Dear dr. Sclafani,
You are right that we have entered a new era of Internet dialogue. But this dialogue is no longer exclusively the domain of doctors.
A truly global invisible College emerges, a labyrinth or network that is complex, self-organising, self-adaptive, with many interpersonal links, small worlds, and redundancy. Brains circulate, knowledge and information circulate. There is little control over who participates. Patients are extremely motivated and its their perspective that fuels this particular debate.
Unexpected connections arise from data placed on the Internet, as you say because the traditional vertical silos now fork into thousand of thin lines; with on the other side a very hungry public, that is mainly us patients. And we combine and connect.
The web reshapes or revolutionises how we learn and create and overturns old notions of ownership, expertise and creative freedom. Knowledge is increasingly managed in a global context. And that is also very true for our little field.
The problem with your call to get medical people involved in this dialogue is a cultural issue. Here, the medical sector is not different from any other sector in the economy that cling on to old prerequisites etc etc – I can write a book about that. It will take many many years and lots of energy to get this culture changed, and a lot of new blood I might add.
The low-glucose hypothesis that I put here on TIMS on another thread and that was the result of some of these unexpected connections on TIMS is a good example of the unbeatable power of the Internet. The reorganisation of this world continues, see for instance:
The week after next, there is an evening meeting with Members of the European Parliament to discuss these sort of issues (The European Parliament is like the US Congress and although probably not quite as powerful, it co-decides in the world's economically most performant market, a market of 27+ European countries and over 500 million citizens).
I have posted the quote below here before but would like to repeat it. It is from the book entitled The Starfish and the Spider: The unstoppable power of leaderless organisations by Brafman and Beckstrom, which captures very nicely what is going on here.
I quote from the book: We look for hierarchy all around us. Whether we are looking at a Fortune 500 company, an army, or a community, our natural reaction is to ask, Who is in charge? This book is what happens when there is no one in charge. It is about what happens when there is no hierarchy. You would think there would be disorder, even chaos. But in many arenas, a lack of traditional leadership is giving rise to powerful groups that are turning industry and society upside down. In short there is a revolution raging all around us...
... The harder you fight this force, the stronger it gets. The more chaotic it seems, the more resilient it is. The more you try to control it, the more unpredictable it becomes. Decentralisation has been lying dormant for thousands of years. But the advent of the Internet has unleashed this force, knocking down traditional business, altering entire industries, affecting how we relate to each other, and influencing world politics. The absence of structure, leadership, and formal organisation, once considered a weakness, has become a major asset.... unquote
To prepare ourselves for this new order will be a major challenge for all of us.