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january 2008 | Welcome to Finding Balance eNews.
Keeping
up with the literature; a broken paradigm
Do
you have a pile of journals at your bedside or desk side? Do you feel guilty
that you haven't read them?
A
close friend of mine told me about a scenario that occurred after the death of
his father, a prominent psychiatrist. When my friend and his family were
cleaning out his father’s house, they found journals scattered all over. They
could not believe the number of journals that his father had kept (read or
unread). On the second day of cleaning, they found a walk-in closet that
contained thousands of journals, some of them never opened.
We
all hold the belief, to some degree, that in one of these journals lies some
wondrous pearl of wisdom that will make us a better doctor or help solve a
patient’s problem in the future. My question to you is; how will you find that
pearl of wisdom in the mess next to your desk in anything less than twelve
hours?
In
the 1940s there were three major medical journals in the
United
States. All three were monthly subscriptions, two of which were
newsletters. Keeping up with the literature meant pouring yourself a coffee on
a Sunday, sitting in your comfy chair, and reading for an hour or two. Many of
your professors grew up with this paradigm; keeping up was critical and
possible.
Since
that time, the volume of medical literature has grown exponentially. More
research is being done worldwide, and it is more accessible than in the past.
In addition, the average physician receives multiple journals, including
throwaway journals, weekly. It is impossible to keep up with the literature
anymore, yet when we see the overwhelming pile next to the bed, we feel
incompetent as physicians and scientists. After all, we were told, “If you
don't keep up with the literature, you are not enough”. One colleague of mine
was told, “If you don't keep up with the literature, people will die.” This
creates anxiety and frustration for us all.
Today
we all have an incredible, inexpensive resource: it’s called the Internet. It
is now possible to find the answer to a problem, if one exists, in minutes. It
is also possible to reassure yourself if no answer exists.
Let
go of the old paradigm of keeping up with the literature, and be thankful that
you have a world of information at your fingertips. Take an hour a week to be
pro-active. Read a journal that you truly enjoy and know that it serves your
patient, quells your anxieties, and feeds you inner science nerd, an important
part of who we are as physicians. For the rest of the information, be thankful
that the Internet is at your finger tips. It is now feasible to search the
literature for answers within seconds. And most importantly, stop piling up old
journals, especially 'throw-aways'. You will appreciate the lack of clutter.
Resources
for understanding the literature:
Daniel Friedland, MD, ABHM author of Evidence-Based Medicine: A Framework for Clinical Practice has created an excellent web site to help you understand and research the realm of evidence based medicine.
Some of the recommended resources are:
And he suggests that providers can also keep up using healthnews services like:
Just
for fun:
really love the new CD by Anoushka Shankar and Karsh Kale "Breathing Under
Water,". Anoushka is the daughter of Ravi Shankar, the renown classical Indian
musician. This new album is a mixture of Sitar music, pop and trance-like
sound. Truly beautiful to hear. It features a number of collaborators,
including Ravi Shankar, Sting, Norah Jones, Shankar Mahadevan, Sunidhi Chauhan,
Vishwa Mohan Bhatt, the Midival Punditz and many more...
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