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OB/GYN Editorial January 2004

How Do We Read the Medical Literature?

Robert B. Taylor, MD

For a minute, let's think about how you and I read journals. Here's a short single-best-answer quiz:

In considering how physicians read the medical literature, I did a PubMed search of the topic "reading habits" AND "physicians." This yielded a diverse group of studies of the reading habits of US women physicians, practicing physiatrists, Norwegian physicians, German diabetologists, Western Australian RACGP Training Program doctors, US family practice residents, and a few others. What follows is a look at commonalities in reading habits of physicians; it is not a statistically supported meta-analysis.

In the studies, physicians tend to spend 3 to 5 hours a week reading the medical literature.

Some respondents reported no reading at all; others reported up to 12 hours per week. House staff, in general, reported the greatest number of reading hours, ranging from 3.7 to 8.7 hours. These physicians in training programs were most often motivated to read to find information about actual cases or upcoming presentations. Although all these figures must be tempered by the realization that they are self-reported, best-guess numbers, it seems safe to say that if you and I read the literature 3+ hours a week, we are in line with other physicians.

In the studies, the types of journals physicians read were often not clear. It seems that physicians read a blend of specialty-specific journals and broad-based journals. I could not find distinctions between research-oriented journals versus those presenting chiefly review articles, nor between subscription-based versus advertiser-supported journals. Of course, in the latter category, all journals are—to a greater or lesser degree—supported by advertising revenue.

One of every five Norwegian physicians reads at least one of the "big four" journals: New England Journal of Medicine, Journal of the American Medical Association, Lancet, and the British Medical Journal. House staff tend to use journals and one major textbook, and medical students tend to rely strongly on textbooks. In the end, I conclude that we read a blend of publications in the medical literature.

What about how we read? Do we gorge—read it all? Do we hunt—search for information? Or, do we graze—pick and choose what interests us? Although a few may read all of every article in their specialty journal, the majority of us do not. It is lamentable but true that in research journals, the articles are often there to be published, to get data into print to be cited, and not to be read by most. The prose in scientific articles is often too dense to read all of every article. Many practicing physicians find the writing in review-oriented publications easier to read at the end of a long day.

Sometimes readers search journals and books for information, seeking data about the illness of a patient in the hospital or office. We once did this. Today, however, searching paper publications, hunting for the answer to a clinical question, is becoming an archaic practice. It is much more efficient to search on the World Wide Web, just as I did in searching for data about physician reading habits. PubMed is free and easy; go to www.pubmed.com. Other subscriber-based ways to search are MDConsult and UpToDate. When hunting an answer to a clinical question, piling journals on your desk isn't done any more.

Most of us "graze" medical journals to keep up to date in our specialty and in the broad scope of medicine. Also, we tend to do it in a specific way. Most of us tend to scan the table of contents for articles of interest. Then we read the abstract and perhaps the discussion of some, but not all, of those articles. Then, very selectively, we read the full text of a few articles.

And so, my conclusions from some admittedly limited research are: We read some 3+ hours a week, include a blend of publications in our reading, and tend to graze the journals, carefully choosing what we read in detail. Do you disagree or have data I did not find while hunting? I would be glad to receive responses.

Robert B. Taylor, MD
Editorial Advisory Board Member
Department of Family Medicine
Mail Code FM
Oregon Health & Science Universtiy
School of Medicine
Portland, Oregon 97239-3098

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