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Playing Doctor on the Web

I’m not a doctor, and I don’t play one on the Web, TV, or otherwise. But I just posed as one. It was in a good cause.

I am a journalist specializing in writing and consulting about diabetes. My highest university degree is a master’s. My credentials are my experience of a dozen years of having and studying diabetes and writing about it.

“On the Internet nobody knows you’re a dog,” as one hound said to another in the famous New Yorker cartoon years ago. It seems now that no one can know that you are not a doctor either, even if you say that you are.

A new website called Sermo opened for business last month. Sermo is Latin for conversation, and the purpose of the site is to facilitate conversations among doctors. It lets “physicians share new clinical observations.”

Regular people like me aren’t welcomed. I know, because I tried to log on as a journalist.

But I then immediately logged on with the same information as a doctor. The site automatically and immediately accepted what I offered as my credentials.

While for a journalist I am not overly cynical, I was suspicious about one post on the Sermo site. Others have accepted the credentials of the poster at face value, but not me.

Somebody who identified himself or herself only as chip2444, wrote on Sermo on September 20. The post eventually captured the attention of the media and health care providers.

Chip2444 wrote:

“There have been over 50 reported cases of sudden death associated with Byetta. We are interested in determining the cause and if the death rate is higher than expected for the diabetic population. Have you seen or heard of a case of sudden death caused by Byetta?”

That’s all that chip2444 wrote and as of October 18 no one else chipped in with any such reports. Someone identified as Atheroman wrote that while he or she has more than 300 patients on Byetta with no major adverse reactions, only the normal nausea.

The only other response on Sermo was someone identified only as mendosa, who wrote on October 17. That’s me, and I wrote, “I have been taking Byetta for nine months and I am still alive!”

For me this is proof that chip2444 is not necessarily a doctor. But Christopher Rowland, who appears to have broken the story in the October 14 edition of the Boston Globe. Others, including Kaisernetwork.org picked up the story and ran with it.

The Globe story says that on Sermo, “Doctors post anonymously, but Sermo knows who they are and screens them to verify credentials.” I think not.

The Kaiser site likewise accepts that the post by chip2444 was “one physician.” However, more knowledgeable experts demur.

David Kliff, the publisher of the “Diabetic Investor” newsletter tells me that he thinks chip2444’s post is just another the the cheap shots that short sellers are taking at Amylin, the company that developed Byetta and sells it together with Lilly. It is not just a coincidence, either, that the Food and Drug Administration just approved Merck’s Januvia, which many analysts expect will reach blockbuster status. Low blows like chip2444’s post may be geared to help Januvia’s sales.

Dr. Bill Quick, an endocrinologist whom I have known, respected, and worked with for years, is likewise skeptical of the sudden death claim. His blog includes a statement from Byetta spokesperson Jamaison Schuler.

“There have been no reported cases of sudden death that have been assessed as being related to the use of Byetta,” Schuler wrote. “We question the motivation for physicians to post egregious comments to a Web site that financially rewards them based on the attention that their posting generates on the site,” Bill wrote on his blog. Because authors are kept anonymous, there’s nothing that prohibits false postings by competitors, investors, or others trying to cause undue concern for patients and healthcare professionals.”

Bill’s summary of this sad situation is as good as anything I could say. “It’s merely an Internet rumor. Don’t believe everything you read on the Internet – even here.”

The dogs are still hard at work.

This article is based on an earlier version of my article published by HealthCentral.

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