Of all of the dustups that the great Health Reform Debate 2009 has precipitated, none is as significant — or as under-appreciated — as the war of words between the American Medical Association and Sermo, the physician-only social network. Wherever the policy debates on the specifics of a health reform bill fall out, we’ll still have much the same system that we have now, assuming the bill passes. Yes, more people may be insured. Yes, we may have an additional government plan. And yes, there will be changes around the edges. But we won’t see the $2.4 trillion-a-year health care business reshaped beyond recognition.
What we will see, however, is a sea change in how doctors are organizing. And this is likely to lead to profound changes in everything from how doctors practice medicine to how physicians operate as public policy advocates.
Let me back up. Earlier this summer, the AMA and Sermo ended a two-year partnership intended to allow the AMA to plug into Sermo’s logged-in physicians. Then the broadsides began: Sermo’s founder, in early July, posted a blog entry that called the AMA “The Biggest Risk to US Physicians.” Over the next three weeks, the social social network put out three separate releases that said that an overwhelming number of Sermo physicians rejected the AMA’s stance on health reform and opposed the current versions of the bills under consideration, noting that three of four Sermo members were not members of the AMA and that nine in 10 didn’t think that the AMA reflected their opinion of medicine.
It is likely true that the AMA’s membership is larger than Sermo’s, and there is no question that the AMA remains the official (and powerful) voice of the physician lobby. But Sermo’s explosive growth and the site’s demographic — younger, Internet-savvy docs — means that the tables will soon be turned and that what the community on Sermo thinks may represent the collective stance of the nation’s doctors. And we probably won’t have to wait long for this to happen.
Of course, having an influential group of wired doctors, unmoored from any formal bureaucracy is only the first step. It won’t be long before online patient communities, too, become more powerful than the old-school advocacy groups that have long spoken for patients. Just take patientslikeme.com, where the future has already arrived in the form of hundreds of highly involved patients swapping detailed information about their disease and treatment.
These new groups don’t mean that traditional patient- or professional-centered associations will cease to exist. But, increasingly, they will have to co-exist with raucous, minimally organized groups of incredible informed individuals. And in a new world in which connections are king and every opinion can be broadcast, this is excellent news. The more voices we can hear, the better.