A startup founded in 2005 and one started at the end of 2010 are battling it out for the hearts and minds of physicians in their bid to build the largest doctor-only network.
Sermo is the bigger dog, at least for now, and claims to have 125,000 physicians registered. The site debuted in 2006 and was created “by physicians for physicians” said Jon Michaeli, the company’s vice president of marketing and membership. A co-founder and former CEO of the company, Daniel Palestrant is a serial entrepreneur and doctor who has since left Sermo.
Doximity is the upstart. A few months ago, the company had 30,000 registered physicians, roughly 5p ercent of the U.S. physician base and now has 8 percent, declared co-founder and CEO Jeff Tangney. Like Sermo’s Palestrant, Tangney is a serial entrepreneur, but unlike him, he is not a doctor. He has a claim to fame: Tangney was the co-founder of Epocrates, one of five startups highlighted by Steve Jobs when the founder of Apple announced the launch of the App Store in March 2008.
Both companies claim to serve the needs of the busy physician eager to connect with colleagues. Both have apps that help doctors solve case problems on the go by reaching out to their colleagues from their mobile devices — iRounds for Doximity and iConsult for Sermo. But that is where the similarities end.
Both can coexist, but it’s important to know their differing visions to help decide how to use them.
Real names vs. anonymous
Sermo requires physicians to register on the site with their real names, but allows them the option of using a handle when on the site. Michaeli says doctors can decide how much of their personal information they want on their profiles. They can even leave a profile completely blank.
Doximity, on the other hand, requires physicians to provide their real names.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“We are a real name and authenticated and they are not — that’s the biggest difference,” Doximity’s CEO Tangney argues. “We find that when you want to give and get real medical advice, whether you are going to listen to it depends on who the person giving it is.”
Sermo’s Michaeli begs to differ.
“Even if you don’t know who it is exactly you are talking to, you know it’s an MD. You know there’s a certain bar that they’ve achieved to gain entrance into the community, which really makes for a much deeper level of engagement within the community,” Michaeli says.
The company has an instant, though rigorous, registration process, whereby identities are matched with several databases using the last four digits of each applicant’s social security number, Michaeli says.
But Tangney claims that Sermo’s registration system has holes in it. How would he know?
“It’s very easy to get verified on Sermo because you don’t have to give a real name,” Tangney declares. “I have an account on Sermo even though I am not a doctor.”
But at the same time, Tangney believes that having that anonymous quality is important for doctors who want to “blow off steam” at the end of the day and talk about topics that are relevant to them without being identified.
“I think doctors need to have a place where they can go spout off about what’s happening with Obamacare and everything else,” Tangney said. “Two-thirds of the posts on Sermo are about politics.”
Michaeli may not agree with this characterization, but he does think it is important for doctors to have a “voice on healthcare reform” and other topics such as healthcare IT. In fact, perusing the news releases section of Sermo shows how engaged doctors are on healthcare issues that are intensely political too. Here are two from 2010 — 81% of Physicians Polled Do Not Believe the Proposed Health Care Bill Will Achieve Sustainable, Affordable Reform; Physicians on Sermo Admire Mayo Clinic of Arizona for Dropping Medicare; Fear Government Intervention.
Different monetization models
Both sides have sought to monetize using the expertise of their physician membership, but the visions are quite different.
Sermo’s clients are pharma, medical device and contract research organizations. Some of them are companies that want to conduct focus groups or quick surveys of doctors. They pay Sermo a cut and the physicians also get honoraria for their time.
But these companies can also do a sentiment analysis, explains Michaeli. In other words, if doctors are talking about a new drug, then companies can pay to see how their products are being talked about.
He noted that the company has had several hundreds of clients over the years
Doximity makes money through a company that represents wealthy international clients who want a second medical opinion. The company also work with the Gerson Lehrman Group, which helps its clients tap into subject matter experts, including those in healthcare.
“They can be hedge fund managers who want to know what doctors think of the latest new stent for instance,” Tangney says. “They pay us to find experts.”
Doximity gets $200 for every expert match they make and doctors who opt in for such requests can make an average of $500 an hour.
“I would say that all of the forums, all of the discussions back and forth on our network is closed and private to the participants,” Tangney said, in a dig to Sermo’s sentiment analysis tool. “It is our model to have your full cv and full bio on so we can find you and say ‘Would you like to help on this malpractice lawsuit seeing you are an expert on this and be paid?’…”
Community vs. network
While Tangney seeks to create a professional network a la LinkedIn where doctors can provide referrals to one another and help doctors garner “ancillary revenue,” Michaeli sees Sermo as a tool for building real community.
“We are not a network. We are a community,” Michaeli says. “It’s bidirectional, it’s very interactive, very collaborative versus a network, which is very transactional.”
In other words, Sermo is not Doximity. Physician-members can write columns on subject matters, solve medical cases by tapping into the collective expertise of the network and voice their opinion on topics that interest and affect them, Michaeli says.
Fair enough, except Sermo’s homepage, in no uncertain terms has the tag line: Connect and Collaborate with the Largest Online Network (emphasis is mine), Exclusive to Physicians. That tells me that Sermo is doing the very thing that Michaeli said people mistakenly do — use the two terms interchangeably. Or Sermo has an identity crisis on its hands.
Doximity definitely wants to be a network. The goal is to provide not only a means for physicians to connect and provide referrals, but provide faster and secure communication, in lieu of what doctors have traditionally used — the fax machine.
“The joke is that the best communication technology in a doctor’s office is what teenagers are using on their phone in the waiting rooms,” Tangney said. “Doximity was born out of all the feedback from physicians … who were frustrated with all the time they waste in trying to get hold of other physicians.”
Why doctors like them
Both Sermo and Doximity forwarded responses to questions I had posed of member-physicians. Sermo to its credit voluntarily provided the contact information of the doctor so that it did not act as a medium between me and the physician-member. Doximity was ready to provide contact information of one doctor. But when I emailed questions and requested to be connected to a physician who could speak about both Sermo and Doximity, the company forwarded responses in an email where I had no way to directly reach the physician (not that I needed to).
Here is the slightly edited response of Dr. Maureen Whelihan, who practices gynecology and sexual medicine, and is a Sermo member. She was not aware of Doximity. Interestingly, she described Sermo as a “blog” and uses her real name on the site.
Sermo is the first “doctor-only” blog that I have discovered. It is wonderful to “bounce things off” my peers not only in my specialty but outside my specialty. It gives a unique flavor of how doctors practice across the country and how their type of practice influences their response to me. I can pretty much get a response almost any time of day with the different time zones!I really find no need to be on another blog because I can have a fun, social conversation about riding my motorcycle to discussing a fascinating case with my peers to getting an immediate opinion about a question right now!I was asked to visit Sermo by another physician who sat on my board at my county medical society. He wanted me to post some of my articles on sexual medicine because he thought that was one “specialty” that the site was lacking. I did just that and quickly learned that there was an interest/need for this content. I have posted over 30 pieces since joining in early November 2011.
I heard about Doximity in its beta phase and was attracted to the idea of an online physician community created by people with proven results in web-based medicine products. When I tested the site, I had many constructive criticisms and after hitting the “feedback” button about 20 times I got a phone call from the CEO. He implemented many of the changes I advised. That responsiveness suggested a growing and adapting communication model that I continued to follow and participate in. Doximity has verified, nonanonymous physicians as well as other features such as contact tracking, iRounds, and secure communications. Doximity is being updated continuously to improve and add features.
Sermo includes a very large group of physicians; however, physicians may be anonymous and that removes some of the ability to judge information presented in the forum.
[Photo Credit: chainat]
