The Twitter Chat that Killed Sermo | #MedDevice

Sermo Twitter

I’m not a physician. I don’t play one on TV. And I’d never heard of Sermo, the largest online physician community in the US (boasting 120,000 members) until @HJLuks mentioned them the week before.

Mine was an innocent invitation to talk during last night’s #MedDevice chat, a feature of the Medical Devices Group, LinkedIn’s largest medical community.

Who knew it could unravel the company.

According to its About page, Sermo is where practicing US physicians – spanning 68 specialties and all 50 states – collaborate on difficult cases and exchange observations about drugs, devices, and clinical issues.

They explain, “Sermo is free to practicing physicians. Revenue is generated as healthcare institutions, financial services firms and government agencies purchase Sermo products to access this elite group of practitioners.”

@TomRines from @SermoTeam began the #MedDevice chat introducing the company and its clientele.

Wait. Did he just say what I think he said?

Sermo listens to physicians conversations to mine business and competitive intel?

@MegloPresto asked about Sermo’s value prop vs. similar platforms. Some of these questions went unanswered and I’m hoping Sermo might address the questions – and negative reactions to the chat – in the comments. Twitter Sermo

It was a tough night for @TomRines and @SermoTeam. I’m sorry it went this way for them. I had no idea what I was walking into or how visceral the reactions would be.

Graciously, Tom ended on this optimistic note: Sermo offer

But if RichmondDoc’s signoff is any indication, I’m afraid it may be too late.

>>> Click to review the archive of #MedDevice chats you missed! <<<

Join the Medical Devices Group on LinkedIn to network and grow your business. #MedDevice is held most Wednesdays, 4 p.m. EST. We interview the medical device industry’s best minds and cover issues including sales, reimbursement, distribution, EMRs/HIT, regulations, and Marketing Medical Devices.

Free Updates

Join the growing number of medical company professionals who get fresh
Medical Marcom updates sent straight to their inbox


  1. I am a physician. And I was an early adopter of Sermo. But I left never to return. Ever. The entire community there is often very rude, insulting and even threatening. There are a lot of conservative physicians who seem to have a lot of time on their hands to rant about Obama, socialized medicine, etc. and woe unto anyone who might have a different opinion. The few other progressives there e-mailed me to warn me to be very careful, that some people have had threats, etc. I finally quit. And yes, they do allow commercial entities to, for a fee, listen in to online conversations there. That was known since day one, though, so I’m not sure why it is shocking to anyone. But I’m not a fan of Sermo and am glad I left. I’ve been involved with social networking for many years, before it was fashionable. This had to have been the worst experience I’d ever had with a network.

    • David, thank you for your comment. Yes, Sermo Terms & Conditions clearly state: “Sermo shall be free to use any ideas, concepts, know-how or techniques contained in such information for any purpose whatsoever including, but not limited to, developing, manufacturing, and marketing products and services incorporating such information.”

      Anyone who carefully read the Terms & Conditions should not have been surprised.

      As the moderator hosting the #MedDevice chat, I shared the reactions the doctors had. Some were surprised; others were disappointed.

    • Charese Pelham says:

      I’m a Sermo member, and an independent. I guess I’m more conservative than liberal, on most issues. I’m sorry to hear Dr. Toub has been harrassed by conservatives on Sermo. Unfortunately, I’ve had the opposite problems; I’ve been severely harrassed by liberals on Sermo. I feel there is room for civilized dissent and discussion. Show me that I’m wrong, and I’ll listen. Demonize me, and I shut down. I think that is true no matter what your viewpoint: liberal, conservative, independent, etc. I don’t think we need to personally attack nor degrade anyone. Rather, I think we need informed dissent, reasoned discourse and discussion. I fear that the “tone” of Sermo has gone markedly downhill in just the last one year. I still like Sermo, but seldom comment anymore, and only go on Sermo for a truly medical concern or interest. Too bad.

  2. The participants of Sermo have repeatedly been told that privacy was a first priority but “it couldn’t, of course, be guaranteed”.

    If it is true that industries are allowed to cull from the private conversations of physicians, this is indeed a serious situation.

    A recent Sermo post emphasized the issue of privacy in response to a comment from Sermo showing up on another blog. Repeatedly, doctors exclaimed that they thought this site was protected and it obviously wasn’t. In retrospect, one has to wonder whether a pharma person was responsible for the information leak.

    Physicians have wanted a place where they could speak openly with one another. Many physicians thought Sermo was that place. It is highly disappointing, to say the least.

  3. Wow this looks like big stuff Joe. You really stirred something up here. This is totally out of my field but I’m looking forward to seeing what becomes of this. Fascinating story, and it reminds us how powerful Twitter can be.

  4. Additionally, I would strongly echo Dr. Toub’s comments on the environment at Sermo. I posted re: this and had hundreds and hundreds of responses. Unfortunately, again, the sane minds were drowned out by ridiculous comments.

    If a better job had been done from the beginning to thwart this extremely unseemly behavior, things may be different now, both for Sermo and for our healthcare system at large. It is such a shame it went that way.

    • I hoped Sermo would take an aggressive and proactive stance today to abate some of what I’m reading today. So far, I haven’t seen anything …

      Kelly, do you think Sermo can make amends with docs re: bad behavior and clear up the confusion from last night’s conversation?

  5. Interesting thread and discussion. Will be interested to see whether this fades away or has longer term repercussions.

    1) Interesting expressions of outrage, but doesn’t seem that Sermo is doing anything they don’t disclose if you read the fine print.

    or even more bluntly: Joe the plumber and Joe the doctor have no clue how their digital data is used and profiled. They would be outraged if they did.
    2) What are broader implications for all companies whose business models depend on data mining, advertising, etc., e.g. Facebook.

    Despite doing a 180 in its privacy policies over the years, FB continues to grow.

    Is this because people ACCEPT their privacy policies? or have no clue, but would be similarly outraged if they did?

    I suspect the latter…and this discussion seems to support my thesis.

    If true, FB’s $80 valuation could blow up any minute Joe the plumber wakes up to what’s actually being done with their data.

    • Vince, I share your curiosity.

      With great deference to Mark Twain, it looks as though reports of Sermo’s death have been greatly exaggerated.

      As far as I can tell, Sermo did not address the post or the commentaries at all today.

      They are, in an unrelated note, offering a free trial to qualified prospects (clients). I’m intrigued.

  6. A Davis says:

    I’m a regular on Sermo, and somewhat outspoken relative to most on the site. In general, I think it’s safe to say that 1) we know that the site is not completely secure, 2) the crowd is mostly moderately conservative (which fits the overall physician demographic), 3) there are some raving loons, mostly conservative, on the site and they are usually recognized as exactly that, and tolerated but politely (or impolitely) ignored, 4) there are also occasional liberal posters who, if they are obviously baiting the conservative crowd, get exactly what they want and 5) the medical discussions, as opposed to the political, are by far more open, more honest, and more varied than on any other forum I’ve found.

    There is very little tolerance for academic “over thinking” of the topics presented; the group consists mostly of private, front line clinicians who make their living on the opinions and decisions they voice on the site. They are open to change, but have a very pragmatic “prove it” attitude, and a couple of percentage points in variance in a single instance or study doesn’t qualify as proof in their minds, so they are viewed by those looking for instant gratification or immediate acceptance as obstinate. The combination of cynicism and conservatism doesn’t make for easy marketing, and the willingness to honestly trash a concept or object they disagree with adds insult to the marketer’s injury. And, as a group, they tend to equate “PC” with “BS”, so the criticism is sometimes pretty rough. As is said with some frequency on the site, “if you can’t stand the heat, get out of the kitchen.” It isn’t a threat, nor an insult, but it is a statement of defiance towards those who would have the crowd attenuate its opinions; by and large, the members of the crowd are thoughtful, have refined their opinions in the kiln of experience, and are not afraid of being totally honest, which is ultimately any physician’s stock in trade when dealing with both patients and colleagues. Complete honesty, contrary to what the PC crowd might have us believe, isn’t disrespectful; it is, in fact, the highest form of respect to think enough of another to be willing to completely open yourself to that person and to rely on that person’s own good judgment to allow them to reach an appropriate conclusion.

    Sermo is unruly, contentious and unpredictable. It is also intellectually stimulating, occasionally bawdy, and a lot of fun. Good luck with that data mining!

    • As a Sermo “prospect,” I have some healthy skepticism about the value of all this data.

      So I’m looking forward to the free trial they are currently offering.

    • A. Davis,

      A nice defense of the community on Sermo. I’m not a member, and have not been on Sermo for marketing purposes yet, but I have run many user experience sessions with physicians ranging from general practitioners through to many different specialists. I love running these sessions for exactly the reasons you describe, the subjects are smart, opinionated, and articulate… the very best people to learn from.

      You just singlehandedly made me want to sign up from the marketing side to see what’s there!

      • Brad, I’m really looking forward to the same.

        I read today on Twitter that Sermo’s numbers are up since this article posted.

        No such thing as bad publicity?

  7. Hi everyone,

    We appreciate the discussion and comments that were shared during the MedDevice live chat last night. Sermo is a free resource for physicians that provides an anonymous forum for discussion about issues important to physicians. The Sermo site enables physicians to be a resource for each other, which has a positive effect on patient care, translational medicine and our members’ ability to manage their practices better. Our community members’ anonymity allows for open conversation, and we take members’ privacy very seriously.

    We are able to keep this site free by allowing clients to read anonymous community posts that mention brands, disease states or keywords they are interested in to identify trends. As noted by host Joe Hage and other participants during the live chat and in posted comments, our business model and our terms of service are transparent and posted on the site. You can find more details and read our user agreement at Our client offerings are available for anyone to view at

    We welcome further questions about Sermo. Please contact me at

    Enjoy a great holiday weekend.
    Jon Michaeli
    VP, Marketing – Sermo

    • Jon, I am very, very happy that you wrote.

      Yes, it was all spelled out pretty clearly in your terms & conditions. To what do you attribute last night’s reaction?

      I would like nothing more than to feature a proper, complete, and unbiased response from your company on this blog. When you do, I will be happy to link to your response from this original post.

      And, I signed up for a free trial today. My curiosity is piqued … I want to see for myself!

      Many thanks for your generous response,

      Joe Hage

      • It was an interesting opportunity to be in the chat last night. I have previously discussed via DM w/ the @SermoTeam account my concerns re: physicians behavior on the site. Unfortunately, I haven’t seen any changes that make me believe the atmosphere would be any more collegial than it currently is. Sometimes arguing is fun, but I have no interest/time to engage in head-butting every single time I post something. I would like to think my perspective (definitely in the minority on Sermo) would have been a source of active discussion; instead, after it was implied that I was less-than-intelligent and less-than-competent, I largely disconnected. It isn’t worth it, and unless the culture of the site changes dramatically, I see no need to return.

        The chat Thurs night revealed to me just how far the Terms & Conditions go. The wording on the site gives clear indication that data mining such as that discussed in the chat *could* happen…but I didn’t realize how far it went. I expected conversations to be monitored *if* I entered sponsored topics/posts…I didn’t realize that *every* conversation would be fair game in order to advance a for-profit agenda. I have no desire to support or perpetuate this, and likely signals the end of my participation on Sermo. I might sign on and poke around every now and then…but I don’t see myself becoming active and attracting criticism just for the sake of it.

        And, rest assured, I tell any colleague who asks exactly this. I explain that I cannot see any value in my being on the site at this time.


  8. Joe, I don’t know you personally but from reading your tweets and posts you seem like a thoughtful and courteous guy…

    …except for the headline that ignited this inferno — “The Twitter Chat that Killed Sermo.”

    I don’t think you got the headline right.

    Maybe Sermo has taken a few hits here, but I don’t see a dead body. If you have evidence or reasoning that this event will have any long term impact, please share it.

    This situation strikes me as more analogous to Facebook’s privacy changes last spring — a small minority of digerati got VERY pissed. They staged an initiative to get people to drop their facebook account — and the result is only 30K FB users leave (from a base of 500M).

    Are you standing by your headline? do you owe Sermo an apology?

  9. Interestingly, I did log on to Sermo after the chat, and saw a posting from another doc about data mining and such at Sermo. The early trend on the responses: “Of course. You would have to be ignorant to think that wasn’t happening.”

    I don’t know if those commenting were aware to what extent their conversations are monitored, but clearly many aren’t very worried about it. I don’t think Sermo is dead…but I wonder if it will move more folks to find alternatives.


  10. I think many of our colleagues are not always aware of what goes on vis a vis Web sites, which is surprising given how skeptical our natures generally are. Witness the blowup some time ago over Sermo’s alliance with the AMA after several physicians on Sermo realized that the AMA owns the CPT codes. I’m not sure why that wasn’t more widely known, but given that it wasn’t, it understandably elicited wide outrage.

    I think Sermo should be recognized as the business is is. As a Web business, it has to accrue revenue, and since it does not charge its users, it must either advertise, get a grant, or else derive revenue from other sources. That said, I think it is sad that what could have been a very useful clinical site has degenerated into something that has alienated many of us.

  11. Mark Campbell says:

    getting the AMA out of Sermo is very good for Sermo. This is simply an issue of politics, representation and avoidance of over the top sleaze. No I’m not referring to Sermo.

    Sermo is largely conservative – they tend to leave alone the bastions of liberal policy, but hours of endless entertainment can be had at the justified expense of current policy makers. Why does Sermo threaten liberals?

    when a conservative thinks SERMO is dead, then maybe I’ll listen – otherwise Google journolist

  12. This has been Sermo’s business model from day one. Never hidden from anyone. For commentary from 2007, see Scott Shreve’s post:

  13. At what price freedom and security? Certainly not with a FREE on the price tag. I am entertained by the tweetchat and some comments. Even more so by the “shocked few” out there regarding the privacy policy Sermo and countless others have posted. Have we not arrived to the bus-stop of reality that everything you contribute, do, buy, “like”, etc isn’t being mined, geo-tagged, researched and RE-SOLD… come on.

    Your Tweets are free and the data is viewed and reported by Radian6, Kantar, Neilson, etc.

    Your purchases are tracked and studied by Citi, BoA, etc. and sold to retailers and the like.

    Your prescriptions are tracked back to the MD, turned into market shares, your other Rx’s blended into segments, and so on. Check the enterprise value of Wolters Kluwer and IMS and you’ll see the beginning of that data market. Again, we think of the decisions between doctor to patient (diagnosis codes) and personal health purchases (loyalty member tracking) and data (rx data) as sacred- but its not.

    Know doubt, Sermo got some real-time feedback vis-a-vis their Promoted Discussion format on this chat. I wonder if they coach clients to be as prepared to control the conversation at the same level that they weren’t…

    Some hate the lack of confidentiality and security in information exchange- but you have to love how this ecosystem works with examples of scrutiny like this one!

    • I suspect many physicians clicked the “accept terms and conditions” box without ever having read them.

      The idea of “someone is going over my conversations and using it somehow” was more than the “shocked” expected.

      But yes, virtually everything online is fair game.

      I was with a client last week and read his home phone number off a website. “Now I’m annoyed,” he said, “that was supposed to be unlisted!”


  14. On the Internet, you just assume there are data mining and similar activities. Even in “real life,” nothing is free/cheap. Even if Sermo didn’t charge the companies for access, they could get the info.

  15. I agree with David. This has been Sermo’s business model from day one and they don’t hide it. Well they don’t don’t hide it well. They are defensive. I have been shut down by them when I’ve questioned this in the past. It strikes me that greater transparency would work better. To that point they should be publishing data etc relevant to HC issues non pharma related in order to demonstrate their value. Sermo’s behavior etc. may harm the ability for promising SM ideas (i.e. LGI) from faster adoption. That is the true downside.

  16. Ok Joe, comments are finally working. This is proof. 🙂

  17. Felix Brizuela says:

    I recent poll amongst Sermo Physicians asked if they felt healthcare was a right to Americans. 80% responded no. It is a conservative blog site. I have tried initiating serious conversations about controversial subjects, and I feel that I am speaking to a bunch of medicals students before they even take a class.. A surgeon on Sermo made incredibly nasty and inappropriate comments about Fibromyalgia patients. Many of his fellow conservatives followed suit. I would love for the american public to see what these Physicians are saying. It would scare the crap out of them!!

  18. Felix Brizuela says:

    The only way not to get shot down on sermo is to make comments that the conservative majority on the site agree with. No cutting edge technology!! Please!! Once you say something like, “fibromyalgia is a truly disabling condition”, your dead!!! No rational discussion. All is “believe in only our out-dated, antiquated way of thinking. This site doesn’t represent the thinking of any rational Physician. There is no such site, and that is what we need!!!


  1. Fair Social Media Practice Principles: Rules for Third-Party Engagement in Patient/Physician Social Networks | Pharmacy Technician Source says:

    […] Recently, there’s been some discussion on Twitter and certain blogs about Sermo, the online physician community based in the U.S. When Sermo representative Thomas Rines (@tomrines) tweeted that “Sermo is an online community for US physicians. We provide our clients the ability to engage with the community” in a recent #MedDevice chat, he caused a “What? Wait!” doubletake (see “The Twitter Chat that Killed Sermo“). […]

  2. […] I didn’t come across something that covered this specifically, I did find a headline that read “The Twitter Chat that Killed Sermo | #MedDevice”. Sermo is site where practicing US physicians come together to discuss and exchange observations […]

Speak Your Mind


5 + 5 =