Twitter Archive: I Get By With a Little Help From My Friends

Recently I've been stymied in trying obtain articles from medical journals in order to support my own research and patient care. There is no major institutional library in Rural. The two major hospitals have reading rooms but, as far as I know, no librarian support. This means that I have to work with an institutional library 260 miles away to obtain papers in journals neither of my local hospital libraries carry--which is most of them. The distant institutional library charges a $15 fee for each article sent, which makes things expensive for this independent rural scholar. Thanks to Twitter, I've found a lower-cost solution:

ruraldoctoring Doing a lit search on PubMed and PISSED that each paper I order is going to cost me $15 via Loansome Doc.
Emergiblog @ruraldoctoring Do you have access to any university libraries? I LIVE for my online library at UWGB. Paying for papers is a rip off.
DrCris @ruraldoctoring I have access to papers. If it's not too many, let me know.
medpiano @ruraldoctoring What's Loansome Doc? Now that I no longer have offical affil., I'm SOL w/reprints, esp. ones that are newer than 6mo old.
ruraldoctoring @medpiano Loansome Doc is service through NLM which discounts delivery price for articles from $30 to $15 if they are sent to hospital lib.

ruraldoctoring @medpiano ..and pay $15/article, which is outrageous because--as you know--any decent lit search will run to 20 papers.

ruraldoctoring @Emergiblog @DrCris @medpiano I'm a UCSF alumna, which gets me no love at all from library services.
  ruraldoctoring @Emergiblog @DrCris @medpiano Since moving to Rural, I don't have access to an institutional library (first time in my LIFE!)

ruraldoctoring @Emergiblog @DrCris @medpiano This is a MAJOR barrier to practicing THOUGHTFUL evidence-based medicine.
DrCris @ruraldoctoring I will send you papers if you send me your pot roast recipe. Want to try it tomorrow.
ruraldoctoring @DrCris OK, pot roast recipe coming your way.

ruraldoctoring @DrCris Pot roast recipe mailed to you.

DrCris @ruraldoctoring Looks yummy. Aus is very asian fusion, so I actually have most of that in my cupboard. DH already bought the meat.
ruraldoctoring @DrCris Maybe I'll send you the key papers and see if you can get them. Otherwise, I might have to ask my mom to get them for me.
ruraldoctoring @DrCris Which will involve a pound of flesh in guilt payments.

ruraldoctoring @DrCris I'll cull through my top-five wishlist and email to you, probably tomorrow.
DrCris @ruraldoctoring Can be top ten if it is a particular issue.
DrCris @ruraldoctoring Can't believe any hospital nowadays that doesn't arrange some access to online journals. What sort of drs do they expect?
ruraldoctoring @DrCris They get the doctors they deserve, that's for sure. You should see how much IV albumin is given to ICU pts, despite Cochrane.
DrCris @ruraldoctoring Hey! Aren't you on holidays? Whatcha doin' on Pubmed?
ruraldoctoring @DrCris Holiday is the only time I get to sit down and do lit searches! Seriously, the issue just came up last week.
ruraldoctoring OK, I'm going to get off my soapbox and go to bed. More driving tomorrow and first evening of JAZZ!
ruraldoctoring But very, very grateful to everyone's offer to help me obtain papers, and special thanks to @DrCris for looking out for me & my pt.

Thus, in exchange for a pot roast recipe, I got most of the papers I needed from Dr. Cris within a few hours. The virtual community may be vast but it is certainly neighborly. Is it completely ridiculous that an Australian surgeon had to email papers published in the US and Europe to a rural family doctor in California? Yes it is.

Comments

[Sarah Stewart]

You've hit on my perpetual complaint. Its all well and good being able to search for articles on Google Scholar - that doesn't help you access full text.

Have a look at http://pubget.blogspot.com/ - between you, me and the gatepost I have been using this blog to access full text articles.

[Theresa]

Good reality check, Me! I was given some odd misinformation about the medical librarian at Macy's originally. I plan to explore their services with non-reproductive health topics, for reasons I mentioned above.

Thanks for the input, everyone!

[me]

OK, but your post says there is no librarian support at either hospital! This is not true, and I was pointing it out in case you were unaware that there is a librarian there who can acquire articles for you. I can see that you may not want to use that particular hospital for the reasons you state, as well as others unstated :-), but, as Rachel says above, the librarian at "Macy's" should not be asking any questions about what you are asking for, other staff should not be aware of what you are researching/asking for unless you tell them, and the hospital should not be asking the librarian to selectively acquire articles or perform searches.

[Rachel]

Theresa, if your hospital library has a real librarian, s/he should not give you any trouble about getting articles no matter what the topic. If s/he does, our professional code of ethics is not being adhered to (I'm a medlib).

[anonymous NP]

I work at a big institution and have access to articles.
I may be able to get you future articles or send info from UptoDate.
Email me and can let you know if I have access to what you need.

[Theresa]

Addendum to Me:

Obviously, I acknowledge that my choosing not to use Macy's library dilutes the nature of my gripe, but I'm exercising blog-author's prerogative ;-D

[Theresa]

Hi everyone!

Darra, if you care to email me info about AHEC preceptorship, I would like to learn more!

Hi me: I am aware of Macy's medical library, but I have some complicated reasons for not using them for the subjects I am currently researching (hint: religious affiliation, small community, medical staff there not supportive of certain practices), although I would use them in the future. Yet another problem with living in a rural community.

[Robin]

Hi...I use a university library service and am able to access just about any medical journal as an e-journal. If you are affiliated with a library of this sort, you should be able to get the articles at no cost. If you aren't, there are several subscription services that are relatively cheap when one is considering the cost of each article.

Ah...I went back to re-read and saw I had missed where you were able to get the articles. Good!

[darra]

Since you are rural would you be interested in becoming an AHEC community preceptor? AHECs usually give online journal access as a free benefit to their preceptors.

[rlbates]

I love this community too! Would love to see more open access to journals.

[me]

uh, if you are where I believe you to be, the hospital you refer to as Macy's has a (small) medical library, with a librarian on staff (Mon through Th), through whom you may obtain journal articles from other libraries, etc.

[Theresa]

Thanks for the offer, PharmacistMike! Open Access would be much more in the spirit of inquiry, wouldn't it?

[Pharmacistmike]

Not having access to full text articles makes no sense. I wish the journals would just figure out a way for open-access. There are several open access sites and I believe the NIH no mandates that studies that they fund need to be open access.

I have access to a medical library, I can't confirm nor deny how I have the access. However, if you need anything for patient care then drop me an email, you should have it from this post, and I am more than happy to look up the info and email it to you. We will assume I am doing it to educate you, haha, and not as a copyright infringement.