Dills believes that lists which grow too large inevitably lose focus. She gets impatient when lists begin to diverge from the subject, and more so when individual postings lead it astray. Others go through a turbulent history where one member of the list manages to upset a lot of people and everyone grows wary afterward. Like real communities, online communities go through cycles. Some fade into silence.
New ones grow up independently.
Anyone in need of support should be discerning in evaluating a group. As with any type of online community, one should simply hang out for a while and see what is going on before posting. Even Scolamiero has had moments of doubt about her idealistic enterprise. Then for a period she grew worried about privacy issues. Then at a conference, a health insurance executive approached her about the possibility of his company getting involved in her list.