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Electronic letters published:
![[Read Comment]](/icons/misc/sectionDOWN.gif){kind=icon}
A tool worth testing
Social Network Analysis - Bauble or Gem?
A novel approach for unlocking the black box
Studying What We Value
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Anton J Kuzel, Richmond, VA, USA Physician; Virginia Commonwealth University
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Scott, et al have raised the visibility of an intriguing tool for the analysis of primary health care organizations. As the authors themselves and the first three commentators have suggested, its time to test the tool for utility in understanding how social networks within practices affect the delivery of care. I personally find the cluster analysis most intriguing - it might be the best example of something that captures group dynamics in an efficient manner. The overall approach makes me wonder if this could function as a sophisticated survey that could be used not only for correlational studies with outcomes, but also to identify practices that would be worthy of more in depth qualitative study. I do hope the authors continue their pioneering work and provide us with more examples of SNA's application to the task of improving primary health care at the level of the office. Competing interests: None declared |
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Colin P. Bradley, Cork, Ireland Professor of General Practice, University College Cork
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The discipline of family medicine is something of a magpie when it comes to exploiting research methodologies from other disciplines. Social network analysis is a shiny jewel indeed with lots of superficial attraction. It purports to capture quantitatively and visually something important about how practices are and how they interact. The questions that now arise relate to how these differences between practices, that can now be so graphically illustrated, relate to other important things such as patient care and if there are good and bad network patterns can the bad be made good. Initial explorations of these questions should reveal whether we just have acquired a bauble or have a real gem. Competing interests: None declared |
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Mark Unverzagt, Albuquerque, USA Physician
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Scott et al have added a new tool to enhance our understanding of primary care practice "behavior." Social network analysis (SNA) has long been utilized by the social sciences but has more recently been incoporated into organizational behavior, crimesolving, marketing, advertising and public health. The latter field has some application to our own, and SNA has been used to understand not only infectious disease outbreaks but also behavior change practices for health promotion/disease prevention, incorporating diffusion of innovation theory into SNA (see Tom Valente and his work in this field). The Scott article is a good introduction to the use of SNA in primary care as a descriptive tool. The real test of this methodology is its effectiveness in helping to understand/catalyze/faciliate change at the practice level. This is an unproven hypothesis. SNA is difficult to understand, hard to explain and even harder to get funded in the biomedical world. My hope is that this article will encourage further use of this tool new to the primary care literature. In an outcome-oriented world, we are a tough lot to understand compared to our specialist colleagues. SNA can only add to our understanding. Competing interests: None declared |
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David Katerndahl, San Antonio, TX University of Texas Health Science Center at San Antonio
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I compliment Scott et al on their article. Social Network Analysis (SNA) has a long tradition in Anthropology and should "speak" to Family Medicine researchers. It is a way of quantitatively looking at interrelationships, networks, and contexts, concepts that we value and have been espousing for decades. This represents a research technique that can allow us to study these concepts within practices, families, and neighborhoods. With the increasing interest in complexity science as it relates to practice, SNA should become a valuable research approach to its investigation. Now all we need is to be trained in its use! Competing interests: None declared |
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