Hosting a Website (and Other Reader Feedback)

Recent columns on registering a domain name and building a website generated a larger-than-usual volume of reader feedback. I am truly gratified to get your e-mails; please keep them coming. In this month’s column, I’ll address the issues people wrote about most often: 1) hosting a website, 2) the Apple Macintosh, and 3) Web development tools.

Website hosting requires two basic components. The first is a Web server that accepts HTTP requests from Web

browsers (eg, Internet Explorer, Netscape, and Firefox) and serves them back Web pages of HTML documents and linked objects such as images. The second component is connectivity (or bandwidth) for transmitting all those millions of bits of data per second.

Two basic options exist for website hosting; choosing the right one depends on your level of technical know-how and website requirements. If you are comfortable with technology and want to have total ownership of your site, consider setting up a Web server on a dedicated computer in your office. One of the most popular servers is the Apache HTTP Server, which uses free open source software and can run on most computers. For more information, visit the Apache Software Foundation. The biggest problem with do-it-yourself Web hosting is the need for high-speed Internet connectivity. Depending on how much traffic your website generates, you might need a T1 (aka DS1 or Digital Signal 1) connection, which can cost hundreds of dollars per month. Most small- and medium-size medical practices cannot justify that kind of expense for a website. If you have a large practice, you might already have a T1 line installed, but you still need to consider how the added Web server traffic will affect performance for regular office users, and whether you need to upgrade to a fatter T3 pipeline.

A far more common and sensible approach is to use a turnkey Web hosting service; this eliminates the hassle and security risks associated with hosting a site yourself. Th ere are literally thousands of companies that offer Web hosting and a wide variety of options such as dedicated servers, increased storage and bandwidth capacity, and heavy-duty tools. If you have a simple, five-page website with no e-commerce activity and fewer than 1,000 visitors a month, you could easily get away with using one of the free hosting plans offered by some of the biggest names on the Internet, including EarthLink, Yahoo, and Tripod.

If you need more features and functionality, you may want to go with a dedicated Web hosting company. My medical practice uses the free American Academy of Family Physicians website engine powered by MedFusion. This has been adequate for my needs, as few of my patients use the Internet. My EHR business (AmazingCharts.com) uses TierraNet, because it has a robust control panel, easy editing and e-mail setup, and other useful features. My consumer website (AfraidToAsk.com) gets a ton of traffic (up to 1 million visitors a month) and requires a lot of bandwidth, so I use Rackspace.com for their ability to quickly scale and allow more bandwidth as the traffic waxes and wanes.

When researching technology companies and the services they offer, I find that tech websites, such as PC World or CNET, provide the best summaries of the costs and benefits of the various options. A few readers asked me about the Apple Macintosh computer. Personally, I think the Macintosh is the most elegant, sophisticated, and easy-to-use personal computer on the planet. I have two Macs at home, and my kids prefer them as well. So, why don’t I use one in my practice? Simply put, I have too many third-party applications that run on Windows. Although the new Intel-chip Mac can run Windows software quite well if you install Boot Camp or Parallels, that’s still one more step to get it up and running compared to a PC.

Apple’s iWeb tool features hundreds of website templates, enabling you to easily build your own site, with no HTML required, and publish your website with a single click. A basic, one-year subscription, which includes domain name and hosting, costs $99.95. In the column on building websites, I neglected to mention the sophisticated development tools that can make it easier and faster to design, develop, and maintain websites and Web applications. I prefer Dreamweaver from Adobe.

Dreamweaver offers the option of working in a visual layout interface or a streamlined coding environment, appealing to both designers and developers. It also integrates with other popular Adobe software programs such as Photoshop, Illustrator, and Flash. See you next month, when we’ll take a look at how to fi nd good tech help.

Dr. Bertman is Physician Editor-in-Chief of MDNG: Primary Care/ Cardiology Edition. He is also a Clinical Assistant Professor of Family Medicine at Brown University and president of AmazingCharts.com, a leading developer of Electronic Health Record software. He also is the founder and president of AfraidToAsk.com, a consumer website focusing on personal medical topics. He is in private practice in Hope Valley, RI.Contact Dr. Bertman at jbertman@mdng.com.