John R. Blair, M.D.

hile the Internet has been intensely utilized for a long time by the academic and organizational arms of anesthesiology, the private practice community has slowly adopted the Web for its purposes. Many nonacademic organizations have failed to see the utility of having their practice go through the exercise of posting a site. The expense of time and money did not seem to be a good return on investment. In many cases, a group of anesthesiologists will “ride” on their hospital’s site. Not infrequently they are dragged along by the hospital’s media specialists who, for the sake of completeness, want all of their hospital-based groups represented on their Web sites. A prime motivator for the hospital is the opportunity to post the telephone number of the group’s billing company to avoid misdirected calls to the hospital’s billing department.

On the other hand, the group may provide services to the community that help attract patients to the hospital. Having the group’s knowledge and skill-set available on the Internet may be beneficial to both; this is frequently the case with the implementation of pain management services. In the situation where the group tags along on the hospital site, however, it has limited input into the content posted on the anesthesiology portion, which can generate some conflict and misunderstanding between the group, hospital and the patients.

For the sake of clarity and control, many groups have chosen to make the jump to construction of their own sites and then allowing a link from the hospital site to their own. The range of these efforts goes from extreme minimalism to extravagance.

Web Site Format
The first step is obtaining a domain name. Many sites, which are hosted by one of the member’s internet service providers (ISPs), use a name that has the ISP’s prefix such as <www.ispname.anesthesiagroup.com>. This method is the most cost-effective but is difficult to transfer and may appear somewhat unprofessional. Domain names that are owned by the organization are easily obtained at a nominal cost from reputable vendors. Domain names can then be hosted by a member’s ISP free or at minimal expense as long as the Web site is not too large.

The competition among Web site developers is very intense, making the cost of an acceptable-looking Web site affordable for just about any organization. Minimal artwork, simple content organization and avoiding use of special programs such as Java^® or Macromedia^® can keep the cost reasonable. Simplicity will allow someone within the group to make minor changes to the site as dictated without professional intervention. Larger groups with more resources to put toward their site may choose professional production and administration to give a little more stature to their Web presence. A sample of such a site is located at <www.capanes.com>, which is owned by Capital Anesthesiology Association of Austin, Texas. This site also includes a secure login for members. Such member portals can be used for schedules, employee manuals and group updates.

A growing trend among private groups, however, is to include the whiz-bang gizmos that are seen on more commercial sites. For example there may be a Macromedia introduction page with essentially a video spot and music followed by the homepage. One usually finds these on sites produced by larger groups in metropolitan areas, but not always. You will see an example of this format on the Web site for Thunder Bay Anesthesia from Ontario, Canada <www.thunderbayanesthesia.ca>. This site has used a piece of modern Web technology in an eye-catching but tasteful way to introduce the viewer to the practice.

Once you find your domain name and the hosting site and format that you can afford, you must compose your content.

Web Site Content
For most private practice groups, this portion of the puzzle is the easiest. Some simple artwork to set your group apart is the first step. Generally most medium to large organizations have some symbol or name that identifies them. This is usually inserted into the site unchanged. At bare bones, the name of the group can be simply used to title the site.

Usually someone within the practice will set down the information to be included. Almost all groups will include a list of their members. Furthermore there is usually a description of each person’s background, training, certification and subspecialty, if indicated. Additional content may describe services provided, preanesthetic and postanesthetic instructions, risks, complications, pain control and general information. Pain management clinics have found additional utility using the Internet to garner referrals in their area by including the Web site on their materials. Referring physicians can visit the site and find information on additional services provided and thereby widen the range of patients referred for treatment.

Probably the most underutilized information concerns patient billing. A Web site can go a long way toward informing patients about anesthesiology charges. Including the payers with whom the group is contracted can fend off a lot of anxiety and questions during the preoperative evaluation. Additionally, displaying the contact number of the billing agency the group uses will allow the patient to gather information from a knowledgeable source without disrupting the physician visit. More and more anesthesiology groups are including payer information and billing company contacts on their Web sites for patient use. Some organizations are putting their Health Insurance Portability and Accountability Act privacy information on the sites, including the required contact information. Some private practice sites have gone so far as to include video of procedures performed by their practices. The Redding Anesthesia Associates Medical Group in Redding, California <www.reddinganesthesia.com> includes movies of pain clinic procedures as well as endotracheal intubation. This site has been in existence for a long time and has received several Internet awards.

You will find as you peruse medical sites on the Internet that most carefully include disclaimers concerning the information found there. It is clear that some of the more extensive sites have had their legal representatives give them a going over before they were posted. You also might find this a necessary step.

Conclusion
Private practice Web sites are becoming more elaborate as well as informative. Rather than simply giving a list of the staff doctors and a few pictures, sites include some useful patient information such as procedures performed and pain management methods. Billing information is more commonly seen, which patients find useful.

As the Internet has become a necessary information-gathering tool for the rank-and-file American, the American patient expects to find his or her doctors there, too.

John R. Blair, M.D., is an anesthesiologist at Northside Hospital and a member of Northside Anesthesiology Consultants, L.L.C., Northside Hospital, Atlanta, Georgia.