Tune up your Web site

Think of the impression you'd make if the magazines in your exam room were three years old. "This practice isn't paying attention," patients might mutter. "Are they this lax when they take care of patients?"

The ideal, of course, is a dynamic site, with alerts about the latest drug recall, seasonal tips about avoiding sunburn or snow-sledding injuries, and articles about new services you're introducing.

Likewise, search engines like Google frequently revise their algorithms for ranking sites in a results list. So you'll need to adjust your HTML code accordingly if you want a high ranking. That's particularly important for Web sites designed to attract new patients.

How you maintain a Web site largely depends on how it was created. The job is easy with do-it-yourself, template sites that you created online with a "wizard" from a Web hosting company or Medem, a physician-patient communication service. That same wizard lets you add a bio for a new doctor or change a phone number-provided you're disciplined enough to do it. When it comes to technical updates, you'll have to depend on the company offering the cookie-cutter site.

Likewise, if you created a site from scratch with software such as Dreamweaver, you can use the same software for updates and submit them to the company that hosts your site on its computer. But again, a busy patient schedule may force basic housekeeping off your to-do list. And you may lack the expertise to handle coding changes for browser compatibility and search-engine success. The answer here is hiring an expert.

And that brings us to the third way that Web sites get created-farming out the job to a Web design and development firm. Such shops can perform maintenance chores as needed at an hourly rate ranging from $50 to $120, says Don Barnes, president of a St. Louis company that matches businesses wanting a Web site with a designer. You also can negotiate a block of maintenance hours per year at a 5 to 15 percent discount. "It's a guessing game how many hours you need, but if you anticipate making changes only once a quarter, you might want to contract for eight hours a year," says Barnes.

If you want to refresh your Web site on a weekly or even daily basis, a design firm can provide a dumbed-down editing tool that enables you to make the changes yourself. This so-called content management software isn't cheap, though. Prices easily top $1,000, says Barnes.

Working with a Web designer on maintenance is sometimes nettlesome. Anybody with a computer and the right software can go into the design business, but can you count on them a year from now? Physicians who hired their college-aged son or moonlighting brother-in-law to create their site know about this problem. If these folks aren't available, who's going to add your practice's new phone number to the site? Then again, a bona fide design business may be too busy to make requested updates on a timely basis.