He has established video and Internet links with hospitals in India, Africa and Malaysia so that his surgeons can give expert advice to less experienced colleagues.

Pittsburgh is in relatively good shape because it largely missed the housing and dotcom booms enjoyed by the rest of the county. Indeed, it is currently building a new sports arena and a new hospital.

In this paper we describe how Internet technology can be used to bridge the gap in the flow of information between consultants and hospitals on the one hand, and GPs and their patients on the other.