I Am Not a Specialist: Why We All Need to Be Worrying about Medical Information

Abstract

The World Wide Web has dramatically altered landscape of information seeking in health. The provision of medical information has historically been business of medical librarians, and their principal clientele has been nurses, and allied health professionals, as well as students in those fields. Accordingly, for decades library schools have seen medical library science as an arcane specialty. The Web, however, has democratized access to health information. Searching for health topics online is now most popular consumer activity after use of email. In this paper, I discuss changes in healthcare information use effected by World Wide Web; give examples of integration of medical librarianship into generalist courses in library and information science (LIS) degree programs; and finally discuss challenges of integrating medical specialization into generalist teaching. Introduction Twenty years ago, in last published survey on this topic, Detlefsen and Gal vin found that 41 of 54 American Library Association (ALA)-accredited library and information science (LIS) degree programs offered at least one course in health sciences or biomedical librarianship.2 Despite apparently high regard for medical specialty in these schools, Detlefsen and Galvin were worried by their findings - not by number of courses offered, but by fact that in these 41 schools, only 25% of full-time faculty self-identified as having a health-related specialty. That is: 75% of these 41 programs were relying on adjuncts to teach, adjuncts who were typically working medical librarians. Adjunct numbers have important implications for specialty fields. Detlefsen and Galvin argued that adjuncts who are working practitioners have content expertise, but because of their position in educational institution, are less able to advocate for change and defend their specialty in curriculum. Because adjuncts typically have full-time employment elsewhere, they are subject to their own employers' needs and responsive to their employers' reward systems before those of schools and programs in which they teach. Full-time faculty, conversely, exist by definition to be full-time educators and not practitioners; and as full-time educators, they are rewarded for maintaining a presence on curriculum and admissions committees that influence training of future specialists and availability of future courses. Finally, full-time faculty members are charged with formal student advising. Adjunct faculty can and do have informal mentoring relationships with their students, but this is not typically considered an explicit function of their job. A May, 2006 review of ALA-accredited LIS program Web sites reveals that of 47 programs either fully or conditionally accredited, virtually all had either medical or health information courses listed in their catalogs, offered at least every 2 years. Twenty-three LIS programs (50%) report a total of 39 full-time faculty identifying either medical librarianship or medical informatics as a research interest.3 Although both medical informatics and medical librarianship focus on medical information, two are not synonymous. Medical informatics is generally defined as the rapidly developing scientific field that deals with biomedical information, data, and knowledge as it intersects with information technology.4 It is an extremely interdisciplinary domain, to which library and information science is one of many important contributing fields. However, medical informatics is dominated by clinicians. Membership in American Medical Informatics Association (AMIA) includes physicians, nurses, dentists, biomedical engineers, medical librarians, researchers, scientists, educators, students and other health care professionals.5 This field, with its origins in medicine and computer science, demands a different, although occasionally overlapping, range of information technology competencies and training than does medical librarianship. …