Q:  As the medical subject contributor to the new Resources for College Libraries, what aspect of medical publishing do you feel has changed the most since 1988?

A:  Medical libraries differ from academic and public libraries in that two-thirds of a medical library budget is spent on journals/serials and one third is spent on texts/monographs. This ratio is reversed in the other two types of libraries noted.

The premium on current research and clinical information in the health sciences is the reason this commitment to journals/serials is so high. Book publication is not sufficiently expeditious for the needs of a medical practitioner. Journals lend themselves more readily to digitization than books so medical libraries have been early adopters of an all electronic journal collection. In 1992, the Univ. of Connecticut Health Center Library, where I was director, initiated a policy of electronic journals in lieu of print journals when electronic was available. Not only could multiple library patrons use a single journal issue simultaneously, there were also savings in binding and storage.

Audiovisuals have always been important in medical libraries because they can demonstrate the eye-hand techniques that are part of surgery and dentistry. AVs have also been a resource for demonstrating the dissection process and techniques. AVs have yielded to Internet website subscriptions similar to e-journal subscriptions. CD-ROMs used on computers have replaced slide projectors and videocassette players.

Digitized medical textbooks are frequently used as reference sources. Either a patron wants to get to a single subject in one e-textbook and searches for a single term; or, groups of digitized textbooks can be searched electronically as a database so that results from multiple sources can be reviewed as one search result. Using an e-textbook in medicine as one would a printed medical textbook is not too common an occurrence.

Q:  There have been so many technology advances since 1988, how has this impacted the material published on medicine?

A:  Whole new medical specialties based on new medical technologies have developed around laparoscopic techniques and health informatics, for example. Each new medical technology results in a journal that medical libraries have to consider for a long term financial subscription commitment. Of course, books are also published on new medical technologies but texts do not represent the same type of on-going cost that is associated with journals.

Q:  Would you consider any one major advancement in the field of Medicine as standing out above the rest?

A:  The deciphering of the human genome is the single most important development representing sea changes in medical research and clinical care.

Q:  How many new subject categories, would you guess, have evolved under the heading of medicine since 1988?

A:  Medical libraries generally use the National Library of Medicine's Medical Subject Headings (MeSH) to catalog their collection. Each year NLM adds to or revises its MeSH terms to acknowledge the changes taking place in the health sciences. These changes over twenty years are most likely in the thousands.

Q:  What are the challenges that you face tackling such a high-growth segment of academic literature?

A. From the perspective of medical library administration, maintaining a collection that has to be representative of new fields on an annual basis means that budgets are strained and collection usage has to be monitored. As a result, titles, whether journals or texts, that receive little use have to be eliminated. Low use journals, in particular, must yield to titles that are more contemporary and have greater potential usage growth.

Keeping patrons informed about and trained in the use of library-based resources is a continual responsibility. Medical students are now expected to use for patient care PDAs on which clinical information has been loaded, e.g., drug protocols, vital sign information, lab result interpretation. This information is often available through a library/institutional subscription to a database; the library is also responsible for helping students load this information onto their PDAs and for providing training on its usage.

The association of the demise of the printed book with the demise of the library is fallacious. Libraries are in the information service business. The format of the information can change but the need for a library as an aggregate of proprietary knowledge sources that no one individual can afford but which is available to and supported by a community will not diminish but increase in its centrality. For profit publishers are not going to disappear and the U.S. government is not about to nationalize the publishing industry.

Q:  Can you give us 3 must-have titles that you feel every library should carry in this subject?

A:  Roy Porter's The Greatest Benefit to Mankind: A Medical History of Humanity (New York, Norton, 1997) should be in all libraries.

Also, I'd include two books by Sherwin Nuland:

Doctors: A Biography of Medicine (New York, Knopf, 1988); and How We Die (New York, Knopf, 1994)

Q:  What is your favorite ice cream flavor?

A:  I'm vegan. A preferred dessert for me is fresh fruit (blue berries or strawberries in season) and apple juice-sweetened couscous.

Q:  Where did you go to library school?

A:  My MSLS is from Drexel University, Philadelphia. I also have a MA in political science from Trinity College, Hartford and a Ph.D. in higher education from the University of Connecticut. Although I retired last year as Associate V.P. for Academic Resources and Services; Directory, Library at the University of Connecticut Health Center, I still continue to teach the elective course in the history of Medicine at the University of Connecticut School of Medicine.

Q:  How many titles have been selected thus far for your subject area?

A:  More than 400!

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