It is daunting to realize that we have just touched the surface of health-related Internet web sites. The use of the Internet as a vital patient care tool is a very real prospect on the near horizon. Yet most hospital systems and physicians groups today just use the Net to post "billboards.'' In the rest of America, the Internet has been much more than a billboard. It has changed the way business is conducted. There's e-mail. There's e-trading for those who invest. On mother's day moms receive e-cards, and there is e-commerce which includes buying and selling online, and also collecting and organizing data that will help a business serve customers better, building that relationship. The Internet is a transaction tool. The latest survey indicates that the volume of commerce on the Net has grown 300% this year over last. According to a survey sponsored by Cisco Systems. Net sales volume accounts for $200 billion and is doubling every 6 months. And, the search for health information is among the top three reasons people use the web. The surveys indicate that people would like better communication with their physicians and most would like to communicate by e-mail. Yet, very few physicians are interested. As part of the research for this article we reviewed dozens of web sites for hospitals and medical groups. While some of these sites are attractive, most simply don't do anything more than provide maps and telephone numbers. People might as well look in the Yellow Pages for the information they can find on th web. Meanwhile, a number of well-funded health sites have sprung up just in the past few months. We searched the web to find sites that would actually allow people to interact in ways that went beyond just finding information. Clearly there is movement toward the ability to conduct transactions over the Net, i.e, patient monitoring, checking on status of claims, ask-a-doc, etc. But, we are just at the front end of this movement and physicians and hospitals have an opportunity to play a leadership role. A number of the sites reviewed for this article, for example, offer the patient the ability to develop his or her own health record and maintain it on the web. It is not conceivable that a healthcare system, along with its affiliated physician, might develop a secure web site that included a combined inpatient and outpatient rcord, accessible electronically by patients and authorized providers from any telephone in the world. It is clear that armed with Internet data, consumers will play an increasingly important role in their own care. Employers are acquiescing to their demands for increasing choice. Copayments are also going up and employees are likely to vote with their feet in selecting providers. Companies like WebMd, Physicians Online, Planetrx.com, drugstore.com, Yahoo and the other mentioned above are filling a need. It should be a wakeup call for healthcare systems and physicians. According to the latest data from Medimetrix, (see medimetrix.com), the most frequently visited health sites on the web today are Intelihealth.com (Johns Hopkins), Mayohealth.org, and OnHealth.com. These sites provide a highly interactive experience for consumers and tons of news and information. They are compelling and traffic-building, have fresh news that is frequently updated and many are transaction. That's what people want. There are so many potential uses of the Internet for physicians and hospitals that it is difficult to properly cover them in this article. Why shouldn't a patient be able to check the status of their account? Has the insurance paid? Is there a patient balance? Consumers can check their bank balances on the Internet. Why not their hospital or medical office accounts? Why not let them pay their balances online? As noted above, some the the HMOs are providing account status information to patients already. Why not the hospitals and physicians? Web sites are multiplying like rabbits. It's going to take a lot of effort to