Should Doctors Meter Their Knowledge?

January 4, 2013

iStock_000014200664XSmallThis is important: The Daily Beast contributor Andrew Sullivan has left to sell his writing through his own company, Dish Publishing.  His new publication will not accept ads but rather will support itself through subscriptions.  Sullivan’s making his move with the help of a metering startup by the name of Tinypass, an e-commerce platform that allows sites to charge for access to content.  During his first day in business his subscriptions ran into the six figures.

Publishers have traditionally drawn eyeballs to ads to make money.  Consequently, publishers do things to directly or indirectly serve their advertisers.  What’s important here is Sullivan’s suggestion that he is now only accountable to his readers.  The middle man has vaporized.  Just a writer, his audience and an inexpensive meter.

This is big for me because I’ve always assumed that our thinking and wisdom are free and that they serve to drive other activities in our world.  But I wonder if the idea of directly selling our ideas and knowledge is more viable than most of us think?

The translation of physician wisdom into retrievable digital content is happening slowly.  I can’t help but think that as scalable models for selling what we know emerge, this translation will happen faster.


BrianSMcGowan January 5, 2013 at 6:38 am

And so it is that the motivations that drive participation in healthcare & social media begin to shift as new ‘markets’ arise. I wholeheartedly believe that there are three certainties in life: death, taxes, and the fact that all behavior is rooted in emergent motivations.

Over the past few years I have seen many #hcsm folks lose interest in actively engaging in new media as a means of sharing and teaching and I am not surprised. In fact, I devote a whole chapter of #socialQI to exploring the science of behavior change…b/c it is that important.

At first some folks seem energized by the voice that they are acquire with their participation and contributions, others are motivated by the impact of their efforts, others are motivated by the social graph that they are building…and some (quite transparently) see the opportunity to share as a business…and are looking to translate their social graph into a publishing ‘empire’.

There is no doubt that the idea of metering knowledge is one that deserves broad discussion, inasmuch as the extracting the value of medical knowledge and experience is a motivation that some may find to me their driving motivation…but inasmuch as information flow that is open and accessible to all is critical to improving healthcare quality, and inasmuch as I see new media as a critical avenue to correct the injustice and inefficiency of closed-access publishing models, well, I for one would become quickly frustrated by those in the medical/healthcare space that chose to meter their knowledge…

But I will certainly give it more thought…and for 25 cents I just might tell you what i come up with ;-)


Allan Besselink, PT, Dip.MDT January 5, 2013 at 11:57 am

Bryan – Great post. The actual clinician knowledge may not be the most important part to meter. Let’s face it – patients already do their research online. But there isn’t any quality control nor specific relevance to the individual context.

The aspect that may benefit from “metering” is the ability of the clinician to integrate and synthesize based on the context. It would be knowledge-based, yet patient-centered and tiered accordingly. As an example, the clinical guidance provided for osteoarthritis (as an example) probably isn’t as context-sensitive as heart disease, thus it would be tiered differently. Your thoughts?


lucien January 6, 2013 at 5:16 am

Great post Brian, as always.

It tips the same issues i blogged about yesterday on LinkedIn Today : Is healthcare about to “go the way of the Dodo ?” New hurdles or maybe better to say changes are lying ahead of healthcare. But we must get pre-active (no typo) in stead of re-active (when it’s too late) .

Brandon Betancourt January 16, 2013 at 1:14 pm

One can argue that those physicians that decide to go down the concierge practice route are doing it for the same reasons Sullivan decided to sell his writing directly to his consumers.

Under the direct to consumer model or concierge model physicians are in essence eliminating the need to do business with the insurance companies (the middle man) thus enabling them to be accountable only to the patient.

For me, I think the question that should be ask isn’t if doctors should meter their knowledge, but rather, are healthcare consumers willing to pay for knowledge from doctors.


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