In September 2006, a small start-up company in Cambridge, MA called Sermo, Inc., launched a social networking site with an unusual twist: only physicians practicing medicine in the United States would be allowed to participate. Sermo, which means “conversation” in Latin, marketed its website as an online community exclusively for doctors that would allow them to talk openly about a range of topics, from challenging and unusual medical cases to the relative merits of one treatment versus another. “Sermo enables the (...) private and instant exchange of knowledge among MDs,” the company announced in its first press release. Even better, participation was free and the site carried no advertising. (shrink)

A growing number of doctors in the United States are joining online professional networks that cater exclusively to licensed physicians. The most popular are Sermo, with more than 135,000 members, and Doximity, with more than 100,000. Both companies claim to offer a valuable service by enabling doctors to “connect” in a secure online environment. But their business models raise ethical concerns. The sites generate revenue by selling access to their large networks of physician-users to clients that include global pharmaceutical companies, (...) market research and consulting firms, and hedge funds and other investors. In exchange for a fee, these clients are offered a variety of tools to monitor, analyze, and solicit physicians’ opinions. In Sermo's case, clients are also offered opportunities to conduct “awareness campaigns” on the site that are aimed at influencing physician sentiment about specific drugs and medical devices. In effect, these online networks have created an even more efficient means for the pharmaceutical industry to track physician sentiment, disseminate messages, and cultivate key opinion leaders. This paper argues that the dual nature of these sites (a) undermines their integrity and transparency as forums for the exchange of medical opinion and (b) presents an ethical conflict for the doctors who use them. (shrink)