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Audience Fragmentation and Social Media: Why Healthcare Is Different
Recently I’ve been spending a lot of time talking about the impact of social media technologies like blogs on healthcare.  I interviewed Steve Rubel of Micro Persuasion about this topic.  I also commented on Toby Bloomberg’s experiences with a physician who was skeptical about blogs.  In that post I argued that physicians should pay attention to blogs because of how they may affect the healthcare provider-patient relationship.  

I decided to come back to this subject after seeing a number of articles John Wagner posted on his blog, On Message, asking marketers to consider the impact of audience fragmentation on communications campaigns.  He says:

“There is no doubt that consumer generated media is important, and its influence will grow.  But it’s critical to keep in mind that the interest in ‘creating’ will always be limited to a segment of the population.  That’s easy to forget when your whole world revolves around blogging.”

In another post Wagner comes back to this theme, saying:

“Many people I know use their computers for e-mail (or IM'ing if they are young) and not much else. They don't read blogs, don't care about YouTube, don't spend time creating commercials for their favorite brands.  They live in the real world, not the online one, as I'm fond of saying.”

Wagner makes a lot of good points, but I disagree with him.  There is at least one important exception to his assertions about social media: healthcare.

Audience Fragmentation Isn’t A Big Issue In Healthcare

Audience fragmentation does not matter much in healthcare because people are turning to the Web in overwhelming numbers to learn about drugs, conditions and medical news.  According to a July 2005 Harris Interactive poll, nearly 117 million American “cyberchondriacs” use the Internet on a regular basis.  

In addition, people believe the information they find is “at least somewhat reliable.”  Why do they trust online healthcare content?  I suggest it is because their peers have developed much of what they find.  As the Edelman Trust Barometer indicates, people tend to place high trust in information developed by their fellows.  

Blog and Bulletin Board Healthcare Content:  Easily Located Or Buried?

If people are going online for healthcare information are they easily finding consumer-generated content on blogs and bulletin boards or is it buried?  To find out I conducted an experiment in Web information gathering.  I looked for online content about a popular ADHD medication manufactured by Eli Lilly and Company called Strattera.  

I put myself in the shoes of someone looking for information about people’s experiences with the medication.  To find out, I conducted a search using the words “Strattera” and “experience” on two popular search engines: Google and Yahoo!.

What I found was very interesting.  First, blog and bulletin board-generated Yahoo Edited Page 1.pngcontent about people’s experiences with Strattera was featured very prominently on both search engines.  In each case, I found consumer-generated content on the first page of each search.  

As the graphic to the right illustrates, I found four examples (see the yellow checkmarks) of consumer-generated content via Yahoo!. (I excluded content developed by advocacy organizations in this search.)
Google Edited Page 1.png

On Google, I found three examples.  Surprisingly, content featured on, a popular blog that highlights patient experiences with psychiatric medications, had a higher page ranking than Eli Lilly’s Strattera Web site. 

What Are People Finding On Bulletin Boards and Blogs?  

I was then curious about what people were learning about Strattera by readingBoard Forum Edited Page 1.png on-line bulletin boards and blogs.  Overall, the patient verdict on Strattera is decidedly mixed. I conducted a search on a new Web site, Board Tracker, which tracks commentary on bulletin boards for information about Strattera.  (Thanks to Steve Rubel for this tip.)  As you can see in the graphic to the right, there were three prominent and widely-read negative mentions about Strattera posted on several popular bulletin boards. features more balanced commentary.  Readers learn about the prosCrazy and cons of taking Strattera – and about some “freaky” side effects.  (See the screen shot to the right.)  

Closing Remarks:  Blogs Are Becoming Increasingly Important

My experiment indicates that consumer-generated content is pervasive and may be  significantly affecting people’s perceptions of healthcare products and services.  It is clear that bulletin boards continue to have a significant impact on consumer perceptions and behaviors.  

However, I also feel that as the healthcare blogosphere expands, blogs will play an increasingly important role.  Although they don’t do as good a job of providing people with customized answers to their healthcare questions, they are becoming sources of trusted, valuable and easily accessible information.  

To learn more about what I think about blogs and healthcare, please see this post.  

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9 Comments/Trackbacks


Fascinating post ... I agree that health care (especially personal health issues) is one area where people are driven to learn more, and the web is a treasure trove of information.

In fact, given the difficulty of accessing and talking to physicians, bulletin boards, websites and blogs are probably the only feasible source for people searching for information.

Of course, a person who is diagnosed with an illness or disease becomes passionate about that subject, so they move from the unengaged quickly.

Good stuff.


Thanks for commenting on this post and for writing such a thought provoking series of articles!


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Well said,i applaud your blog,mental health consumers are the least capable of self advocacy,my doctors made me take zyprexa for 4 years which was ineffective for my symptoms.I now have a victims support page against Eli Lilly for it's Zyprexa product causing my diabetes.--Daniel Haszard

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Thanks for helping us be known as the gold standard of citizen medical sites. Unfortunately due to one or both of willful ignorance or outright theft on the part of the site's former domain registrar, with various other domains redirecting to that site.

The .org domain is now a parked site with one of the registrar's sister companies making outrageous claims about current traffic (i.e. what we used to get on on weekdays) in an attempt to sell said domain for a ridiculous amount of money.

Right now we're getting all of 1,000 visitors a day, 10% of what we used to see.

Thanks again,


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