HealthTap: The Emperor’s New Clothes of Social Sites

Michael Millenson

Posted 1/08/12 on Forbes

You can’t get much cooler than HealthTap: slick Silicon Valley start-up, social media darlingsavvy and successful backers. But when you closely examine the service HealthTap actually provides, the money and good looks fall away. Like in the fable about “the emperor’s new clothes,” behind the buzz, there’s nothing there.

OK, maybe one thing: a really risky way to get medical advice.

Here’s how a Feb. 4 New York Times article described the company’s website:

[U]sers post questions and doctors post brief answers. The service is free, and the doctors aren’t paid. Instead, they engage in gamelike competitions, earning points and climbing numbered levels. They can also receive nonmonetary awards — many of them whimsically named, like the “It’s Not Brain Surgery” prize, earned for answering 21 questions at the site.

Fellow physicians can show that they concur with the advice offered by clicking “Agree,” and users can show their appreciation with a “Thank” button.

So far, so good. But there’s more. The professional credentials of the physician answering your question, such as a board-certified specialty, are not available on the site. Instead, you get a crowdsourced “reputation level” built up by accumulating HealthTap awards, by  clicks of approval from other doctors and by other measurable activities at the site.

HealthTap CEO Ron Gutman calls this providing a “transparent” reputation. And really, what are the chances of anyone gaming that system? Pay no attention to the problems over at TripAdvisor. Doctors would never conspire to boost ratings, particularly the kind of doctors whose motivation is to “attract new patients by increasing visibility in search engines, social media and mobile apps,” as HealthTap alluringly puts it.

The advice itself is limited to 400 characters, a length the Times worries is “hardly well-suited for providing nuanced answers to some medical questions.”

That’s harsh. A pithy reply can be perfect. You might ask, “Just diagnosed with pancreatic cancer. What next?” Instead of a long-winded answer full of facts, your HealthTap doctor can succinctly respond: “Don’t start long novels or buy green bananas.” Heck, at 46 characters, that could even be a Twitter Doctor Tweet.

HealthTap tells users its site helps you “better understand your health, make better health decisions, and find the best doctors.” The information is “free, reliable, independent…and trustworthy.” If the potentates of Palo Alto proclaim their clothing is magnificent, who am I to disagree?

But if you strip away the conceptual coolness and Google-like goals (“a healthier, happier world”),  the naked truth is in plain sight: you’re getting a few sentences of free medical advice from a group of random physicians, with reputations attested to by other random physicians, who are taking the time to answer your question for free either because of a desire to generate new business or a desire to help their Fellow Man.

How that becomes “reliable” and “trustworthy” is beyond my understanding, though I guess it is independent. I happen to think prompt, free and potentially misleading information is a bad bargain when it comes to your health. And you’re probably going to take the time to double-check it against or a similar site, anyway!

In a recent post on the influential website, a physician comfortable with the web and blogging explained why he had become disillusioned with email communication with patients except under certain circumstances. Internist Robert Sadaty wrote about the confusion email can create:

Mostly everyone has either sent or received an email in which the content somehow did not fully convey the point intended. Despite reading, and rereading the message, the intent of the email was never fully apparent. I often felt that my responses were clear and concise, only later to learn that further clarification was required….In the end, the potential back and forth that can occur with email often resulted in the need for an office visit in order to clarify the mess that was created from the original email.

Maybe that’s the point. By consistently providing just enough information to be confusing, HealthTap may hope to provoke a significant number of users into paying to see a participating doctor and, presumably, persuade a significant number of participating doctors into paying HealthTap for that referral. Form follows function.

A future version of HealthTap may provide a better ratio of reward to risk. Right now, though, the hoopla can’t conceal that this is a game where the odds are tilted against the patient.

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