What We Can Learn From Sermo – and What We Can’t

The biggest threat to associations today is the internet pure play – the web-only organization that delivers the core value of associations, without any of the financial or cultural baggage.

Sermo represents one of those threats. It was the first professional social network for physicians, founded in September 2006. Its primary value is to give physicians the ability to connect with each other to ask questions, share knowledge and help each other. Today, it claims about 100,000 registered users.

Sermo’s chief marketing officer, Gina Ashe, spoke on a panel with me at ASAE and the Center’s Healthcare Association Conference last week in Baltimore. As a non-physician, I had never seen how it worked, and came away quite impressed. Her examples of how Sermo can advance health care were engaging and compelling.

Some reasons why:

Sermo works hard to keep technology in the background. Though its user interface today is reasonably pleasing eye candy, its first interface was simple and bare. When Sermo develops features, Ashe said the recurring question is, “Does this create harmony between the community and technology, or put our community at war with it?” This is a good test for any website.

Sermo doesn’t try to pull physicians out of their workflow, but integrate itself into how they work. Trying to pull physicians (or anyone else) out of their workflow is asking for failure. This is a good principle for any social network.

Sermo tries to balance the freedom that flows from anonymity with a desire to ensure responsible and ethical behavior. Sermo’s mantra is “anonymity with accountability.” Only one quarter of its members use their real name, which undoubtedly encourages participation. But this anonymity is not total, because the company knows who every member is, even when public users don’t. Sermo also verifies the the professional credentials of every member. You must have an M.D. or a D.O. to be a member, and you have to prove it. (However, Sermo might open the network to non-physicians in the future.)

Accountability, Ashe said, is also imposed by public reputation of users, which is developed over a period of time through the quantity and quality of a user’s activity. This sounds a lot like eBay. Sermo also requires users to pledge upon registration that they will disclose all potential conflicts of interest.

This is all good food for thought for association leaders.

However, I have always had concerns about Sermo’s business model, and nothing she said that day erased my concerns.

For example, some aspects of the company aren’t 100% transparent to my satisfaction. True, it discloses that its sponsors listen to the conversations, and she said it clearly tags member physicians who are employed by pharma. But she didn’t say whether this applies also to physicians whose research has been even partially funded by drug companies, are paid to speak about their products, consult for them, or own pharma stock.

And, while Sermo clearly names three investment firms as major investors, this isn’t enough for me. If I were a user I would want to know if any specific pharmaceutical company is listening to my particular conversation. As I said, transparency is not complete.

Further, though Sermo requires members to promise to disclose their conflicts, I am not completely assured, given what we know about human nature. People lie, rationalize and obfuscate.

This may seem like hairsplitting. But this is where where the hottest battles in medical publishing are raging today.

Ashe also discussed a new Sermo offering, in which its feeds can be displayed directly onto Bloomberg computer screens. This means that traders in a company’s stock can watch Sermo members comment about a company’s products in real time. With some pride, Ashe said these conversations are starting to move company stock prices.

This is frightening. It’s fertile ground for fraud, abuse or price manipulation. Ashe told the conference that the community self-regulates, but this rings hollow at a time when self-regulation in financial services is a bad joke.

If I were a Sermo user, I might not be happy knowing that my professional concerns could affect the stock market – especially these days. A single rumor – whether true or false – has been known to shake markets. And if I were Sermo, I might worry if this concern could put a lid on my members’ comments.

Sermo is young and it is smart, and its people have figured out a good deal of the social networking equation. But there’s a still a lot more to learn. Here’s hoping Sermo abides by the words of P&G’s leader, A.G. Laffey: Fail early, fail cheaply, and don’t make the same mistake twice.

(Disclosure: My employer, the Massachusetts Medical Society, publishes the New England Journal of Medicine. Sermo approached us in late 2006 about the possibility of partnering with them, but we declined, mostly because we were already developing our own social network experiment. I don’t know if that constitutes a conflict, but in case you think so, here you go.)