In Reply.—For many years, Richard Horowitz, MD, presented a wonderful lecture series for pathology residents in Los Angeles, California. He talked about what it meant to be a pathologist and how to prepare for a job in the real world. He asked me to give one talk on how to succeed in private practice. I touched on the importance of personal interaction, getting out of the office, and building bridges with the medical staff and administration and the “power of donuts” (gestures of appreciation for the laboratory staff)—many of the themes espoused by Pierre Keitges, MD.1 I never used the words “transformed” or “involved” but I did say that this behavior was what it took to be an indispensable, “linchpin” pathologist.
Fast forward to today. Technology communication is guided by 2 main laws: the Sarnoff law and Metcalfe law. The Sarnoff law2 (named after David Sarnoff of NBC) states that the value of a network grows with the number of viewers. This is a one-to-many relationship and describes radio and television. It also describes most resident teaching activities: 1 way and fairly passive.
In contrast, the Metcalfe law3 focuses on the value of paired connections. It states that the value of a communication system grows as the square of the number of users of the system. Examples include fax machines and e-mail: neither is of any use if you are the only one who has it, but they become a key part of your life when all your contacts are connected. The growth in value is faster than just the increase in the number of users. The Metcalfe law describes the discourse in the doctor's lounge and interactive discussions at tumor board. But it also characterizes many of the network effects of communication technologies such as the Internet, the World Wide Web, and social networking. Web sites and blogs such as Twitter and Facebook are at the center of this law. Communication now uses collaborative tools, to which Dr Horowitz may not have given a fair trial. His comments seem based more on The Social Network (the recent movie about Facebook) than Facebook the Web experience. Social media has more depth and value than the movie depicts. The protagonists may indeed be “nerdy young geeks….lacking social and interpersonal skills” but the tools are remarkable means of engagement. They certainly are not substitutes for face-to-face interaction but when used correctly they serve to initiate and enhance meaningful dialogue. As discussed in my Archives editorial,4 social media remains an important niche opportunity for our profession that can be effective in widening our audience.
So, what if Dr Horowitz created YouTube videos of those powerful resident lectures or chose to write a weekly blog focusing on the “Dr Keitges Ethos.” Suddenly his influence would grow from 20 a year to thousands.
The Internet has changed all the rules of engagement. Now the audience is more than fellow physicians in the hospital lunch room, a few folks in administration, and the 100 employees in the lab. It is the world.
Dr Horowitz has been a great role model and mentor to many young physicians who now use the social tools he disparages. Please, Dr Horowitz, share your talents. Embrace Pathology 2.0.5 Make a global difference, rather than a meaningful—but local—one. Create a blog that is so insightful that others are compelled to dialogue with each other and spread the Keitges' gospel. Help pathologists by creating an online presence that they want to emulate. Take a walk outside the hospital and join the conversation that connects people and ideas. You will find many friends waiting for you there.
The author has no relevant financial interest in the products or companies described in this article.