By Daniel Ghinn 
Much has been said about the rise of the HCP Digital Opinion Leaders. In fact, I’ve been writing about DOLs since 2012, when I first presented the idea at a medical affairs conference in Basel. At the time, I had just written the first edition of my book, Activating Digital Opinion Leaders, based on observations of how certain health stakeholders were developing a trusted reputation that was shaping medical practice.
In my research for the book, I interviewed physicians who were making a significant impact among their professional networks on social media, who told me how medical challenges were being solved collaboratively by HCPs on platforms like X, sometimes even leading to new medical practices. Now, thirteen years later, it has become widely accepted that social media plays a significant role in how many HCPs learn, share ideas and even shape policy.
Today, the idea of a Digital Opinion Leader seems to have entered the mainstream of healthcare communications, not only among industry and organisations, but healthcare professionals, too. As I talk with stakeholders, from industry, to agencies, to HCPs, it’s clear that we are not all on the same page about how to answer a key question: What (or who) exactly is a Digital Opinion Leader?
Myths about Digital Opinion Leaders
Misunderstanding what makes a Digital Opinion Leader can lead to some challenges, and disappointing outcomes, as industry players attempt sometimes-embarrasing content collaborations and drive an even deeper wedge into the too-often limited trust that exists between themselves and their HCP customers. So let’s start by taking a look at what a DOL is not. While misconceptions about Digital Opinion Leaders abound, I have outlined three of the top myths I often hear about DOLs.
Myth 1: A DOL posts a lot of content
You do not have to look far today to see a list of “top social media voices” at a recent medical congress, or in a particular medical chat. But are these so-called top voices Digital Opinion Leaders? Not necessarily.
While posting frequently about a medical topic makes an HCP a participant in that online conversation, it is useful to consider the nature of their posts and how other HCPs engage with those posts. Some HCPs are prolific ‘amplifiers’ of other HCPs’ content. They play an important role in disseminating the ideas of others, but if we are looking for opinion leadership then we should consider whether the HCP is indeed posting their own opinions.
We should then consider whether those opinions are resonating with other HCPs; do they show opinion leadership? We can test this by analyzing how other trusted HCPs respond to their original posts, and the extent to which other trusted HCPs amplify their views. If an HCP’s online views appear to be shaping the views and conversations of other HCPs, we might have a basis to say they are an opinion leader.
With this in mind, a highly active HCP on social media might well be a DOL, not simply because of the volume of their posts but because of the impact of those posts on other HCPs. Other HCPs might simply be adding to the noise.
Myth 2: A DOL is a KOL who is active on social media
Even in this digital age, the traditional model of a Key Opinion Leader, or KOL, is still an important concept. KOLs play a vital role in opinion leadership, often leading and presenting scientific research. So I can understand why it might be thought that if a KOL is on social media, they must be a Digital Opinion Leader.
In fact, being a KOL on social media does not necessarily make an HCP a DOL. This point is complicated, because research shows that the papers of academic authors who tweet, are more widely cited, even outside of social media. So it’s possible that for the KOL who is on social media, their being on social media can support their offline impact as a KOL. But when it comes to classifying the online KOL as a Digital Opinion Leader, we must ask the same question: on social media, is the KOL truly impacting the opinions of their HCP peers?
I am assuming for now that we are considering the digital opinion leadership of HCPs, not all other stakeholders. There is an argument for the “Patient Opinion Leader” which I originally made in my 2012 book, but for now the scope of this discussion is the role of healthcare professionals on social media. There are millions of HCPs on social media, who provide an incredible dataset for learning about the behaviours and impact of DOLs.
Myth 3: A DOL wants to monetize their online influence
The myth that DOLs want a career as paid influencers feels like the preverbial elephant in the room. When discussing Digital Opinion Leaders, the idea is sometimes there in the back (or front) of the mind of well-intentioned healthcare marketers, that DOLs will post anything for money. I hear from HCPs who have been offered significant payments in return for posting product endorsements on social media, and in fact agencies now exist whose entire business model relies on the recruitment and enablement of sponsored content by online HCPs.
But when I speak with true Digital Opinion Leaders, they often tell me how careful they are to steer clear of simply being a pharma mouthpiece they will have nothing to do with such schemes. “No pharma company is going to pay me to say anything”, said Dr Kevin Fernando when I spoke with him last year on my podcast episode, “Every Day is a School Day”. Another doctor told me how she felt accepting a payment to promote a product she did not believe in would compromise her online integrity, diminishing her potential to do good through social media.
To understand the significance of this point, it is essential to understand what motivates HCPs to post on social media. While every HCP has their own specific motives, I frequently hear from HCPs about how they consider social media to be an essential tool for ongoing scientific learning, sharing new science and dispelling misinformation. “Social media is essential for physicians in oncology”, as Dr Shaalan Beg told me in our conversation in the podcast episode, “Social Media is Saving Lives”.
This is not to say that industry collaborations with DOLs is impossible; in fact I have had the privilege of supporting many successful industry-DOL engagements, based on shared values and topics that are important to both parties. Since every DOL leaves a visible digital footprint of their conversations and openly-shared thoughts, there is every opportunity for any stakeholder to learn what is truly important to that DOL and find ways to engage with empathy.
What is your context?
The question of what, or who, is a DOL depends on context. I recommend starting by considering why you want to identify a DOL. Are you looking for an HCP who makes an impact in a particular field of treatment? Are you looking for a DOL who impacts scientific education among other HCPs, or are you looking for somebody who is a vocal advocate for patients? There are many behavioural metrics – both quantitative and qualitative – that can be tracked and analyzed to determine who is the most qualified DOL for a particular objective.
In a recent CREATION.co analysis to rank DOL candidates, a set of quantitative metrics provided an initial shortlist of 50 DOL candidates (from thousands of HCPs observed in the relevant online conversation), which were subsequently considered in the light of additional qualitative data to refine the list to ten DOLs selected for meaningful and empathetic engagement.
Nineteen metrics – such as the number of times another HCP mentioned a particular DOL candidate within the relevant conversation, or the number of times this DOL candidates relevant posts were shared by other HCPs – were identified to determine the initial shortlist of 50 DOL candidates. After normalising the data, each metric was weighted according to its significance for the client’s particular objectives. Peer trust was deemed to be particularly important, and so was patient advocacy, since the client was looking for a DOL who was well trusted among their relevant HCPs and who demonstrated significant support for patients. So in this case the DOL shortlist included only the most trusted HCPs in the conversation, who also cared about patient advocacy.
DOLs are trusted online by their peers
As I write this, I am traveling to the world’s largest in-person oncology meeting, hosted by the American Society of Clinical Oncology and attracting tens of thousands of physicians. It’s a huge live event, but the combined impact of the live sessions together with the amplification of new science by HCPs on social media is set to have an even greater effect on the knowledge of those treating cancer all over the world, even those who cannot be there in person.
HCPs will not only be posting about the science they discover at the ASCO congress, they will be sharing their own reflections on it. But with so much content expected over the next few days, how do HCPs listening and engaging online know whose opinion to trust?
In practice, the community of millions of online physicians learns who to trust by a kind of virtual peer review process that happens informally and organically, as HCPs mention each other and amplify each others’ posts. The most trusted HCPs are not always the loudest, but their credibility among their online peers is tested and reflected in their engagement with each other.
So throughout the congress, the CREATION.co team will be listening, analyzing and identifying the most peer-trusted HCPs in the conversation, based on our tried and tested methodology that quantifies online validation among professional peers. We will not be looking for those making the most noise; instead we’ll be highlighting the HCP voices most trusted by their peers in the online conversation (you can watch the highlights of our research in the CREATION ASCO Debrief webinar).
How to find your DOL
So to sum it up, a DOL will not necessarily be the loudest voice; they will not necessarily be a KOL; and they probably do not want to position your message in return for payment. They certainly are trusted by their online peers. The rest is up to you, for your context.
If you would like help to identify your true DOLs, engage them with empathy so that you can activate them for good, we have the tools and experience to support you. We’ll also help you to scope out what’s important in your own DOL considerations, based on your objectives.
If you are an HCP on social media and have a view on this piece, I’d love to hear from you! Either way, get in touch and let’s talk.
