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:
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.
@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 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.