The Internet is rewriting the rules of business in almost every industry. Healthcare is no exception. Primary care givers, doctors and nurses, however, have been slow to adapt to the new reality, perhaps assuming that a Web site is not a necessity for great patient care. Doctors and nursing provide hands-on services, of course, but a major part of the job is communication. For some patients, it's the only service. However in many medical practices, time to communicate is at a premium. And for a growing number of people, the Web is rapidly becoming their prime source of information. In other words, if patients don't get it from the source, they'll likely go to the Web. So, despite the title of this article, for doctors and nurses, it's not a question of whether, but of when. Physician surveys generally find that only around 30 to 40 percent of doctors have their own Web site … nurses, almost none. If you have a Web site now, examine whether it is accomplishing everything it could. If you don't have one, here's why it is essential to create one for your practice. To better communicate with current and future patients It is difficult to have long, in-depth conversations with every patient who walks in the office door. Materials you commonly hand to patients to make up for lack of time are probably inadequate or may be regarded as one-sided. A proper Web site can add to the patient experience by presenting more background on you the doctor, and more background on the procedures or services that are offered. You can link to authoritative sources where patients can go for more exhaustive detail. To control the sea of information The Internet is the Wild West of media, filled with a tremendous amount of vetted, professionally sourced material. However, it is also filled with the claims of hucksters, frauds, and outright liars. By presenting all the relative information about your specialty, with links to qualified sources, you provide a deeper understanding of the subject matter without taking chances that your patients' late-night Web searching is going to give them either false hopes or false fears. Chances are, there's even information about you already out there in cyberspace. A 2005 Wall Street Journal article noted, "Several Web sites have sprung up that encourage patients to post anonymous reviews of doctors and dentists, and some frustrated patients have created entire Web sites to criticize specific physicians." Few professionals can successfully keep a low profile these days. It's easy for someone else to fill the vacuum if you don't. To minimize lawsuits As the old saying goes, "Communicate or litigate." Lawsuits can be at best a distraction, or at worst, a practice-wrecker and a financial disaster. A variety of Web sites now compile every malpractice lawsuit in searchable form for consumers, so a black mark can stick around indefinitely. In a Medical Economics article, "How Plaintiffs' Lawyers Pick Their Targets," the attorneys being interviewed noted that "lack of communication" is frequently what leads to a lawsuit. A study by Wendy Levinson published in JAMA examined the causes of litigation and found similar results. "Simple things like orienting the patient about what to expect during a clinic visit or being sure information and instructions were understood made the difference." By creating and maintaining a content-filled Web site, doctors can decrease the chances for misunderstanding and can credibly attest that they have adequately presented the risks for any procedure. By presenting all sides of the issue, providers can give patients a more thorough explanation than would be possible in an office setting. Some medical providers even use this forum to publicly acknowledge and apologize for mistakes. Some centers, such as the Children's Hospitals and Clinics in Minneapolis, have seen lawsuits drop by half after implementing such a program. To reinforce expert status If a future patient or local journalist enters your specialty and your city into a search engine, what will pop up? Without a good Web site, it won't be you. It may even be the practice that keeps getting ranked higher than yours in publications and inexplicably keeps winning awards. A journalism study conducted last year found that the very first step more than three quarters of all writers take is to enter relevant keywords in Google. Be visible in the virtual world in order to be visible in the real one. If you operate the type of practice that has regional or national appeal, there is even more reason to get the word out. The most efficient way to reach the people looking for your kind of service is through the Web. To increase office efficiency How many questions that support staff takes time to answer over the phone could be covered on a Web site? Posting maps, office hours, types of insurance accepted, and other details will cut down on routine phone calls. Printable patient documents posted on a Web site can cut down on the time new patients will spend filling out forms in the waiting room. A Jupiter consumer survey found that 63 percent of consumers would switch to a doctor with a Web site that offered credible content, appointment scheduling capabilities, or secure communication channels – and that survey was from a few years ago, when fewer people had broadband connections. If you want to set up a site yourself from scratch, it can be done, but you may find it simpler and faster to hire a Web designer or firm. Some even specialize in creating sites for physicians for a few hundred to a thousand dollars, plus monthly hosting fees. To encourage doctors and nurses to establish their own Web sites, Medical News and American Sentinel University have joined forces to create a forum for the best in Internet communications. It will include three key elements: 1. Physician- and nurse-only blogs for medical communications. 2. A Web site with hints on how best to deal with medical Web sites with links to other sites. 3. Annual awards for the best physician and nurse Web sites. More information will be forthcoming on these new initiatives. Richard W. Oliver, PhD, CEO of American Sentinel University, has taught strategic, technical, and healthcare management courses at Vanderbilt and Cornell University's business schools. He is the author of seven books on management and biotechnology.