Biggest and best? The optimal size of professional health networks‘s recent announcement that it has acquired a share in Swedish healthcare practitioner network has prompted me to ask: do professional health networks have an optimal size?

The primary criteria to consider when framing such a question should logically be predicated upon a consideration of the stated aims of the community’s organizers, and the external perception of its brand.

Who constitutes’s community?

It is not unreasonable to assume that a site which features ‘UK’ in its suffix is targeting the United Kingdom as its core constituency. This is borne out in part by such definitions as we may encounter on the site itself, with the ‘About‘ page referring to ‘the largest and most active community of medical professionals in the UK’, ‘available to UK-registered doctors in primary and secondary care’. However,’s core values page, where it speaks of the primacy of trust, collaboration, transparency and independence to its enterprise, makes no such regional associations.

It will be interesting to hear more about how Swedish doctors are responding to their site being badged with a UK medical community’s logo, and to better understand whether they interpret the language of the press release which speaks of’s ‘strategy to expand internationally’ as being consistent with their own aims and aspirations as Swedish healthcare professionals.

None of the above need necessarily concern us if we assume that the members of MedUniverse self-identify as healthcare practitioners first, and Swedish healthcare practitioners second. Perhaps focus groups were convened prior to this transaction taking place in order ascertain the community’s response to such developments. However, it is something of leap of faith to assume that this is the case without evidence of the same.

No community’s aims and aspirations must remain immutable through time as a precondition of their existence, and networks can have several potential boundaries of scale. For example, we can acknowledge the utility (which need not also necessarily infer the validity) of all of the following orders of magnitude:

Global –

Continental –

National –

Regional – SussexDoctors.[suffix]

Practice – [PracticeName.suffix]

Personal – Blog and/or suite of social web presences

However: if members have been recruited on the basis that the community in question serves a particular need they wish to fulfill (for example joining a national community in order to connect with other primary care practitioners within their own country), upon what basis can the community organizers assume that they will be able to retain their membership or convince them that they are serving their best interests if they subsequently choose to reorient the community’s direction by endeavouring to broaden (or, less likely, to narrow) its remit by transforming its enterprise into a continental or global one?

I posed a question to the #hcsmeu community as to whether it is felt that the ‘’ suffix of would impede its expansionist campaign, but it is just as important to ask: how will existing members feel about seeing the badge on the site?

If they are interested in creating connections with other international healthcare professional communities, they will doubtless be delighted. However, if they perceive significant differences between primary and secondary healthcare provision in the UK and Sweden and joined primarily as a spur to their desire to continually interrogate, assess and refine their own practices as a UK health practitioner, their response may be confusion, consternation, or downright irritation.

Do professional networks in health have an optimal size? A site aiming to serve UK or Swedish healthcare professionals is never going to exceed the size of the healthcare professional community. What sort of constraints does this place upon the growth expectations of the business behind it?


2 thoughts on “Biggest and best? The optimal size of professional health networks

  1. This is an interesting post Andrew. Have you heard from yet?

    In relation to the question that you pose on optimal size of a professional network and the constraints on growth of the business behind it I have a few points in relation to

    + It is the biggest physician professional network in the UK (nearing 175,000), and unsurprisingly sub-groups exist within it based on specialities, so in relation to size: ‘the bigger the better’ as it makes it more representative. 175,000 members is a HUGE network – the General Medical Council state there are 231,325 doctors registered to practice in the UK

    + I believe it is the most used place on the web for UK doctors (even beating big hitters like BMJ by a long mile) – the folk at must have comparative stats. I think that the number one use of the service is for access to a free email address (that doctors are given as students). Not sure what the split of activity is on the site i.e. % using email, % actually engaging in dialogue in forums, % engaging in commercial content etc

    + They command a Premium (the capital P is intentional) for access to their audience (that they have worked hard for years to build). Commercial organisations pay significant sums to sponsor forums, add clearly signposted content etc. Have a look at the Commercial Opportunities section of the website for case studies:

    I am currently the lone ‘no’ in the #hcsmeu survey that you link to in your post above, so my thoughts on the word ‘UK’ in the brand name of being applied in other countries are:

    + According to the news release at the following link they will adapt to local needs and in some cases keep existing local branding so ‘UK’ will not appear:

    + The reason I don’t think ‘UK’ is too much of an issue as when I have undertaken digital communications for UK clients and bought use of UK-based professional group and association e-distribution lists often up to half are non-UK residents. i.e. healthcare professionals from around the world want to join groups in the UK (it is the international language of medical communications). So I think the impact of ‘UK’ in branding (in this instance) is neutral to favourable in impact

    • Hi Neil

      Many thanks for having taken the time to compose such an informative contribution.

      So yes, DNUK provides a great service to UK healthcare professionals.

      However, as we look at ways to democratize the health conversation in order to take into account the needs of the turn to participatory medicine away from dictated medicine, I wonder whether corralling the most active debate among primary and secondary health practitioners within the confines of a single community is good for the debate.

      And, regardless of what we personally thinking of the ‘UK’ branding issue, it will be interesting to get a larger sample of responses from Swedish doctors as to whether they believe being aligned with the brand will serve to advance their unique, specific interest.

      Finally: yes, DNUK have reached out to me privately in several guises which is very kind of them, but we await a public response, if they feel one is necessary.

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