Posts Tagged ‘hospital library’

Medical Libraries

August 5, 2009 1 comment

When I tell people I’m a librarian, they ask for which town.  I respond, “Oh, I’m not a public librarian.”  They then promptly want to know which university or college I work for. “Oh I’m not an academic librarian either.”

Well what on earth else is there?  Special libraries.  The general public isn’t highly aware of special libraries, which usually consist of coroporate, law, or medical.  Like other libraries, special libraries exist to serve a community, only a much more tightly defined one.  Also, our community is generally out to make a profit, so we must prove that we’re helping with that end goal.  An often stress-inducing issue for special library directors is to prove to the company that we help them gain capital and aren’t an easily thrown-away bonus for employees.

So what exactly are the benefits that medical libraries provide to hospitals?  Hospitals are dedicated, through ethics and legislation, to evidence-based medicine (EBM).  EBM means that a doctor needs to back up her decisions with clinical studies and/or published research.  Doctors are human beings, not robots.  They cannot possibly perfectly remember every study they’ve ever read on, say, schizophrenia.  So a patient comes to an appointment with schizophrenic symptoms and the current drug isn’t working.  The doctor wants to try a new one.  She needs to find the studies done on the efficacy of that drug on schizophrenia, if it isn’t the normally prescribed one.  This is where the medical library comes in.  We are the repository of this evidence.  If a doctor comes in wanting a study on schizophrenia and a specific drug probably done in the late 1990s, we search for it for her.  This is a large part of a medical librarian’s job.  It is even possible to get a rush request for an article.  In academic libraries, this means a paper is due soon.  In medical libraries, this means there is quite possibly a life and death situation.  I am not exaggerating.  Doctors need the information to make the right decision now in some cases.  One of the things that I enjoy about the medical library community is when one of these requests come in, we can directly call another medical library that will drop everything to fill our request asap.

Many hospitals, particularly here in Massachusetts, are also teaching hospitals.  This means that they are affiliated with a medical school of some sort and train interns, residents, lab techs, nurses, etc… In these hospitals, the medical library is even more important.  Interns and residents needs a resources and a place to study in their often long hospital rotations.  These medical librarians then also need a touch of academic librarian skills, mainly in teaching medical students that Googling won’t work for their papers or for practicing reliable EBM.  We help them find resources for papers, educate them on using PubMed and Ovid, and educate them on the importance of EBM.

An even smaller number of medical libraries are also open to the public.  The public will come there for higher-tech, more in-depth resources on medical issues.  I have no personal experience working in such a medical library, but a librarian I know told me that the main challenge is to not let the public start treating you like a doctor.  You provide information, but not advice.

Even medical libraries that are not technically open to the public end up interacting with patients and families and friends of patients.  Hospitals are easy places to get lost in, and a cozy library with a big reference desk looks like a promising place to ask for directions, or for the best place to wait, or even just to find someone to talk to.  I can’t count the number of times I’ve looked up a doctor and scoured the hospital map to help a patient find the location of their appointment.  Similar are the phone calls from people who call the first number they manage to find on the hospital website and immediately start telling you their entire case history when you answer the phone.

Patients are the main reason for the final difference between medical libraries and public or academic libraries: privacy laws.  Yes public and academic libraries are concerned about the privacy of their patrons, but medical libraries are subject to the patient rights privacy acts.  This means that our laptops we check out to doctors have to be encrypted, our wifi is incredibly limited as to what it can access.  I can’t talk about anything a patron is researching, even if I don’t name names.  What if I mention it and someone else at another hospital goes with it and makes an important discovery before my patron at my hospital does?  I could have cost my patron and my hospital millions of dollars.  Similarly, if a public librarian finds say a tax document in a returned book that doesn’t belong to the patron who returned the book.  She can just shred it.  If I find patient information in a book, I have to report the patron to their supervisor for failing to protect patient privacy.

This truly points out the main difference between medical libraries and public or academic libraries.  Public and academic libraries attempt to present an open inviting image.  They are out to help everyone for the greater good. Even though this is not technically the case, as not just anyone can acquire a library card from them, it is still the image given.  Medical libraries are largely about privacy.  We’re a refuge in the hospital for our patrons.  We protect the hospital’s interests.  We assist our doctors with providing the best care possible so that patients will choose to come to us when they’re sick instead of a competing hospital.  Yes, we’re working to help people, but we’re also a business.