Wednesday, October 17, 2012

Letter to the Editor - Journal of Hospital Librarians​hip

Dear Editor,
I've just finished reading Christine Marton's series of articles on the Online Presence of Medical Library Web Pages (1-3). I am a Librarian at a nationally recognized medical library, however regulations don't allow me to identify which one. Since clever readers will be able to identify me eventually, I must state here that this is my opinion and does not reflect the views of my employer. My place of employment is not one of the Libraries discussed in any of these articles, so this isn't just 'sour grapes'. In fact, my Library isn't even attached to a Hospital.
According to Ms. Marton's bio page at the University of Toronto ( ) primary interest is "the online health information behaviour of specific population demographics, primarily women and cancer patients."
Reading these complaints against the top 10 facilities in the United States, it is obvious that her interest is not Medical Libraries in the US. I contend her initial hypothesis is entirely wrong. The whole study was designed around finding links to the Medical Libraries at these locations for public health information. Why does she suppose that Hospital based Medical Libraries are bastions of Public Health Information? The United States has a variety of Medical Libraries and even those attached to major Hospitals may not undertake Dissemination of Public Health Information as one of their missions.
The National Library of Medicine ( ) provides a link to for Public Health Information. PhPartners identifies itself as "A collaboration of U.S. government agencies, public health organizations and health sciences libraries."  The FAQs do not list any Hospital Libraries as partners. They also list their goals as:
  • Organize and deliver public health resources so they are easier to find and use.
  • Identify and develop collaborative projects to meet the information needs of the public health workforce.
  • Increase the visibility of the partnership with librarians and the public health workforce.
  • Increase the information literacy of the public health workforce.
  • Strengthen the collaboration among the Partners.
I don't see Hospitals listed in the goals nor Libraries. I see "Increase the visibility of the partnership with librarians" which I paraphrase as 'let Librarians know we exist'. I don't see that anyone is pushing the theory that Hospital Libraries are supposed to be a source of Public Health Information except Ms. Marton. I see a lot of support for Government sites providing Public Health information. In Ms. Marton's article, she repeatly mentions the number of sites linking to the best known and best reviewed government source -- MEDLINEplus.
I believe the top 10 Hospitals in America are those that provide the best service to their patients. They are almost all heavily involved in the training of upcoming medical professionals. Their Libraries, accordingly, are directed at the Medical Professionals especially Medical School Students. Ms. Marton's articles point out very well how well linked some of these Libraries are to the departments they support. She doesn't seem to notice that the separate websites of those Libraries often tell you their primary goals or function. For example, Ms. Marton identifies Johns Hopkins' Welch Medical Library web site - For some reason I don't understand, she doesn't mention the giant banner on that page that reads: "Welch Medical Library  Serving the faculty, students & staff of the Johns Hopkins Medical Institutions".  That's a pretty obvious mission statement and it doesn't include the words Patients or Public.
The Mayo Clinic Library site's About page ( ) does mention patients. "Mayo Clinic Libraries is dedicated to meeting the information needs of Mayo Clinic employees, students, and patients." However further down the page they tell us that their system is really split into multiple libraries; a system for researchers & students and a separate set of patient & consumer resources. "Although Mayo Clinic maintains a private library system, visiting students and health care professionals are most welcome to use the traditional and electronic collections on-site. Specialized libraries serving hospitalized patients and their families, consumer health libraries, and special collections and archives related to the history of medicine and the history of Mayo Clinic are also available."
Third ranked Mass General's Library site - - is the first one that specifically states its goal is to support patients. While Ms. Marton decries the Library's placement on the third level of links, she doesn't seem to mind that all of the departments, Oncology, Gynecology, Neurology, etc, are also on the third level. The third navigation level is the first one to offer any webpage links. The first two levels show organization of the web pages into discreet sections. In talking about this third ranked major hospital, Ms. Marton missed the mark by the widest margin. Mass General doesn't have a Medical Library in the sense of a Library that caters to Medical Professionals. That Library is the Boston Medical Library - They jointly support the Medical Schools of Harvard, Boston U, Tufts, & U Mass. Mass General Hospital has three libraries to serve patient's needs; two are for entertainment and one for public health information. Doctors would contact BML for their information needs.
In summary, Ms. Marton is applying a public health principal that simply doesn't exist in this instance. The Medical Libraries associated with these top three hospitals, and I'll warrant the top ten too, don't exist for public health information. Since that isn't their goals, the Medical Library isn't a major portal on their institution website. Of course  Ms. Marton's searches for Hospital Medical Library on the Public web site of these Hospitals didn't find the Public Health Information she wanted. She was looking in the wrong place. The Medical Libraries that don't provide patient support are on the Intranet, not Internet.
By the same token, you're not going to find links to the Staff Library at my institution on our Public Website. It isn't for the public. From the Intranet, I can find all of the resources.
Ms. Marton, you are looking in the wrong place for the information you seek. To decry the Hospital Libraries for not meeting your goals when you aren't a patron of any of those Libraries is the worst form of prejudice. You are judging these Libraries by your standards, not by their goals. When they are meeting their goals, which don't include you, you say they aren't doing their job. I'm sorry, but those Libraries need to be judged on their stated goals and not yours.
J. Shore
Systems Librarian
@7shores on Twitter
  1. Christine Marton (2012): Invisible: The Online Presence of Medical Library Web Pages on Hospital Web Sites, Journal of Hospital Librarianship, 12:1, 14-24. 
  2. Christine Marton (2012): The Online Presence of Hospital Medical Librarians on Hospital Web Sites, Journal of Hospital Librarianship, 12:2, 171-180. 
  3. Christine Marton (2012): The Online Presence of Information Services at the Rehabilitation Institute of Chicago, Journal of Hospital Librarianship, 12:4, 342-350.


  1. Well said. Only somewhat recently have hospital libraries begun to have any Internet presence, but it wasn't because of patients. It was because their users (doctors, nurses, etc.) needed the library online so they could connect to resources from home. Some hospitals do that via VPN through the Intranet while other like mine use a separate authentication. The point is though, our move to the Internet was not driven by public but by our users that we serve. Since it is driven by the users we serve, we are located in the areas they would commonly view.

    1. Thank you.

      Readers interested in another point of view on this subject can find the link to The Krafty Librarian's blog on the right hand frame of this page. We say very much the same thing, but coming from different viewpoints, we have different examples and reasoning.

  2. Here at the Hirsh Health Sciences Library at Tufts University we provide academic library service to all the schools on the Boston Campus and the staff of the Tufts Medical Center. The statement in the letter, "That Library is the Boston Medical Library - They jointly support the Medical Schools of Harvard, Boston U, Tufts, & U Mass." is incorrect. Our users have no relationship to Countway. I think you might elicit the same response from Boston University and UMass.

    1. Thank you for that information. I took their statement (on the URL above & quoted after this sentence)to mean they were _the_ resource. I suppose they are just _a_ resource. "The Boston Medical Library serves as a resource for the medical school faculties and medical students of Harvard Medical School, Boston University Medical School, Tufts University School of Medicine and the University of Massachusetts Medical School."

      I've learned separately that the Treadwell Library serves as the staff resources library at Mass General. They list on the URL I provide in the letter/post. That library is the first one in the top three that is open to patients and the public as well as staff.

  3. Update: I've been conversing with the articles' author. She contends that she is not making judgments or testing a hypothesis. She says the searches were simply exploratory.

    I disagree. In my opinion, telling people they have to do something to become more visible is a judgment that invisibility is bad.

    She still doesn't believe that some Libraries want to be invisible to the public and are instead concerned only with their patrons' ability to find them.

    One point we agree on (and I'll quote this portion only): "My concern, if I may call it that, is that the invisibility of hospital libraries and librarians on hospital websites **may** be one factor that leads to funding cutbacks or closures of hospital libraries, consumer health and medical alike, and that is of concern to the profession of medical librarianship, given the number of cutbacks and closures in recent decades."

    I agree, but feel that public exposure isn't the test. The only ones that can test whether they are visible to their management are the Librarians at the Hospital. No researcher can answer that from outside the Hospital.

    I've also apologized to Dr. Marton for referring to her as Ms. Marton. The information on her bio page is outdated but she can't change it. She has been awarded her PhD.