Few healthcare organisations in this country have managed to create the sort of virtual professional communities to which the Internet seems so well suited. It will come - but first people have to conquer the reticence that leaves so many discussion forums with enough significant silences to fill a Harold Pinter play.

One group that has overcome the problem is Emergency Care Online, a mailing-list based discussion forum for staff involved in pre-hospital emergency care - primarily ambulance paramedics, but with some input from doctors and nurses.

Though small - it claims 350400 members, and estimates that between 40 and 50 per cent post messages on a regular basis - it is certainly active. I signed up on a Friday afternoon. By the time I came into the office on Monday morning there were a dozen messages waiting for me, and as many again arrived in the next half hour.

True, the paramedics did have Panorama's recent expose of the ambulance service to chew on.

They didn't like being dubbed 'drivers with first-aid training'.

But there was much else, including a considerable amount of banter.

Not everyone was impressed. 'Well what a fun weekend I've had, ' came one angry e-mail. 'Having recently returned from three months away courtesy of the Royal Navy submarine service I thought I would spend a while going through my e-mails.

'Many hours and over 4,000 postings later, I simply cannot believe what irrelevant, ill-thought out, sometimes abusive and sometimes plain nonsensical rubbish has been written by some members of the list.'

His plea to keep postings relevant and concise applies to any discussion forum, as does his request for members to give their names and qualifications. As he says, you might take a bit more notice of an anaesthetist's views on airway management than a first aider's.

This and other sites of interest can be reached via HSJ 's website at www.hsj.co.uk