A 2003 study of the adoption of online medical applications by Victorian GPs showed that not only are very few using them, but also very few have plans to do so. This paper asks why this is so. Three possible explanations are investigated: that their current IS/IT aligns with their strategy, rendering change unwarranted; that they do not have the requisite means; and that there are non-strategic, non-means reasons. After an analysis of the relevance of concepts of strategy and alignment to the medical profession, relevant concepts are applied to the data. The findings are not encouraging for government plans to improve access, equity and efficiency through online medical applications.