Readers of the Journal should be aware that, in Massachusetts and perhaps other states, some physicians are providing diagnostic and treatment services over the Internet, without having seen or examined patients. This practice involves providing patients with prescribed medication after the patient completes a questionnaire and an on-line, physician-generated “conference” regarding symptoms and medical history. Ostensibly, the provision of this service is rationalized as a way of improving access to medical care and counteracting the lack of physicians in underserved areas, and as a simple convenience to patients. Curiously, one on-line service claims to provide “real time, online, confidential emergency medical care and advice,” but it is implied that the service would be most helpful to those “experiencing symptoms of an apparently minor medical illness for which you would like some medical advice and/or initial treatment.”1 The same service recommends that its users “obtain timely medical follow up with a physician, in person,” and affirms that “we are not a substitute in any way for conventional medical care.” It does not appear to require follow-up by the doctors providing the on-line service itself.