Tuesday, February 19, 2008

Sermo - The Power of Physician Information

Sermo.com is a physician-only conversational website. Sermo rests on the premise that doctors, as part of the sisterhood and brotherhood,

• will freely exchange views on a secure website

• their views will possess the power to predict trends

• their views will provide relevant and early information to improve the system

Sermo has another power – the power to assemble survey information quickly, sometimes overnight, to fathom how doctors are thinking.

I was thinking of this the other day as I read an excellent article in the New York Times Magazine. “Miracle Workers? Why We Expect Doctors to do the Impossible.” The article contains this paragraph, which is right on.

“Ultimately, it is no doubt simply irrational to expect physicians to simultaneously be great clinicians, great scientists and great psychologists and humanists (as well as great accountants. Some are; but a medical system built on the assumption that such mastery can be normative would be an exercise in folly. Perhaps this is why in recent years, the doctrine of ‘evidence-based medicine” has become so influential in American medicine. By pushing medical providers to makes their decisions almost exclusively on the basis of statistics, this doctrine implies that what is good for a group can be assumed to be good for every individual despite the fact that this is often not the case (italics mine).

The piece cited a 2006 Consumer Report Survey where patients get their medical information. This information influences their decision-making, and in some cases, empowers them

• 59% Read books and articles about the condition

• 39% Read about the condition on the Internet

• 44% Asked the doctor about treatments they had heard about

• 47% Brought a list of questions and concerns

• 28% brought a friend to an office visit.

Given its power to gather information almost instantly, Sermo might consider a survey about how doctors gather their information and make their decisions. Do physicians
rely upon,

• Common sense, clinical experience and patient history

• Patient wishes and expectations.

• Information from journals and books

• Internet sites with diagnostic-support information

• “Evidence-based” information, clinical protocols, and pay-for-performance criteria

• Gathering information for “defensive medicine purposes”

• Gathering information that health plans are likely to pay for

• A combination of the above

Quick access to physician information has power. Physician trends and opinions are a moving targe. The target can be traced through frequent surveys showing what's likely to work or be accepted on the clinical frontlines.

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