Jonathan J. Vitale, DO, says he uses Sermo, a physician-only social network, because it’s a safe environment where he can let down his guard and converse with other physicians in confidence.
“On Sermo, you’re able to take off the veil that you have to wear a lot when you’re talking with colleagues who aren’t physicians, friends or family,” says Dr. Vitale, a third-year family medicine resident in Chicago. “If you discuss certain topics in front of people who aren’t physicians, they may misunderstand what you’re saying, and you can come across as naive or arrogant.”
Dr. Vitale began using the 8-year-old social network last year. He has joined the growing ranks of doctors who use social networks for physicians to connect and talk shop. Today, more than 200,000 U.S. physicians use Sermo, according to the company. It’s the second most-popular physicians’ social network. Doximity currently holds the No. 1 spot with more than 250,000 physician members, according to the company. The U.S. has about 835,000 professionally active physicians, Kaiser Family Foundation data show.
Both networks are free for physicians and closed to the public. Only physicians can join Sermo and access discussions and other content. Doximity caters to physicians but also allows medical students and other health care professionals such as nurse practitioners and physician assistants to join the network. Physicians using the networks can converse more freely than they could on other social networks such as Facebook and Twitter.
Other physicians’ networks, such as QuantiaMD and Ozmosis, are out there as well, and some networks, such as OrthoMind, cater to physicians in certain specialties. But Doximity and Sermo are the most popular closed physicians’ networks, judging by their user base. Here’s how the sites are different, what they offer their users and why physicians are choosing them.
Doximity, which launched in 2011, is comparable to LinkedIn, with a HIPAA-compliant twist. The company verifies the identities of its members, and encrypts physician-to-physician communications to ensure they meet security standards set by the Health Insurance Portability and Accountability Act.
Doximity also provides physicians with their own fax number, which allows them to use their smartphones and tablets to send and receive faxes. In addition, physicians can use Doximity to peruse the latest medical news and literature, earn continuing medical education credit and find consulting opportunities. Also, the iRounds feature allows physicians to post clinical questions that others can respond to. The network also serves as a directory of U.S. physicians, as it has created profiles for nearly all the nation’s physicians, even nonmembers. Members can use Doximity on a Web browser or download the app for iOS and Android devices.
“Doximity has allowed me to connect with local doctors and even specialists who aren’t affiliated with my health network,” says Sam Urick, DO, a general internist in Pittsburgh. “I have patients whom I’ll send wherever they want to go, and I can now communicate with their physicians in a secure manner.”
Doximity’s network, profiles and search function are the network’s most popular components, notes Nate Gross, MD, the co-founder of Doximity. He sees Doximity becoming a powerful job-hunting tool in the coming years.
“Physicians know that their Doximity page is their résumé of record,” he says. “In the tech industry, almost nobody sends in a résumé anymore. People just link to their LinkedIn profile. Physicians are starting to realize that their Doximity profile may give them their next job.”
But Doximity user Jermaine A. Campbell, DO, says he’s not sure Doximity can replace old-fashioned CVs just yet.
“It all depends on who’s doing the hiring,” he says. “Some physicians are not on Doximity. We need more physicians to join Doximity before the network can really function as a résumé service.”
But Dr. Campbell, a general internist in Boca Raton, Fla., finds Doximity’s other features so useful that he visits the network daily.
“I use Doximity for linking up with doctors in different areas and different specialists,” he says. “When I had cases in the hospital and no one was around, and I needed, for instance, neurology input, I could post a case on Doximity, and maybe the next morning there would be three or four responses.”
Physicians can also use Sermo to consult with one another electronically. However, there’s one big difference—many physicians on Sermo choose to be anonymous. But the network verifies that its members are licensed physicians, so users know that they are conversing with other physicians.
Sermo’s main mission is to improve patient care, says Jon Michaeli, the network’s senior vice president of global community and marketing.
“The physicians who join Sermo can talk about anything, including clinical discussion, health care reform and practice management. But there’s a focus on Sermo on clinical case discussion,” he says.
Sermo offers physicians groups specific to diseases and specialties, where physicians can share information and collaborate, Michaeli notes.
“Sermo is really about physician collaboration and the crowdsourcing of knowledge and insight to improve patient outcomes,” he says.
Unlike Doximity’s, Sermo’s network is not HIPAA-compliant, so physicians need to avoid identifying patients when using it. Another feature of the network is the opportunity to earn money by participating in market research. Members can access Sermo from a Web browser, and iPhone users can download the Sermo app.
By remaining unnamed on Sermo, physicians can feel freer to share case information and ask questions without fear of damaging their reputations, which allows for better learning opportunities, Michaeli says.
“Physicians are posting about patient situations that could have been handled better or were not handled correctly in an effort to educate other physicians,” he says. “These types of insights would not be posted in a regular community. It’s important that physicians share these learning moments, and they’re reluctant to do that when they’re identified because they could be seen as unskilled and incapable in their practice.”
Dr. Vitale doesn’t use his real name on Sermo, and he says most of the physicians he encounters on the network don’t either.
“On a site such as Sermo, anonymity helps people to relax and say what they really want to say,” he says.
But do hidden identities let physicians unwind a little too much? Some media reports suggest that discussions on Sermo often veer into the unprofessional—perhaps because users are posting under an alias.
Dr. Urick says he’s seen some nasty comments on Sermo.
“Over the weekend, a physician posed a question on Sermo, and another physician wrote back, ‘Are you an idiot?’ ” he says. “You can expect that when people can keep a secret identity.”
Nevertheless, Dr. Urick says the network’s cloaked nature has benefits.
“Some of the comments may be viewed as unprofessional if the private sector or patients were able to see what doctors truly think. But on the other hand, doctors, just like people in any other profession, need to vent,” he says. “As a physician, you’re seeing patients, you’re at the hospital, and you maintain a certain level of decorum. I think a lot of physicians use Sermo as their outlet.”
Dr. Urick has also taken advantage of Sermo’s honoraria opportunities, in which physicians can earn money by participating in surveys and focus groups. He says he gets $10 to $30 for completing a five-to-10-minute survey and $30 to $40 for longer surveys that take 30 to 40 minutes to complete.
Dr. Vitale says he’s reluctant to take the surveys, and he suspects other physicians might be, too, because of the profession’s emphasis on financial disclosure.
“Whenever you give a lecture, you have to make disclosures at the beginning of it,” he says. “You have to say if you have any affiliations with any companies. I think a lot of doctors nowadays are wary of having affiliations with companies, so they may not want to take surveys for money.”
Michaeli says the vast majority of Sermo’s market research is double-blinded and ergo exempt from disclosure requirements.
Sermo generates revenue by facilitating market research and sharing its content with pharmaceutical companies and clinical research organizations, among others. This means that information physicians share in discussions on the network may be shown to industry stakeholders, though Michaeli notes that physicians’ user names and other identifying details are stripped out.
Doximity earns revenue through its employment service, in which interested physicians are alerted to full-time jobs as well as locum tenens positions and consulting opportunities. Hospitals, physician employers and Wall Street firms pay for Doximity’s help in finding candidates. The average compensation for physicians for a consulting gig arranged via Doximity is $400 per hour, Dr. Gross says.
Neither Doximity nor Sermo disclose what percentage of their users take advantage of the opportunity to earn honoraria. However, Michaeli says curbside consultation and discussion are two very popular features on Sermo, and Dr. Gross says physicians are most interested Doximity’s networking aspects, such as their profiles, the physician search function and the opportunities to connect with one another.
To make the most of Sermo’s discussion groups, physicians shouldn’t be afraid to speak their mind, Dr. Vitale says.
“Overall I find Sermo to be a very supportive community and a safe community,” he says. “If you have a strong opinion that you can’t voice on Twitter or even among your family and friends, you can do so on Sermo. If anything, you will start a spirited discussion.”
Dr. Vitale also notes that Sermo isn’t meant to be a substitute for general-population social networks such as Facebook. Physicians should use both, he says.
“Physicians always have to keep the pulse on patients, patient experience, and how health care is affecting people who are not doctors and who are not in the health profession,” he says. “I tell doctors that it’s wonderful to use sites such as Sermo, but they should also be on other sites that encompass everybody. A really good doctor understands not only what it’s like for the doctor but also what it’s like for the patient.”
Yet professional social networks carry fewer risks, and may offer more benefits, than personal ones, says Liz Marsh, who teaches continuing medical education courses on social media to physicians through the Kansas City (Mo.) University of Medicine and Biosciences’ College of Osteopathic Medicine.
“Professional sites such as Doximity or Sermo are more accountable,” says Marsh. “They’re more credible and more secure. They allow physicians to share helpful information. The personal sites are trickier in that they are more about your personal life. You face more patient confidentiality problems there.”
Whether physicians are using personal or professional sites, Marsh suggests following other physicians who are known for using social media successfully to get a good idea of what they share, such as Kevin Pho, MD, the founder of KevinMD.com.
She also suggests physicians take a step back before posting anything on Facebook, Sermo, Twitter, Doximity or anywhere else.
“If you’re posting something on any site, know that it is permanent and it does live forever, ” she says. “I’ve seen a few cases where physicians’ old posts have come back to haunt them, even when they had the best intentions.”
Physicians shouldn’t be afraid to ask a colleague to review a post, she notes.
“Sometimes when you’re writing something, you might feel it has a certain tone,” she says. “But if you have a colleague read it, he or she may say, ‘That does not come off as witty; that comes off as snarky.’ “