Shooting the breeze, medically

New site lets doctors chat about health topics, but critics question unsubstantiated postings

By Daniel Lee — Indy Star

Indianapolis, MA - May. 14, 2007 — Social networking on the Web has evolved into much more than kids logging onto MySpace. Sermo.com is providing doctors with an online forum — a sort of virtual hospital cafeteria — to ask questions, state opinions or just vent.

Only instead of photos and links to friends and favorite bands, Sermo is more like a no-frills chat room for serious medical talk.

The new service is a recent example of how the Internet increasingly is helping to shape the nation's health-care debate.

Doctors can use Sermo to trade observations or ask for advice on a tricky diagnosis. Physicians can even conduct quick opinion polls on topics such as the effectiveness of a new drug.

"We're creating a unique protected environment where we authenticate that only physicians have access," said Dr. Adam Sharp, an Emergency- Medicine physician with St. Vincent Hospital in Indianapolis who serves as Sermo's Medical Director on a consulting basis.

"We're giving them a pretty useful resource: At a moment's notice they can ask the same question of 14,000 other colleagues."

Sermo, which is Latin for "conversation," sees benefits from such raw, unfiltered peer commentary. The company says doctors, who can join for free, can learn from one another. It's a members-only, password- protected site.

The company, based in Cambridge, Mass., sells access to the site to customers such as investment funds or market-research firms looking for insight into how drugs or other medical products are viewed by physicians. Membership packages for those customers run from $150,000 a year and up.

The company said it has about a dozen customers, mostly investment funds, and expects to turn a profit this year.

Sermo also attracted powerful financial backers. SoftBank Capital, a venture capital firm that has backed Internet hits such as Yahoo! and E*Trade, has provided about $8.5 million of Sermo's $12 million in funding.

The site, which launched in October, has more than 14,000 physicians enrolled and is growing at a rate of about 800 members a week, Sharp said.

Like much of the Web, though, Sermo can be a little like the Wild West.

Postings by doctors are anonymous. As with online encyclopedia Wikipedia, Sermo does not edit comments by its physician members.

Instead, said Sermo Chief Executive Dr. Daniel Palestrant, the online community of physicians polices itself by calling out members who make postings deemed to be unreliable or false. It's a concept known as the "wisdom of the crowd."

Sermo customers, such as a hedge fund investing in health-care stocks, also can ask member doctors specific questions about drugs or other medical products that affect stock prices.

The company tested the idea in March on behalf of a client when it asked its members to handicap the likelihood that Provenge, a prostate cancer drug made by Dendreon, would get a favorable ruling from a Food and Drug Administration review panel. Sermo's member physicians overwhelmingly said yes.

Later, when a favorable FDA review was announced Dendreon's stock more than doubled. However, the stock later fell sharply when the FDA requested more information.

Palestrant said customer questions are labeled clearly to let doctors know they are dealing with a customer, not a fellow doctor. He added that, for now, pharmaceutical companies are barred from being customers because of potential conflicts.

The site, however, already has drawn protests from major drug makers, such as Indianapolis- based Eli Lilly and Co., over postings making what the companies said were unsubstantiated claims.

Soon after the site launched, a physician made a posting claiming that Byetta, a Lilly drug used to treat Type 2 diabetes, had been associated with serious problems in some patients.

Lilly, after becoming aware of the posting, complained to Sermo. "A Web site such as Sermo should have some responsibility to validate that information," said Lilly spokesman Jamaison Schuler, who called the claim erroneous.

Sermo did not remove the posting. Palestrant, however, said the physicians on the Sermo community acted as they were supposed to — policing the site for commentary that is not backed up by scientific data.

One doctor wrote that the allegation had "no foundation in fact." Palestrant pointed out that no other doctors using Sermo supported the claim against the Lilly drug.

Schuler also pointed out that Sermo sometimes rewards physicians with nominal payments for their participation on the site, a practice he said raises some potential conflicts.

Sermo called the payments, $20 or less, insignificant.

The content on Sermo runs from banter about the latest Medicare reimbursement policy to practical tips.

Sharp, for instance, said he learned from a posting that it was better to have a patient on a stretcher on the floor than in a bed to get better leverage when placing a dislocated hip back into the socket.

Dr. Deanna Willis, an assistant professor of family medicine at Indiana University, registered with Sermo after being told about the site.

Willis said she sees potential merits, but added that she would prefer to communicate with other physicians through more specialized methods such as e-mail lists through the American Academy of Family Physicians.

"We're hoping to create a unified voice for physicians," Sharp said. "The technology of the Internet has made that possible, so we're going to capitalize on that."

Call Star reporter Daniel Lee at (317) 444-6311.

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