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I don't know why Dr. Zuger did not mention librarians specifically in
her New York Times article, but I can speculate about it from my
direct experience with physicians for 20 years as a PhD in biomedical
research, trained for my career both as a student and post-graduate
fellow, in clinical settings. (I'm currently in my second year as a
MLS student, targeting a career in medical/clinical librarianship).
Physicians simply don't feel that anyone except themselves can
critcially read clinical literature from a medical point of view.
Even if they could, physicians feel that non-physicians, outside of
the medical culture, cannot apply that information in a meaningful
way. And that includes librarians.

Although they may feel that librarians can find information for them,
they certainly operate on the concept that it may not be directly
applicable to their needs.  Maybe more so, physicians feel that
information seekers outside their discipline are missing resources
that they need. From my experience with this, I find that physicians
feel that  "outsiders" do not have the training to read all the
nuances in the literature that would be applicable to a clinical
setting. As a PhD, trained in hospitals and clinics and a successful,
externally funded biomedical researcher in muscle and cancer
diseases, often working side-by-side with physicians, I found that
physicians were willing to accept the fact that I could read this
literature as a scientist, but they repeatedly operated as if I could
not apply it, even though they openly acknowledged that I had been
trained to do so. It always came as a surprise, and was very
threatening to them, when they found out that I could. I was often
told that I was operating out of my "box" in this regards. They saw
me as a challenge to their knowledge base.

As a patient, I don't know how many times I've been told that I am
"too" knowledgeable in medicine when I question what physicians are
doing in my care and why. I talk the talk, understand the
significance of what it means in my care and it bothers them. In this
setting, they also see me challenging them and their decisions.

The "informationist" editorial by Davidoff and Florance in the Annals
of Internal Medicine, I feel, is basically addressing the issue of
transitioning librarians from targeted information suppliers to a
more integrated role in patient care as a new kind of information
health care provider and "information transfer agent", to fill the
gap that physicians currently can not, for whatever reason. If
medical/clinical librarians become more knowlegeable within a
clinical setting, I fear that many physicians may develop the same
attitude towards the library profession that they have operated on
with me in the past as a scientist or a private patient.

Although I have met the occasional exceptions, most physicians that I
have dealt with have a strange ambivalence towards what they
recognize as failings in their information seeking behaviors, while
at the same time preventing others from filling their needs. I think
this attitude (and understanding from where it is derived) will be a
major barrier to overcome if medical librarians are going to make a
paradigm role shift in a clinical environment.





>True enough - but Dr. Zuger only mentions libraries, not librarians.  Why
>this omission?  My job as a professional is to stay up-to-date on the most
>authoritative, reliable, knowledge-based sources, in whatever format they
>may appear.  Dr. Zuger does herself and her readers a great disservice by
>leaving the librarian out of the information retrieval process.  She
>complains that she hasn't enough time to spend on the search, let alone on
>the retrieval of the full-text documents.  Isn't that what we're here for?
>We, as the information professionals, may need to make a concerted, all-out
>effort to educate our audience as to our services.  We can save the health
>professional an enormous amount of time, and provide more current,
>comprehensive and reliable information, than they themselves may have
>knowledge of, or access to.
>
>Molly Harrington
>St. Joseph's Hospital and Medical Center
>350 W. Thomas
>Phoenix, AZ  85013
>602-406-3299
>[log in to unmask]
>
>-----Original Message-----
>From: T. Scott Plutchak [mailto:[log in to unmask]]
>Sent: Wednesday, October 25, 2000 10:14 AM
>To: [log in to unmask]
>Subject: Re: New York Times E-Commerce today
>
>
>I'd recommend reading the article first and then deciding what you're going
>to put in the letter.  Dr. Zuger's piece is well-written, factually accurate
>and makes a number of important points that we have been at pains to express
>to our patrons for several years:
>
>1) The remark about "trudging to the library" is in the context of searching
>NLM's "invaluable site" and she's emphasizing that there is very little
>full-text yet available on NLM's site.  She makes the further important
>point that doctors should not make decisions based on reading only the
>abstract.
>
>2) She goes on to say that more and more journals are putting their content
>up, and that while some of it is free, much of it is not and it requires a
>library to subscribe to make it available.
>
>In other words, the point of her article seems to be "It's not all on the
>Internet and it's not all free!"  Who can argue with that?
>
>T. Scott Plutchak
>Director, Lister Hill Library of the Health Sciences
>University of Alabama at Birmingham
>
>[log in to unmask]

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Diane C. Rein, Ph.D.
BioComm Consultants
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