The O.K. Corral was a site in Tombstone, Arizona Territory where a gunfight took place on October 26, 1881. In that fight, the Earp brothers and “Doc” Holliday killed some cowboys who refused to disarm.

I mention this as a analogy to what I foresee happening in the health social media realm where the conversation is not as friendly or beneficial as some pharma social media pundits would have us believe. If pharma marketers are not careful, they may find themselves in the middle of the crossfire.

I am talking about the crossfire between physicians and patients, especially with regard as to which “stakeholder” group will be more credible as hired “opinion leaders.”

You probably already know all about physician KOLs (“key opinion leaders”) and how pharma hires KOLs to influence doctors. I predict that in order to be effective in social media that are inhabited by patients, pharma will hire respected patients to follow the discussion and to point their followers to “key” information, which includes key Rx-related information or information that supports the benefits of Rx products (see “Some Social Media Patient Opinion Leaders Want to be Paid Pharma Professionals” and “PHARMA Co Patient Opinion Leader Programs“).

This will lead to the inevitable conflict with physicians who may have different ideas as to what “key” patient information should be.

At two recent industry conferences, I witnessed what I think is the opening salvo between the two opposing camps. First, at a multi-channel pharma marketing conference that I chaired in Princeton, NJ, a physical wall was erected between a physician panel on one side of the room and a patient panel on the other side. Both were supposed to talk about what they wanted from the pharmaceutical industry. As I reported, the patients essentially wanted money and were quite forthright about it. The physicians, on the other hand, were too sophisticated to ask for money directly — they already are getting plenty of money from pharma. They asked for technology or rather free technology such as iPhone apps.

But the conversation that hinted at the coming Social Media OK Corral Docs vs Patients struggle occurred during a patient panel at the Digital Pharma East conference (ie, “A Panel of ePatients Discuss Key Issues that Affect their Lives, Relationships and Treatment”).

Part of the discussion revolved around how the “value proposition” of patient online communities was the vast amount of information available from patients that is “more accurate” than information that patients typically get from healthcare providers/physicians. That, in itself, is not surprising or dangerous. But another statement made by a patient panel member sets the stage for the coming gunfight. That statement concerned patient evaluation of specific brands. The patient said that her physician was of the opinion that all branded Rx drugs for treating her condition were essentially the same. She begged to differ and pushed for her favorite brand.

It seems that patients are more in tune with pharma’s direct-to-consumer (DTC) advertising premise: one brand of insulin or ACE inhibitor is better than another brand. Usually, it’s the advertised brand that’s better than a competitor brand or the unadvertised generic brand.

Since Rx DTC advertising has ingrained the belief in consumers and patients that one brand of Rx is better than another, it benefits pharma marketers to use online patient opinion leaders such as those on the above-mentioned panel to influence other patients online. Once they do that, marketers are again placing themselves in the middle of the patient and his or her physician just as they have been accused of doing with mass media DTC advertising.

There is a wall between physicians and patients not only at industry conferences, but also within online communities. Patients have their communities and physicians have theirs. Unless the two stakeholders can meet online and have a dialogue, someday there will be a gunfight. Pharma marketers will continue to arm both sides. Maybe they’ll get caught in the crossfire, maybe not. Time will tell.