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August 29, 2007

Why people won't post stories about their piles?

Posting stories to social health sites seems to be different to other types of site. And it’s not just that sharing the story of your haemorrhoid operation is qualitatively different to posting your holiday snaps of the Maldives to Flickr.
Getting the balance between personal payoff and social benefit seems to be genuinely tougher for health-focused social sites. And I’m not sure we’ve got it right yet on Patient Opinion. People post on the site out of range of motivations that include altruism, anger and gratitude – so there is clearly some personal and emotional pay off, and the telling of the story itself helps.
But we haven’t yet hit the big time – we may have had thousands of people posting stories and rating services but we’re still a long way from where we want to be.
Interestingly we’re not alone – the feedback section of NHS Choices is currently only receiving 2 to 3 postings per day about the whole of the NHS in England. And commercial sites like Organized Wisdom fair little better. This US site aims to help people who have experienced illness and disability share and organise their wisdom through structured ‘wisdom cards’ that say what was good and bad about a particular illness experience. A great idea but in the few months since they’ve launched they seem to have only manage to create 403 wisdom cards (unless I’m misreading the site).
So what would be the real motivator that would make people post about their illness experience? The sites with the most hits seem to be unmoderated and to mainly just offer a way to rate and comment about individual professionals by name. This produces both good and bad comments but in my view (and here I’m influenced by my own experience as a family physician) the motivation to both praise and libel your own personal doctor is often driven by fairly deep needs – we all tend to see our doctor as a bulwark against death. Or to resent the actual or perceived power that we have surrendered to them and hence to tell atrocity stories about them. (I know this isn’t always true but I do think it happens a lot).
So pure personal feedback is I think a lot less informative than people think its gong to be. Which is not to say that there won’t be quite a few successful sites that thrive by giving people the chance to publicly sound off about their doctor – there will be? But unlocking the social value that lies above these bottom feeder sites is the key to creating a site that actually helps people live with the enduring distress of illness and disease. And no one has yet found the personal pay-off key that will unlock even a fraction of the millions of health interactions that happen each week in the UK.

Posted by Paul at 8:30 PM