utilization. The AMA, for instance, boasts 16,000 “Likes”. That’s a lot of doctors, to be sure, but less than 10% of its dues-paying members. The Facebook pages for House, MD, by comparison, have over a hundred thousand fans.
Perhaps physicians are concerned about carrying on medical dialogues because of privacy risks – well-publicized risks in the case of Facebook. Maybe it’s the cases that have made headlines, of doctors who’ve irresponsibly posted details of a case on Facebook, and been fined by state boards and fired by hospitals. But, as far as these authors are concerned, that’s throwing out the good with the bad. With today’s social networking tools, doctors can share important research and discuss practical considerations, discussing practice and clinical cases that would otherwise go unremarked upon or briefly mentioned at Wednesday conference. Physicians can also develop virtual friendships with other physicians based on shared experiences and mutual respect, which may translate into patient referrals, fellowships and jobs. Doctor-doctor social networks are now also being used by specialty groups to do everything from plan conferences toobby on the Hill.
If these tools have piqued your interest, we’ve included a few physician social networks that are beginning to tap into the potential of a meaningful, educational online dialogue.
Self-described as the “Largest Online Network, Exclusive to Physicians,” Sermo has over 120,000 members spanning 68 specialties. The network has four main features: connecting with colleagues, learning from them, earning honoraria by sharing clinical insights, and adding one’s voice to discussion and petitions regarding healthcare policy. It’s free for physicians to join (credentials are verified) because their business model centers on selling member physicians’ insights to healthcare institutions, financial services firms, and government agencies.
Sermo declares that “the most priceless resource for any physician is other physicians.” To that end, they’ve gone to some lengths to guarantee discussions remain private and secure – doctors on Sermo can vent freely (and anonymously) about patients, colleagues or administrators. And they can consult each other on clinical questions, even share images of rashes or strange radiology findings, to see what the group thinks about a case.
Doctors Hangout is “A Personal & Professional Networking Site for Doctors & Medical Students Worldwide.” It was founded by an Indian doctor and as far as one can tell most of its 23,191 members are South Asian physicians and medical students. Unlike Sermo, Doctors Hangout appears to have an emphasis on personal networking between medical professionals (e.g. the largest group on the site, “Single Docs,” has 1,124 members).
The brainchild of ePocrates founder Jeff Tangney, Doximity is built around HIPAA-compliant messaging, but also facilitates phone calls and referrals to colleagues, reconnecting with former classmates, and specialty-specific news. Doximity grew to 30,000 members by the end of 2011. If you, as a doctor, head over to Doximity.com and enter your name, you’ll eerily find you’re already listed. In fact, setting up an account on the site only requires verifying your medical school and year of graduation.
Emergency physicians international
(Full disclosure: EPI is the social network-cum-magazine sibling of Emergency Physicians Monthly.) With over 1,500 members, EPI is an example of an emergency medicine-specific doctor-doctor network. EPI describes itself as the “First Magazine & Online Network Devoted to Global Emergency Medicine.” To this independent author, emergency medicine seems to be particularly well-suited to interprofessional networking given that EPs tend to have more flexibility in terms of international travel than other physicians (e.g. family practitioners). Then again, if EPI wants to compete with social presence of Doctors Without Borders (MSF) online, they’ve got their work cut out for them.
Twitter can be as inane, or as useful, as the accounts you follow. Fortunately, there are some really smart and fun EM physicians on Twitter, and a number of journals and organizations, who update with enough frequency to make logging in worth your while, even if it’s just via smartphone, while you’re in line at the grocery store. The Tweets often contain links to interesting articles or opinions: @emlitofnote covers peer-reviewed literature, @poisonreview is a toxicology resource, and @drkillpatient provides some guilty pleasures from his (or her) anonymous account.
Twitter is particularly great as an adjunct to conferences; you can see what people in the audience are saying about a particular speaker, and learn about social events after-hours. Recently, tweets relating to particular conferences or events have been collected at Storify.com, which makes it easier to parse through the cacophony.
Twitter works fine if you’re passive, but to participate it takes some effort to get your thoughts condensed to a series of 140-character tweets. If you think about it like public text messaging, you’ll probably get the hang of it. Just remember, even if you’re not using your real name, be careful not to compromise your patient’s privacy, or workplace code of ethics (and remember, with smartphone GPS services, tweeting from your phone can accidentally disclose your location).
Once viewed as a trivial hobby by more eminent researchers and writers, blogs now serve as the elder statesmen of social media - and they can act as a base of operations for social networking. Witness the conversations that grow out of posts at Life in the Fast Lane (lifeinthefastlane.com) or Academic Life in EM (academiclifeinem.blogspot.com), two terrific EM blogs that are full of educational resources and advanced thinking about emergency topics. The comments that various posts generate spill over into Twitter and Facebook, and spawn fodder for future podcasts or blog posts, on those sites or elsewhere. You can almost view the large EM blogs as forming their own doctor-to-doctor social network.
We haven’t mentioned all the physician social platforms that have failed, or have changed focus, like iMedExchange and Ozmosis. And we haven’t delved into non-EM speciality-specific networks, like PeerCase for oncologists or OrthoMind, for orthopedists. There are other social networks based on sharing knowledge with patients or a lay audience, like Quora, Sharecare, MedHelp, and HealthTap, that we’ll be covering more in depth, next time.
But the ultimate online physician social network probably doesn’t yet exist. We can suppose it will be HIPAA compliant and secure, so doctors can discuss cases and express opinions without liability. We know it’ll work just as well on mobile phones and tablets as it does on laptops and desktop computers. Maybe this network will interface with major EHR systems or health information exchanges. Maybe it will be an outgrowth of an “old school” social network, like a professional society or medical organization. The network may fund itself with CME offerings or by selling the (de-identified) content of physician discussions to third parties (we’ve yet to see a sizable network grow that required membership fees).
Whatever that future physician social network looks like, we think there are too much incentives – both financial and education – to NOT try to corral and capture physician’s thoughts, activities and behaviors, online. It’s just a matter of time.
Boyd, D. M., & Ellison, N. B. (2007). Social network sites: Definition, history, and scholarship. Journal of Computer-Mediated Communication, 13(1), article 11. http://jcmc.indiana.edu/vol13/issue1/boyd.ellison.html