Free Web Sites Luring Many Physicians Online

Family Practice News, Jan 15, 2001 by Sherry Boschert

Welcome to www.wewantyou.com.

More than 20 Internet companies are offering free construction and maintenance services to physicians who launch online medical "homes" on Web sites operated by the companies.

What's in it for you?

Better informed patients, according to Dr. David Howlett, a family physician in East Granby, Conn. He had been seeing more and more of his patients coming in with stacks of printouts about their medical problems from less than reliable Internet sources. So he accepted a free offer from a student group to build a Web site for his four-physician suburban practice. Now he steers patients to the site, which offers links to other Web sites with good information about health-related topics.

"It has worked out well for us to send patients to that to get some information and then come in and be ready for the consultation," said Dr. Howlett, president of the Connecticut Academy of Family Practice.

For example, a new patient who recently was diagnosed with prostate cancer used the Web site before his first visit with Dr. Howlett. "When he came in, both of us were on the same page and we could just talk about what he should do."

But on the downside, working with the students proved to be more work for Dr. Howlett than he had anticipated. One year after starting construction, the site still was not completely finished. "You get what you pay for," he remarked.

Yet dozens of companies--most of them fueled by venture capital funding--are betting that the "free" Web sites offered to physicians will offer acceptable quality. The companies hope to eventually turn a profit by forging partnerships with vendors and medical associations, offering fee-based services beyond the basic offer, or using other strategies.

Ultimately, financial participation from health plans will be needed for long-term survival of such enterprises, said Dr. Edward I. Fotsch, CEO of Medem, San Francisco, one of several companies that are partnering with medical societies to offer free Web sites. At least two health plans have begun reimbursing some physicians for online consultations with patients, and several insurers are working on integrating communications with physician Web sites, he noted.

Medem, which has forged alliances with the American Medical Association and others, reports that about 20,000 doctors have registered for its Web service, launched last May. Another company Salu.net of Portland, Ore., sealed agreements with the American College of Cardiology and other groups and claims to have signed on more than 17,000 physician users since its founding in 1997. Other companies target a single specialty such as Cambridge, Mass.,-based Beansprout.net, which aims to link pediatricians, parents, and childcare providers.

The American Academy of Family Physicians turned down partnership offers from many of the "free-Web" companies. The AAFP (www.aafp.org), the American Osteopathic Association (www.aoa-net.org), and a handful of other medical societies each chose to offer their own services for hosting Web sites for physician members.

The Web will play an integral role in physician practices--a role that should remain free of commercial interests, said Dr. Robert Graham, who recently retired from his post as AAFP executive vice president. "The Academy Web site should be the site [physicians go to] when they get up in the morning and turn on their computers.

Dr. Graham questioned whether the for-profit companies will be able to keep advertising away from physician Web sites, as many of the companies currently do to attract physicians. Investors could assert control of the sites, diluting the medical society's role in decision making, he warns. "If you lose business control, you don't know at some point in the future what your members or the public have to go through to get to you. These venues make it easy for even "technophobic" physicians to build a Web site--sometimes too easy. In less than 10 minutes a FAMILY PRACTICE NEWS reporter built a Web site posing as an ob.gyn. at www.obgyn.net, and later built a site as a pediatrician at www.doctor-page.com. Conceivably such phony sites could be used for fraudulent sales of products or services. Beansprout.net, however, called to verify the reporter's physician status before the online form had even been completed. The companies that provide entry through the medical societies also provide a heightened level of secu rity.

Dr. Howlett jumped at the AAFP's offer and built a second Web site for his practice in less than 2 hours. "The great thing is you don't need any software. You don't need anyone to build it for you," he said. One drawback: The site links only to other AAFP sites, limiting the places he can send patients for information. "I direct people to my other site to get to those other links."

Data suggest that 85% of physician offices have the equipment to access the Internet but most of them are not online. But the growing barrage of Web site offers could help change that.

The potential benefits are worth the effort, Dr. Howlett noted. He advises colleagues considering a practice "cyberhome" to "lump in and get a Web site."