I think that some of the change comes from the increase in popularity in other social-media forums -- ten or eleven years ago, sites like this were about all anyone had for friendly chatting around a common topic. Not so today. Also, Google has changed its search algorithms a few times and it sometimes has caused MedHelp to drop back from the first page of search answers to further back. Most people only click if they see something on the first Google page, or maybe the second.