I signed up for WebMD with a good deal of skepticism, became more and more enthusiastic as I began using it, and have ended up both delighted with it and puzzled about its ultimate value for family physicians.

Described by its marketers as having been “designed to simplify health-care practices by integrating multiple administrative, communications and research functions into a single, easy-to-use web-based solution,” WebMD is a subscription service ($29.95 a month) that concentrates a host of Internet-based products and services of potential usefulness to physicians. Here are some of the features WebMD offers:

• A messaging center for sending and receiving e-mail, faxes and telephone messages, as well as for hosting teleconferences;

• An insurance transaction center that offers online patient eligibility checks and referral authorization for certain health plans;

• Hosting of personal web sites for physicians — a chance to design and hang out your own cyber-shingle;

• Online CME modules, a library of health care journals and other published resources, and links to almost every health-care-related association and company on the Web;

• Links to financial services companies (such as E*TRADE) and special deals on online banking, insurance and automobile purchasing;

• Online access to a full range of medical-surgical supplies, equipment and related services through McKesson General Medical (currently under development);

• Links to weather, news, sports and much more.

What is this?

If you're used to browsing individual web sites to meet specific needs, you may find this service a little overwhelming. But get used to it. WebMD is what's known in the industry as a “health care info-mediary” — that is, a web site and set of web-based information services that provide health care content while also beginning to link together the various participants in the patient-care process: physicians, hospitals, insurance companies and patients. It's the direction other web-based services are likely to go.

The right answer?

So, if you want to buy a new BMW, send e-mail to your colleagues, get a weather update and trade shares of stock while you do patient eligibility checks, WebMD is the place to go. Right?

Well, maybe not. I found that many of WebMD's features didn't work the way they were advertised. Here are some examples:

• Despite several attempts over several days, I couldn't get the web-designer application to accept and publish my personal web site. (It's now up at www.webmd.com/Health/NC/ChapelHill/DavidKibbeMD,MBA — easy to remember, huh?)

• The system registered me as a “general/family practitioner,” not having a category for board-certified family physicians. (The WebMD webmaster has promised to make this right.)

• Most frustrating of all, some of the offered features seem to have “dead ends” that don't deliver. For example, the fee-schedule analyzer serves up a sample report, but the screens don't tell you where to go or how to obtain the promised analysis of your fees according to your specialty!

Other alternatives?

Of course, WebMD isn't the only place you can go to find information products and services for doctors. For example, the Physicians' Online Network (POL), currently the leading medical information and communication network for doctors, pulls together some of the same resources as does WebMD. Launched in February 1994, POL (www.po.com) provides a secure, physicians-only environment featuring access to MEDLINE and other medical databases, clinical symposia with peers and national experts, CME, daily medical news, recruiting services, private e-mail accounts, Inter-net access and many other services. POL connects its members — the largest online community of authenticated physicians — with colleagues, professional associations, health plans, drug companies, luxury-goods purveyors and other resources. Although POL is free to physicians, its pages carry heavy pharmaceutical advertising. (Thankfully, WebMD does not.)

In fact, many health-related “supersites,” such as Medscape (www.medscape.com), offer resources specifically for doctors. What appears to differentiate WebMD from POL and others is its conjunction of commercial resources (i.e., those related to practice management and the business of medicine) and clinical resources.

Stay tuned

WebMD promises its members that “you now have the tools to cut time and cost from your practice. You have an insurance verifier, a reference library, an answering service and a continuing medical education resource at your fingertips.” This member, at least, has spent several hours trying to get the service's features to work right and hasn't yet succeeded. WebMD may well represent an idea whose time has arrived. Unfortunately, the execution is still a few steps behind.

But please stay tuned. In late May, WebMD announced a merger with Healtheon, an estimated $7.8 billion deal that more than doubled the new combined company's stock to $105 a share. The merger of these two health care Internet companies was made even more noteworthy with the announcement that Microsoft, the world's largest software company, will guarantee $150 million to underwrite subscriptions to WebMD by physicians and pledged $100 million to advertise WebMD on web sites over the next five years. DuPont and chip maker Intel have also invested heavily in the deal. My bet is that we will hear a lot more about Healtheon/WebMD in the coming months.