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Five key components to building an online community for physicians

February 17, 2015

This is the second post of 4 in preparation of the #hccmty flipped panel by Blair Ryan, CEO of The Rounds, Canada’s fastest growing, secure, online network, exclusively for physicians.

All 4 panelists will be presenting their ideas and sparking conversations on this blog so that the on-stage event at the February 25 #hccmty meetup will be but one more link in the chain, not the start or end point. Read the first blog by Colin Hung.

For more information on the #hccmty event.

Eventbrite - #hccmty Meetup - Building Online Health Communities

By Blair Ryan (@TheRounds@BlairJRyan)

Headshot Blair Ryan“How is The Rounds different from other physician communities?” is a question we at The Rounds are asked quite frequently. In other words, what have we done differently that has contributed to our success?

There are multiple ways to answer those questions. For instance, nothing at The Rounds has come without hard work and dedication, nor has it come without vision and belief in the fundamental need for a place for physicians to gather in a secure and engaged network. First, it is important to explain how we at The Rounds consider and define ‘community’.

A community is a place where people who share common interests, values and intentions gather to engage and support with each other in relation to those common interests and goals.

When it comes to The Rounds, this means we’ve created a place, (an environment, if you will) where physicians interact in meaningful ways to bring about significant and meaningful outcomes, especially in terms of patient care.

With this in mind, when it comes to the concept of ‘community building’, we’ve boiled it down to five key factors that contribute to our success.

Relinquishing control & listening

The difference between The Rounds and many other – if not most – online communities is that it is self-moderated by our physician members. That is, we relinquish control of the flow of information and the the comments and replies which, in turn, facilitates more realistic dialogue. This also creates a greater sense of ownership and power for physicians and therefore reinforces the concept of community.

To put this into context, let’s compare the interactions on The Rounds to the interactions on the comments section of a major news publication. On a newspaper site, commenters are all invested in the same news story, but do not share the common goal of supporting or connecting with each other. On The Rounds, commenters are replying to posts created by fellow physicians with the implicit desire to assist, augment and grow the collective knowledge base.

Concurrent to the need to relinquish control over the flow of information within the site, is the requirement that The Rounds listen to the needs of members. By listening, we are better able to build a product that eases the flow of information. In fact, we just rolled out a new version of the site that is entirely based on user feedback.

Creating trust and having trust

We can all relate to the fear of surrendering control of something to someone else. The uncertainty of the outcome can be frightening. But, in order for a true community to exist in an environment like The Rounds, there must be trust. We must trust that our physician members have their own best interests at heart and we must continuously remind our members that they can trust us to maintain that environment for them.

This is why we allow full-fledged discourse on The Rounds on any topic that is posted – from patient specific cases to clinical challenges, issues of ethical concern to running a private practice and beyond. Furthermore, we always remind members that The Rounds is entirely HIPAA and PIPEDA compliant – meaning the network is a trusted and secure place where they can always feel at ease to share opinions, comments and so on.

Facilitate value

The Rounds logoWhile we make every effort to relinquish control and allow members to self-moderate, The Rounds also seeks to reinforce the inherent value of the network by way of reminders and suggestions. Sometimes it’s hard to see the forest for the trees, so every once in a while, we’ll send a note to those within the network suggesting that they connect with a certain physician or consider a certain post that may have been overlooked. This approach still permits us to be ‘hands off’ the information, but helps to bring awareness to the overall value contained within The Rounds.

Private & secure

It almost goes without saying that, for The Rounds, having a private and secure place to establish community is paramount. Physicians are saddled daily by concerns of doctor-patient confidentiality, HIPAA and PIPEDA legislation, ethical questions surrounding use of traditional social media channels and so on. The Rounds is successful at community building because we help physician overcome all of those challenges are more.


Here’s the big one. The ultimate. Arguably the most important and immutable essence of The Rounds. It is free for physicians to join. We have studies showing physicians would be willing to pay to be part of The Rounds. So why is it free, you ask? Because keeping our network free for physicians is what allows us to focus on the other four components of community building (relinquishing control, privacy & security, value and trust-building). Physicians spend years increasing their knowledge and experience, often spending hundreds of thousands of dollars to do so. We do not want to add to that burden in anyway at all, even if it’s by implicitly requiring a physician to make a choice to spend money on this community. We have a safe, secure, valuable community that is full of knowledge and potential to increase patient outcomes – making that community free to join is crucial to success.

This post is just grazing the surface of what it means to build a physician community online. We hope that you consider the talking points presented here and bring your questions, knowledge and ideas to the #hccmty Meetup on Feb 25, 2015!

Let’s get the conversation started here:

  • Do you think online communities can be self-moderating?
  • What do you think are the key components to success when building a thriving online community?

Panelist posts

10 Comments leave one →
  1. February 22, 2015 8:21 pm

    Great post Blair.
    I’d like to drill a little deeper into the concept of self-moderation.

    You state: “The difference between The Rounds and many other – if not most – online communities is that it is self-moderated by our physician members.”

    In my opinion, self-moderation is not unique to The Rounds. In fact, all successful online communities are self-moderating. The fears of mis-information in online health communities is largely unfounded because where there is an active group of people who share a strong sense of community, mis-information is quickly corrected. In the study by Esquivel et al. they found that only “10 of 4600 postings (0.22%) in a breast cancer community were found to be false or misleading. Of these, seven were identified as false or misleading by other participants and corrected within an average of four hours and 33 minutes (maximum, nine hours and nine minutes).

    Esquivel A, Meric-Bernstam F, Bernstam EV. Accuracy and self correction of information received from an internet breast cancer list: content analysis. BMJ 2006 Apr 22;332(7547):939-942

    Mis-behaviour is rare in the communities that I have stewarded and/or studied. A community ethic and etiquette is usually established by the early adopters. At the inception phase it is wise to recruit early adopters who will help establish the type of tone, personality and attitude desired for the community. It sounds like you did exactly that upon conceiving of the idea of The Rounds.

    Community management is not synonymous with moderation. A community manager is a steward, ensuring the community is about the people, helping them make connections, build trust and form relationships and develop a sense of community. A community manager also monitors the health of the community ensuring that the growth is sustainable and the activity is constant. I talk more about the importance of activity in my post for the #hccmty panel.

    Good community management (although I don’t really like the word – I prefer stewardship) is not about having control. Good community management includes much of what you outline in your post: a) active listening, b) responding first and foremost to the needs of the members and the community, c) creating and having trust, and d) facilitating or demonstrating value both to members within the community and to stakeholders outside the community.

    I understand and definitely agree that The Rounds is and should be private to members only, but, boy would I love to have a chance to see the community first-hand. Kudos to you and your team.


  2. cmaer permalink
    February 23, 2015 10:03 am

    Self-moderation is the ideal, I believe, but I know that this is not always successful even with physician communities.

    Colleen makes an important point that even with self-moderation of a site, physicians can benefit from community management. And I believe any physician online community can be supported more strongly with designated physician champions.

    The need to facilitate value in a physician online community is critically important and somewhat understated in Blair’s post. The ability to provide a private, secure forum where physicians can discuss things is “table stakes” for a successful community, I think. But in terms of value, physicians are looking for more – as demonstrated by both Sermo and Doximity in the US.

    I look forward to continuing this discussion with Blair in person on Wednesday.

    Liked by 1 person

  3. Shirley Williams permalink
    February 23, 2015 8:40 pm

    Nice outline of The Rounds. I am intrigued on what is the balance [ and line] between self moderation and active facilitation? When is it important for the moderator or facilitator to jump into a discussion? If at all?

    Liked by 1 person

  4. Christina Lizaso (@btrfly12) permalink
    February 25, 2015 11:29 am

    Echoing Colleen’s comments, successful communities do self-moderate. How they get to that point comes back to the founders and community “stewards” laying the groundwork by working to ensure a diversity of viewpoints participate, working to ensure there is an active group of participants, and nurturing community champions to feel invested and have access any needed tools (such as community guidelines). As Colleen and I have discussed in the past, it is really easy for a community to go off-track and a consistent moderator is who is going to have the community pulse and steer as needed. Sounds like The Rounds has that good foundation and is walking that line of knowing its community and taking small actions as needed. All those small actions add up and ultimately create a sustainable space where there is trust.

    As to key components for success, The Rounds has hit the nail on the head with relinquishing control and listening. And tying into Colin’s post, if your main goal is to have a group to market to then a community might not be your best vehicle. Thriving communities are constantly doing temperature checks by asking what members want from participating. Same principles as the drive for being patient-centric. Communities succeed by letting the members shape what the community becomes and what it seeks to achieve and by continually asking members for feedback which is then put into practice and used to guide decisions.

    Value is certainly also key. For me, on Mondays I’ll be looking at my week and think, hmm… which twitter chat groups do I have time for? There are always great conversations going. Even in my busiest weeks though, I’ll get sucked into #hcsmca or another group’s chat because time and again their topics are interesting to me personally and I walk away having gained something. We make time for the things that give us value. Community “stewards” help ensure not only that the value is there but also that the benefits are spelled out in various ways and places to bring the values top of mind for members and potential members.

    Liked by 1 person


  1. Don’t Knock the Nudge: Moving from online community engagement to real-life behaviour change in health | Colleen Young
  2. Building Online Community in Health: Blockbuster #hcsmca-#hcldr-#eRounds Toronto Meetup | Colleen Young
  3. The Nature of Online Communities | hcldr
  4. “Is anyone there?” – Is your online community a ghost town? | Colleen Young
  5. #hccmty Event – Program Details and Livestream Wed Feb 25th, 2015 – Toronto | Colleen Young
  6. Is an online community really the brass ring you are seeking? | Colleen Young

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