• by Liz Tascio , December 2, 2008

Physicians can be a tough bunch to reach

Now that Dr. Nicholas Genes is an academic chief resident at Mount Sinai School of Medicine, he doesn't have as much time to keep up with his own blog or with Grand Rounds, a medical-blog index he founded; these days, other emergency doctors share aggregating duties there.

Genes does make time to be on the editorial board of medscape.com and to maintain a blog for his residents. He checks uptodate.com for new peer-reviewed medical info, hangs out in the New England Journal of Medicine's online community, and keeps tabs on what's newly published on jwatch.org (that's Journal Watch, for you non-physicians). His video podcast of choice comes from emrap.tv, created by two emergency-medicine faculty members in California.

Industry experts say physicians tend to be slow to adopt new technology. But doctors are beginning to spend time on niche social networks; they're sharing medical podcasts and videos; and they're test-driving electronic health records from companies like iMedica. Some Twitter at work (Genes doesn't, for fear of violating patient privacy) and at conferences. "I do sleep," Genes assures. "I think, honestly, that [Web 2.0] makes us a lot more efficient."

In fact, the latest online activity of doctors seems to be changing not just health care, but niche advertising, too.

Just What the Doctor Ordered

When software developer Tobin Arthur launched the social network iMedExchange last summer, he expected physicians to talk about cases and share advice and opinions. And they do. But they also started chatting about American Idol, trading bottles of wine, and sharing travel tips.

In response to requests, iMedExchange is adding a Craigslist-like marketplace and a vacation-home swap. A requested "personals" feature is under consideration, too.

Arthur allows advertisers to build branded microcommunities and engage only with doctors who voluntarily enter that area. Sermo, which launched two years ago and has 90,000 doctors in its network, works almost the same way.

"We made this community a promise from day one that we would never directly advertise," says Dr. Adam Sharp, Sermo's chief medical officer. Even if he were to sell a marketer an ad, "I'm not sure they'd get a whole lot of bang for their buck," he says. The doctors moderate the site themselves using a rankings and ratings system, pushing away unwanted content.

Companies that bring value into the community do well, say Sharp and Arthur. For example, physicians, whose cash-driven businesses provide them with income they need to invest, have had a lot of financial questions lately. "We're doing a financial series with UBS ... on the site providing great financial expertise for physicians," Arthur says. "We're going to be doing a lot of offline events where financial experts will be out lecturing doctors, and Ritz-Carlton will be a part of that."

Medical SNS can get even more niche. Do-surgery.com is a social network just for orthopedic surgeons, launched in July 2008. Digital agency Greater Than One created the network for DePuy, a Johnson & Johnson company that makes surgical equipment and trains doctors to use it.

Do-surgery is barely branded, says Marc Michel of GTO. It doesn't have to be: It's open only to surgeons who have taken DePuy classes, about 95 percent of whom sign up. So far, surgeons from 30 countries have joined. "Despite the fact that surgical devices are something you want to touch, feel, use, they can discuss the cases, they can look at the surgical videos," Michel says. "This is built for them, by them, and it's something they can contribute to."

Niche network The Holistic Option brings together alternative-medicine practitioners, and is also open to consumers. Founded by Kelly Campbell (also the founder of creative agency Liqui-Site Designs), the social network just might increase the credibility of alternative medicine among Westerners: Practitioners who want to join are vetted one at a time by an advisory board of professionals, all handpicked by Campbell.

Campbell vets advertisers, too. She doesn't work with Google or Yahoo, though she admits that decision limits her revenue. "I wouldn't want a prescription drug coming up if someone types in 'natural remedies for [high] cholesterol,'" she explains. "I think the integrity of it is much more important."


Bum Deal

One particular Web 2.0 experiment aims to make doctor-patient interactions more efficient for both parties. Dr. Elliott Justin, an emergency room doctor for almost 30 years, says many patients who come in could have just sent him a jpeg. This fall, he launched SwiftMD, a subscription service that replaces actual visits with virtual ones. Skeptical? Justin says he once diagnosed - the squeamish should skip this part - a businessman's hemorrhoids via Web cam.

"He's at a very ritzy hotel in London. The house doctor comes and tells him that it's either a hemorrhoid or an abscess and he needs to see a surgeon," Justin says. Instead, the man contacted Justin, and with the help of an "awkward, unique position of his laptop," Justin concluded it was not an abscess, sent the man to a drugstore for ointment, and told him he'd contact him in eight hours to see how he was doing. "I saved the guy an unnecessary surgical procedure," Justin says.

"What I really want to demonstrate is that the future of health care is virtual, and that health care can be delivered outside a brick-and-mortar setting," Justin says. "We can deliver health care where people are."

SwiftMD subscribers pay $9 per month. For each doctor "visit," they pay $59 and get a call within 30 minutes.SwiftMD even handles requests to insurance companies for patient reimbursement. Justin says he's got 32 physicians on board; his goal is to sign up 100,000 patients in Swift's first 24 months.

For all the ways the health care industry is experimenting with Web 2.0, some physicians get a big benefit the old-fashioned way: by blogging. Dr. Kevin Pho, a primary care physician in Nashua, N.H., blogs at kevinmd.com and has about 16,000 subscribers; his Twitter feed gathers up to 10 new followers a day.

Pho says he started blogging in 2004 because he wasn't seeing a physician's perspective in mainstream news. Since then, his blog has been cited by The Wall Street Journal, NPR, SmartMoney magazine and more; Pho himself has appeared on CBS News.

"There are some doctors who are averse to or aren't comfortable with social media," Pho says. They're too busy to learn it, or they just don't see a benefit. But Pho says that maintaining a well-read blog actually helps him stay current and informed. And as for being too busy? Well, that might be a valid concern. "I do most of my blogging at night," he says, "after my family sleeps."