Voices of U of U Health
Why Every Physician in Utah Deserves Free Access to PubMed Research
By Christy Jarvis, MLIS
Imagine holding the key to a vast treasure of knowledge—one with the power to improve people’s lives. But only a select few are allowed access, while others remain locked out.
The Spencer S. Eccles Health Sciences Library at the University of Utah holds the key to a wealth of information, including digital access to millions of articles from thousands of medical journals published worldwide. These publications share clinical trial results, innovative therapies, and evidence-based practice recommendations—resources that can significantly impact patient care.
As a librarian, I help U physicians access these journal articles to support evidence-based care. Physicians who work outside of the university don’t have the same access, because the content we license is only available to the campus community.
The Haves and Have-Nots
I’ve long recognized the massive information divide between providers in academic settings and those in private practice, community settings, and rural health settings. While the first group has unlimited access to medical information, the latter does not, creating a disparity in health care.
Research shows that patient outcomes improve when physicians practice evidence-based medicine, which relies on clinical expertise, patient preferences, and the best available evidence. Unfortunately, many Utah physicians lack access to this essential third component.
Physicians search for evidence on PubMed, a database from the National Library of Medicine. They can view study abstracts (a short summary) for free, but without a journal subscription, they can’t access the full paper. With 75% of the research on PubMed behind paywalls, finding the best evidence can become a frustrating, time-consuming task for physicians.
Possible workarounds are less than ideal: Physicians could purchase individual articles but that requires a new account for each journal—too time-consuming for many physicians. And articles may cost $99 apiece—too pricey for many practices.
Improving Information Access
For years, I thought about ways to narrow the information divide so all physicians could access evidence on PubMed. When Michael Good, MD, former senior vice president for health sciences, first met with our faculty librarians, I was inspired by what he said: “I’d like us to be the university for Utah, not just the University of Utah.”
Colleagues at other institutions have considered the same dilemma. Some created programs to level the information-access playing field for physicians in their state. I took a three-month sabbatical to learn about their approaches, for the benefit of Utahns. Based on the models I studied—including journal-buying clubs, state AHEC (Area Health Education Center) memberships, professional association benefits, and complex online “portals”—I created a proposal to implement a simple, straightforward system that would allow all physicians across Utah to access full-text articles using the familiar PubMed platform.
I received two small grants from the Network of the National Library of Medicine for a pilot program, followed by a National Library of Medicine grant to extend the program throughout Utah. We’re five months into the year-long grant.
Any physician licensed in Utah (MDs and DOs) may register for free PubMed access through our service by submitting a registration request with their Utah physician license number, which we verify. We then create their account in Article Galaxy, a pay-per-view article provider.
We email registered physicians a link to a customized PubMed interface with the full-text article delivery function. We suggest they bookmark it for future use. It’s easy for physicians to navigate because they’re already using PubMed. We’ve just given them a subsidized full-text access option.
So far, the program has:
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Registered more than 450 physicians from 16 different counties, including 10 rural and frontier areas.
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Served 800,000 patients, nearly 25% of Utah’s population.
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Delivered about 190 articles per month, fully covered by our grant.
It’s heartening to see significantly more providers accessing literature that can help them make informed, evidence-based decisions for patient care.
Future Plans for the Service
When our grant ends in the fall, we’ll seek anonymized feedback from users to see if the service improves their ability to practice evidence-based medicine. If we get positive responses, we’ll seek post-grant sustainability funding. Projections suggest the service should cost $120,000 to $150,000 annually—not cheap, but a worthwhile investment to ensure that every physician in Utah can review the best available evidence for patient-care decisions.
Moving forward, I’d like to scale up the service to provide PubMed full-text articles to nurse practitioners and physician assistants. Administrators at small health systems have asked that we include these and other categories of providers.
At the moment, Utah is the only state in the region using this unique model to provide full-text access to physicians who otherwise wouldn’t have it. We’d like to expand the service so physicians—and patients—in other states can benefit. I designed the service with simplicity in mind, so it’s easy to implement in other settings where physician health information access disparities need to be addressed.
I’m passionate about narrowing the information divide, but I sometimes have to remind myself that this isn’t a passion project. It’s about advancing the U’s Impact 2030 vision to improve the lives of all Utahns. It’s impactful, with concrete results. Physicians who want to provide patients with evidence-based care can now say, “I’m accessing articles that I couldn’t read before.”
