When radiation oncologist Michael Tomblyn recently saw a 21-year-old patient whose eye was protruding from its socket, he turned to his fellow physicians for help. Dozens of doctors offered suggestions, including fungal infection, HIV-associated lymphoma or a cocaine-associated sinus problem, eventually steering him toward the correct answer: rhabdomyosarcoma, a fast-growing cancer most often observed in young children.The diagnosis didn't take place in a doctor's lounge. It happened on Sermo.com, a social-networking site for licensed physicians, which Dr. Tomblyn and 25,000 doctors like him visit regularly to consult with colleagues specializing in areas from dermatology to psychiatry.

Why is this important for state legislators? Because Sermo is teaching us that quality healthcare doesn’t have to come from strict licensing regulations, be approved by the Food and Drug Administration, or planned by medical academics. It comes just as easily from the spontaneous order of freely associating individuals. No single medical authority judges what information physicians are and are not allowed to exchange on the Sermo community. No central planner oversaw the clinical diagnosis in the excerpted case study above. There’s just a pure, simple, regulation-free information market. Sermo members must be licensed physicians, true; but another network could easily employ private accreditation services and build something very similar and just as helpful.