September 14, 2010

Discussion forum for emergency physicians - hot or not?

I guess most of you have participated in some kind of discussion forum as there are thousands of them out there. They are a convenient form of communicating with other internet travellers. The discussions are archived so that you can browse or search through earlier topics and usually you can see more information about the other users on the forum. This is to compare with an early invention of the Internet - the good and old (email) postlists which are still pretty common today. I still remember a trauma postlist I was a member of. It had very interesting discussions, for example the classical one about whether or not to insert a needle into the 2nd intraclavicular space in traumatic cardiac arrest. Having the  most eager trauma specialists of the world on board meant it was a heated but professional discussion. This level of activity has never been reached in a good emergency medicine forum.

Well forums in general maybe don't have a good reputation as well intended and professional arguments tend to be killed in the end by emotional havoc, leaving the forum participants angry and irrational (since we are talking arguments, there is one that is so funny it will unwind your intestines... Monty Pythons argument clinic!). Then there are those that only want to stir up emotions, the net trolls. Still there are quality forums out there and it seems that the longer they have lived the better they get, probably as the members get to know each other better.

So I have often wondered why on earth we emergency physicians have not got a decent forum for our community? Almost every day I have a question of some kind and am burning to have it answered; a ECG riddle, clinical decision point or whatever. Every now and then I wonder "how do they do this in other countries" as comparing treatments between continents often has it's interesting pearls of wisdom. In my emergency department in Lund (Sweden) we are a very young specialty and we are very commonly hitting the walls of other specialties. So often I would like to learn from the experience of my colleges abroad who have been there and know how particular obstacles were solved. A common discussion forum is a perfect place for this.

I have to mention BMJs very interesting experiment, they have a recently launched sub-site called Doc2Doc which has the goal of "connecting doctors worldwide". It is the best try I have seen yet and they seem to be aware of the net troll problem as only doctors can register and each and every registration is processed manually. Which means they actually check if you are a legitimate doctor in your country. Impressive! There are lots of features within Doc2Doc such as the ability to start your own blog in there - all in all it is a light weight social networking site like for example Facebook - but for doctors only. I did try this out and must say I am impressed but I have not touched it for a while now as I was overloaded by information that I did not need. I am only interested in emergency medicine, the best training centers for GPs in UK or treating acromegaly surgically or medically does not touch me at all. And so I put it on ice but I will be keeping my eye on this interesting experiment.

Besides that, there are several websites having the same idea and I will not delve into them here since I have not found any with an active EM group. It all comes down to one point - we want it simple and familiar. We don't have the time or energy to try out yet another website which may or may not be worth our time. Doctors are really lazy and impatient when it comes to getting to know new websites. Then there are already thousands of passwords and web addresses we have to remember at work and every new login to remember has to be for a very good reason.

So what about the social networking sites we already know, have a login with and are familiar with? Facebook, Google groups and LinkedIn are the ones everyone knows and all of them have tools for easily creating a discussion group. Most of us already have a login at some of these sites and starting a forum for emergency physicians is really easy to do. I did a quick search of "emergency medicine" in all of these sites and well there were a few hits but none of them very active or rich of members.

I must say, I really don't understand why someone in our tech-savvy EM group hasn't been there and done this. Now that the technology is there, easier then ever before and completely free - it makes me wonder if there is some other hindrance? Could it be that physicians are shy to share their thoughts in front of colleges? Or afraid of revealing some gap in their medical knowledge? Or just find new technologies scary? I really don't know! What do you think?


  1. Excellent questions and I too wonder why our EM specialty hasn't boomed with various discussion forums. I don't think that emergency physicians are unfamiliar with technology, but rather EPs probably don't want to stick their neck out there on controversial topics. This is the litiginous age of Medicine and HIPAA. Risk Management is a major force in hospitals. Also, physicians probably have colleagues with whom they can discuss cases in person.

    That doesn't mean that a forum or listserv can't arise in EM. Perhaps we start with less controversial things such as student advising (eg. Student Doctor Network) or "Ask the Expert" where students, residents, and EPs can ask their opinions on topics.

    Excellent post.