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Keeping up to date with clinical evidence

It has been said that in order to keep clinically up to date, one would need to read 19 journals a week. Yet I am lucky if I am able to put aside an hour to catch up, and we all know that some weeks are so hectic it is hard to open any journals at all!

One of the joys of being a generalist is that I get the opportunity to care for patients with just about everything. I never know what is going to walk through the door next, and I certainly never have the chance to get bored with my work.

But keeping up-to-date is always a challenge, and sometimes I envy colleagues who work in a specialist field, where it seems much easier to keep up with a more focused literature. Clinical evidence seems to be constantly changing, and the sheer volume of knowledge continues to grow.

I try hard to be an evidence-based practitioner, and regularly use online resources such as Clinical Knowledge Summaries to check on current recommendations during consultations. But is there a way that we can be made more aware of this rapidly changing information? I have a number of email alerts, such as regular updates from the National Electronic Library of Medicines, which can sometimes turn up several times in one week.

However, much of the information is not relevant to my needs, and I have to wade through a lot that I am not at all interested in to find items directly related to my role.

Recently a company that wanted to send me relevant information for my shopping emailed me. Their idea was to create a database of my likes and dislikes so that they can appropriately target their advertising.

While I personally don't want to find my inbox full of advertising, it did make me think about the system they use. Wouldn't it be useful if we could subscribe to a database where we can enter all our clinical interests, work setting and the scope of our practice? Relevant advice and guidelines would then just pop up as they are published. We never need to worry about getting out-of-date again!

I sometimes wonder how patients feel when they see a clinician trawling the internet before they make a decision about their management. Other professionals have told me that they hate to use reference sources in view of patients, as they worry that they will be perceived as not knowing what they are doing.

Interestingly, last week as I treated a patient after looking up the relevant guideline online, she told me, quite unprovoked:  "You know that's what I really like about seeing you. I know that you will always take the trouble to find out the best treatment for me. You never palm me off with just anything." So it seems that patients clearly accept our need for information sources, and it doesn't appear to reduce their confidence in us.

Your comments (terms and conditions apply):

"Like Adele signing up for e-bulletins definitely helps keep up to date" - Debbie Challinor

"I sign up to as many e-bulletins as possible" - Adele Brodie, Cambridgeshire