I'm often asked to come in as a consultant to help hospital staff members and other groups of healthcare professionals "get up to speed" on online consumer health. These are some of the guidelines my clients have found most useful.

1. Jump into the Net.
Successful providers must offer online information and services. If you decide to wait for things to "settle out" before proceeding, you'll end up in a permanent state of paralysis. Go ahead and get your hands dirty. You'll need to learn as you go anyway.

2. Get comfortable with the online medium.
Learn about the dynamics of networked systems by becoming a part of them. If you haven't already done so, spend a few hours surfing the links in your own areas of interest. Buy a book at Amazon.com. Open a brokerage account at etrade.com. Bid on an antique toy robot at ebay.com. Listen to what the technology is trying to tell you.

3. Get the major part of your learning curve behind you ASAP.
You'll need to be willing to make a few mistakes at first. That's the only possible way to do things in this fast-changing landscape. Ask your colleagues, friends, and patients to help you. Remember that all the folks who are now online learned how to get there from their friends.

4. Putting your existing patient education materials up on a Web site is just the beginning.
The patient handouts of pre-online days were one-way, top-down, and unpersonalized. No feedback was allowed. Effective consumer health information on the Net must include two-way communications, personalization, and user feedback. As you will learn as you become more involved, the Net is primarily about communication and only secondarily about content.

5. Respect and cultivate "smart patients."
Physicians are now encountering significant competition from the customer: Smart patients who have "gone to medical school" on the Internet. Don't be affronted or embarrassed by such patients--even those who may sometimes think they know more than they really do. Take them seriously. Encourage them to learn all they can about their condition. Treat them like respected colleagues. Learn from them. They will save you a great deal of time, trouble, and embarrassment.

6. Learn all you can about online support communities.
These online networks-made up of patients who share a medical concern-are an important new type of health resource. Learn all you can about such groups. Encourage your patients to form or find support groups for their health concerns.

7. Visit online support groups for conditions you deal with frequently.
Visit several groups for the conditions you see most often. Volunteer to help out as an expert consultant. Good starting points include www.psychcentral.com, www.acor.org, and www.cmhc.com/selfhelp. Or do a Web search for your condition of interest plus " self-help," or "support group."

8. Check out the for-profit world of online health.
Good starting points include americasdoctor.com, betterhealth.com, drkoop.com, healthcentral.com, intellihealth.com, mediconsult.com, onhealth.com, and webmd.com on the Internet and America's Doctor and Better Health on AOL.

9. Look for creative ways to give away information and services you now get paid for.

10. Understand the dangers of *not* going online.
If things occasionally seem difficult--and sometimes they will--just remember that providers who choose not to respond to their patients' growing demand for online communication will lose market share to Net-savvy competitors. Those who resist the idea of communicating online with patients may find their practices increasingly limited to older patients and others without online links. They will lose their younger and more Net-sophisticated patients to Net-savvy competitors and will watch the slow migration of their industry from their familiar offices and clinics to the new frontiers of the Internet.

Published in The Ferguson Report, Number 2, April 1999

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