The Informationist: A New Health Profession?

• Librarians
• Librarianship
• Evidence-based medicine
• Information services
• Information management

Physicians have always had a professional obligation to base their decisions on the best available information, an assumption now explicitly embodied in the concept of evidence-based medicine (1). For decades, when physicians wanted information from the published literature, they relied heavily on medical librarians or office assistants to do the searches. The advent of computer-based indexes such as MEDLINE promised to change all that by putting the basic information retrieval tools directly into physicians' hands. The disappointing reality, however, is that physicians still don't regularly search the medical literature themselves, nor do they ask for professional help in searching nearly as often as they need to. Many questions arising in clinical encounters that can, and should, be answered on the basis of evidence from the published literature are therefore never addressed (2, 3).

Explanations for this sad state of affairs aren't hard to find. First, the published evidence that clinicians need is scattered among thousands of journals, textbooks, monographs, reports, guidelines, and the like, many of which are not electronically indexed. Second, electronic indexing of articles is far from ideal (4, 5), and the techniques of electronic searching are still complex and arcane. As a result, electronic searches all too often yield no “hits” at all or avalanches of irrelevant citations (6). Third, most physicians now in practice did not acquire the skills of literature retrieval during their training. And although 80% of medical students report that their literature searching skills are adequate by the time they graduate (7), those skills rapidly decay unless clinicians use them regularly, which few manage to do. Finally, even using current electronic systems, finding and selecting literature-based data to solve a single patient-related problem can easily require an hour or more (8). Physicians don't, and never will, have …