When a patient asked recently for a prescription for Dostinex to revive his flagging libido, Brooklyn internist Sean Khozin was uncomfortable recommending the drug, which is used to treat hormonal disorders.

Dr. Khozin took his concerns to Sermo, a virtual community of doctors who share experiences and information online. He soon had 10 responses, all of them agreeing there was no evidence for using the drug to treat the man's loss of libido. He ended up not prescribing it.

“The input was very helpful, and I discussed with the patient the fact that I got unbiased recommendations from colleagues,” says Dr. Khozin.

Welcome to Health 2.0, where social media meets medical science. After lagging every other profession in going electronic, doctors are today flocking to blogs, Twitter, Facebook, YouTube and networks such as Sermo to learn, chat, commiserate and sound off about the state of modern health care. The implications for patients are significant as social media give physicians instantaneous access to an almost limitless pool of advice and problem-solving tools.

“Physicians are more and more using the Internet as a resource, Googling to get a more accurate diagnosis and injecting information in a more proactive and dynamic way,” says Fard Johnmar, Envision Solutions' health care marketing consultant.

Membership grows

While consumers were quick to embrace social media, doctors were initially skeptical about its value. Now, prodded by the need to be smarter and more competitive in the complex world of modern medicine, doctors are becoming converts. The two largest doctor-only social networks, Sermo and Medscape Physician Connect, have more than 100,000 members each nationwide. According to a Manhattan Research report released earlier this year, 60% of doctors say they use or want to use social networking sites.

The enthusiasm spans generations. The average Sermo user is in his or her late 40s or early 50s. Many are solo practitioners in rural areas with little time or opportunity to hang around the hospital cafeteria for impromptu consults with other physicians.

Richard Schoor, for example, is a solo practitioner in Smithtown, L.I. The 41-year-old urologist frequents Sermo, blogs as the Independent Urologist and runs his own online forum, the Physicians Entrepreneur Group, which has about 60 members who exchange advice on running a medical practice. Dr. Schoor says he's gotten valuable information from the online forums, including advice on equipment that has prevented costly mistakes.

Even doctors at big medical centers are social media regulars. Mount Sinai Medical Center neurologist Errol Gordon regularly logs onto Physician Connect to give or get information, including the time he sought out cardiologists' opinions about potential heart issues with a stroke patient. “It's almost addictive,” says Dr. Gordon, 32. “It gives you perspective, a national flavor of what people would do in the same situation.”

The most enthusiastic don't stop with doctor chats, but regularly blog and tweet about anything from tough cases to health care reform. Dr. Khozin tweeted in April about swine flu as it began to emerge as a potential public health problem. “I wanted to put things into the right context and talked about the fact that swine flu is less virulent,” says Dr. Khozin, who has Twitter and Facebook icons on his e-mail messages.

Some enthusiasts are even using online video, such as Dr. Alan Copperman, co-director of Reproductive Medicine Associates of New York and vice chairman of obstetrics and reproductive science at Mount Sinai. Three months ago, Dr. Copperman and his partners went live on YouTube with two videos demonstrating the in vitro fertilization process. By the end of May, some 40,000 people had viewed them. Dr. Copperman, who has six more videos in the works, acknowledges that YouTube can be a savvy marketing tool, but says his main goal is to ease patients' fears, especially in a world where IVF clinics can turn out patients like the Octomom.

Promoting the mainstream

“Evidence-based medical doctors need to take back the ground they've lost to the fringe and show that mainstream medicine is good,” says Dr. Copperman.

Whether social media can ultimately make doctors smarter and patients healthier remains to be seen. Critics worry about patient privacy, conflicts of interest and the potential liability when doctors give advice to physicians they don't know for the purpose of treating patients they've never seen. Though practitioners and sites are careful to emphasize the safeguards they use to protect patient privacy and ensure accuracy, even aficionados are skeptical about some of social media's supposed virtues.

“I worry that we almost get our message lost amid the noise if every thought comes pouring out in a blog or a tweet,” says Dr. Copperman.

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