Medical information

Libraries have always received medical questions, and now they are becoming even more common. There are some special problems in dealing with them that you need to be aware of.

There are probably many reasons why people think of the library when they have a health related question. Some of these are:

  1. The library has done a good job of convincing the public to turn to it for all information needs. It's a pat on the back to you to have people come to you for help.

  2. For whatever reason, patrons feel that they can't ask their doctors. This is very common, since people often feel that the doctors don't have time or can't explain the problem in ways they can understand. Sometimes they just mistrust the doctor, or want another opinion.

  3. The consumer rights movement has made people more aware of their need and right to know encourages people to learn as much as possible about self-health care.

    The major problems we have in dealing with these kinds of questions are finding out just what the patron really wants, finding information the patron can understand, and distinguishing between giving information and giving advice.

    As you know, finding out what people want is tricky under the best of circumstances, but it can be especially difficult when dealing with health questions since people are often embarrassed and reluctant to discuss the problem with a stranger. Yet, doing a complete reference interview can be especially important with these questions since chances are you will not have many medical reference tools in your branch, and will have to send the question on.

    Medicine consists of amusing the patient while nature cures the disease. by Voltaire.

    You will have to be as tactful as you can, and use your judgment about when you think you have all the information the patron is going to give you without being embarrassed. It helps if you can explain to patrons that you need to send the question on, and that the more information you have, the better job can be done in answering the question. When reference centers work on medical questions for you, they have access to a very large amount of information, and the more specific you can be, the easier it is to provide the data. For example, if a patron asks for information about diabetes and that's all the information the reference center has, all they Can do is send very general information. However, if the real problem is learning about the problems of diabetes and pregnancy, then they can send much better, and more specific information.

    The library can supply quite a bit of information which will help patrons with medical questions. You probably do have some books on medical topics in your collection at the branch-perhaps a general book on health, and some on particular topics like heart disease, child care, pregnancy and so forth. One thing to be aware of is that these can be outdated very quickly. New advances are being made daily and a book that's even a few years old can be pretty old stuff as far as medicine is concerned. You might want to caution your patrons about that.

    Finding literature that's understandable to your patrons on health care topics is one of the problems you will have. For some very "popular" areas, like diabetes, or heart attacks there is quite a bit of literature available for the lay person, but for many other conditions, little or nothing is written for the person without a medical background. When you do send a question on, you should take care to point this out to the patron, and find out if they want to see technical literature, too, or if they only want what, if anything, is available in popular literature.

    No matter what you give your patron, you should make it a habit to point out to them that medical knowledge changes so fast that the library can make no promises that what they have is the latest knowledge available. They should be reminded that a doctor, or other health professional should be consulted. The patron may not choose to take that advice, but it should be given.

    As with all reference questions, the library's role is that of providing information to the patron, but not one of interpreting that information. It's extremely important to be careful of this in regard to medical literature, since we are not doctors, and only a health professional is qualified to give medical advice. For example, if a patron has read a paragraph about a certain disease in a book in the library and then turns to you and asks, "Does that mean that if I have these symptoms 1 have that disease?," that is a question of medical advice that you just can't answer. You must refer them to a doctor. Or perhaps you read a definition of a medical word over the phone to a patron, and they ask you to explain It because they don't understand the definition. All you can do is try to find another definition they might be able to understand better - you cannot try to interpret the medical literature for them.

    Sometimes people will want to give you a list of symptoms and ask what disease would match up with them - again that is the sort of question that you cannot answer. That's a matter of giving advice rather than simply finding literature - you would be taking it on yourself to diagnose a condition. This does not mean that you can't do medical questions, since as we've seen, there is a vast amount of information to be had (not all for the lay public, though).

    The distinction just needs to be made between providing literature for your patron to read, and giving medical advice or interpreting that literature. It sounds simple, but in practice you may run into difficult situations. Patrons can be very persuasive in trying to get you to give them advice, but you simply have to be firm and refuse to do it. If you are in doubt at all about how to handle a question, don't hesitate to contact your headquarters reference librarian, your reference center or a nearby hospital librarian.

    If you do have a hospital with a library near you, try to become acquainted with the librarian, and find out what their collection is like, and what their policies are on helping you, and helping the general public. Many hospital libraries have a policy of not serving the general public without a doctor's permission, but they are all willing to help the public library if you, as the librarian, call them. The hospital librarian can often provide copies of articles which will be useful, and give you advice on how to handle tricky questions. These libraries are set up for the hospital staff, though, and they don't have much popular level material, so what they send will be technical. Remember that hospital libraries don't serve the general public so don't refer patrons to them directly unless you check with them first.

    When a question reaches your reference center, they often check with the medical libraries. If it's easier for you to have the reference centers or your central library make the contacts with hospital libraries, they are usually happy to do that. If your patron happens to be a health professional she can use the medical libraries directly, and in fact, that is probably better for her, since there is a library network which works through hospital libraries set up to serve the health professional. You can go ahead and take those questions, but it works faster and more efficiently if health professionals do go directly to hospital libraries, so you might want to suggest that in those cases.

    What do you do when patrons ask for information which you think would be upsetting to them - for example, they say they have a disease and ask you to read them the definition and you see that the dictionary says that it is a fatal disease?

    That's a tough situation to be in, and it does happen from time to time. You need to remember that the patron does have a right to the information just like any other patron, and the librarian should not take on the role of censoring what she thinks the patron should see or not see. If the patron comes into the library, you should give her the books that she needs, but do be sure to remind her that her individual circumstance combined with new developments may make the material obsolete and she needs to talk to her doctor.

    The situation is somewhat different with this type of question when the patron calls on the phone. When people visit the library in person, they can choose what they want to see, and read the entire passage or article about their topic. You can't spend the time to do this by phone, so you must choose what to read and what to leave out, and that can be misleading. When the question is tricky, you are much better off to insist (and you have to be firm) that the patron come to the library and read the material there, rather than trying to read it over the phone.

    The phone also presents problems with medical questions which involve being sure you have heard the right term. Many medical words sound very similar and are spelled almost alike but may have very different meanings. If you have any problem at all being absolutely sure about the term over the phone, you should insist that the patron come to the library and use the tools herself. Don't let the patron trap you into deciding which of two terms is the one she wants - you'd be making an interpretation you can't do.

    Go to Telephone Inquiries for Medical Information.

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    This page was updated December 4, 2003.