What’s so special about Up to Date?

Wonders The Krafty Librarian, who reports doctors’ reactions when a local health system decided to restrict Up to Date access to on campus users. (Linked at Grand Rounds by Hospital Impact). Up to Date is expensive and very restrictive in its access options. Institutional subscriptions generally only provide on site access. Apparently it’s prohibitively expensive for many institutions to provide home access for all users. Like the Krafty Librarian I wonder why so many folks swear by it.

She writes: “But is UpToDate's content really that much more superior to FirstConsult and eMedicine that doctors are willing to put up with a product that seems to have extremely restrictiveve access policies and is not rapidly expanding into needed areas like the handheld and EMR market? Or are physicians apathetic? They know about UpToDate, they know it is a good product, but they don't care to learn or be bothered with other products because they are sticking with the one that they are familiar with come hell or high water.”

Hmmm--- I have mixed feelings. Apparently, according to one of the links in the post, emedicine has an institutional edition which requires a paid subscription. This is news to me, and I’m struggling to understand how it differs from the free version of emedicine I was already familiar with. So is Up to Date really that much better than the free version of emedicine? Emedicine seems to be a work in progress, and is getting better and better. However, it doesn’t seem as well organized or as extensively linked as Up to Date. It’s a large and growing collection of stand alone monographs. And, if renowned expertise in the authorship is important, Up to Date has the edge with a list of contributors that reads like a parade of stars. Also, it’s advertising free, and the free version of emedicine is not (if that’s important to you).

But Up to Date may be living largely on reputation. As the Krafty Librarian points out, doctors are familiar with it and trust it. I don’t agree with some of my colleagues who think it’s all they need, or that it’s even the best resource. I use it extensively and have a personal subscription so I can access it at home (very important to me), but I find it complementary to many other resources. Disadvantages include imprecise searching (you usually have to combine searching and browsing) and somewhat limited graphics. I think there may be other resources that provide a better bang for the buck.