Ocean Deep

Staying afloat on a sea of medical information?  

 On graduating in 1986 I vividly remember someone suggesting that half of the knowledge I had been taught would be out of date within 6 years. That was a very sobering thought as it represented about the same period of training I had just completed, and as a medical student I had believed I would emerge from medical school reasonably ready for the many years ahead of my medical career. Knowledge then was largely accessed through the medical school library’s extensive book collection or by discussion with local colleagues. 

Since then of course the World Wide Web has turned a trickle of information into a flood and gone on to fill lakes, seas and now oceans of medical knowledge. This knowledge is ready to swamp us as we seek to make well informed and up-to-date decisions in our consulting rooms, with those in our care who also have access to this wealth of information. 

Here in the UK there have been recent lively debates about the nature of medical professionalism following the Royal College of Physicians report in late 2005 entitled ‘Doctors in society: Medical Professionalism in a changing world’ and I am also aware of the work of David Stern (University of Michigan) and his colleagues in the book he edited ‘Measuring Medical Professionalism’. However, whilst acknowledging the enormous change in the context of medical practice that the internet and associated media have caused- there is little more said in these discussions than doctors should be ‘life long learners’ engaged in continual professional development.  

I believe we are in danger of being overwhelmed by the modern flow of information and need to recognise that a core part of professionalism is a need for learning how to manage the information available to us. Along with the call for doctors to work in partnership with those in our care we must learn not only how to frame the health problems presented in mutual terms but also the information and aspirations that define and might meet those expectations. This is no mean task within a time limited encounter with patients who often bring information from different sources to ours or when a situation remains one of uncertainty and risk.  

For my work in family practice I find I must rely not only on clinical skills, communication skills and experience but also information skills. I believe these information skills comprise knowing how to access reliable information, rapidly and from sources concise enough and straightforward enough to be useful real time with patients in the consulting room. This is extremely challenging but also extremely rewarding when done well. 

I believe it is time that the learning of how we access and use information –the work of medical informatics- is put to work in partnership with those shaping the professional lives of doctors. The necessary educational methods must support both doctors and their patients.  

I believe that the management of medical information has become a fundamental part of modern professionalism. 

Do join the debate: how do you stay afloat on the oceans of medical knowledge?