Like-minded Physicians Influence Each Other

Sep 02, 2008



Aristotle said it first, or at least best: "Man, by nature, is a social animal." You just have to look to the success of Web sites like LinkedIn, MySpace, or Facebook for proof that social networking is an integral part of our lives. And further, that the act of socializing influences our behavior.

That holds true even for groups of people we usually think of as highly rational and data-driven—doctors. This has been known since 1954, when Herbert Menzel and Elihu Katz conducted the first major study on the impact of physicians' social networks. By examining the social process by which doctors influenced each other to adopt a new drug, tetracycline, they found that the diffusion of information was a social process. Funded by Pfizer, the study was originally intended to assess the impact of medical journal advertisements. Surprisingly, Menzel and Katz discovered that while promotional materials enabled knowledge and awareness of the drug, it was not sufficient to convince physicians to adopt the product. The more significant factor impacting a physician's prescribing rate was the subjective assessment of his or her peers.

Since then, numerous studies have confirmed Menzel and Katz's findings and further expanded the level of detail to track the specific diffusion paths by which physicians influence each other. A 2006 study conducted at the Brigham and Women's Hospital evaluated the network of influential discussions regarding women's health issues among 33 primary care physicians across four separate clinics in a six-month period. Again, the findings confirmed the impact of peer interactions, and supported the concept that efficient dissemination of information can be achieved through peer influence.

So, with such compelling and consistent research results, how do you use this information to support your brands? The answer can be found in models that enable peer influence.

Optimizing medical communications

Not all medical communications are the same. Even within the context of peer-to-peer interactions, certain events or tactics provide greater peer influence and demonstrate higher ROI than others.

In rating the effectiveness of practices designed to promote behavioral change among physicians, Dr. Jeremy Grimshaw conducted a meta-analysis in 1998 that evaluated 1,139 references. Grimshaw, director of the clinical epidemiology program of the Ottawa Health Research Institute and director of the Center for Best Practice at the University of Ottawa's Institute of Population Health, found interactive educational meetings (participation of healthcare providers in workshops that include discussion or practice) were among those consistently most effective in promoting behavioral change among health professionals. Among interventions of variable effectiveness was the use of local opinion leaders (practitioners identified by their colleagues as influential). And among the interventions that had little or no effect were didactic educational meetings (such as lectures).

In short, interactive educational meetings in which healthcare providers could engage in active dialogue offered greater impact than traditional didactic educational meetings. And yet, most medical communications programs today—such as lunch-and-learns or dinner meetings—still rely on didactic presentations by a key opinion leader (KOL).

The study might suggest a possible reason why brand managers may be noticing their medical communications programs are not delivering the ROI they would expect. Understand: the value of KOLs is not in question. It is the nature of the format in which a KOL presents. A format that allows for maxium peer-to-peer interaction may well mean the difference between a high-influence and a low-to-moderate-influence program.

Birds of a feather

It also has been found that dialogues between HCPs (healthcare providers) who professionally resemble each other tend to provide an even greater effect than interactions between nonsimilar individuals.

For example, a primary care physician may look to specialists (KOLs) for updated information on disease states or therapeutic choices, but a PCP may be influenced more readily by another PCP when learning best practices based on clinical experience.

"Interpersonal communication is usually more effective when there is a high degree of professional resemblance between the individual attempting to introduce the innovation and the recipient," states Robert Sanson-Fisher in a recent report in the Medical Journal of Australia.