Hospital Libraries in the United States: Historical Antecedents by PATRICIA A
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Hospital Libraries in the United States: Historical Antecedents BY PATRICIA A. WOLFGRAM, Librarian Saginaw Osteopathic Hospital 515 North Michigan Avenue Saginaw, Michigan 48602 ABSTRACT pital, founded in 1847, through a sum appropriated by trustees of the hospital [4]. Mt. Sinai Hospital The hospital health sciences library of today that Library was founded in 1883 through a personal reaches out to the world knowledge base through elec- tronic networks bears little resemblance to its forebears. contribution from Dr. Alfred Meyer [5]. Johns Yet to understand the challenges and future directions of Hopkins Hospital had one of the largest hospital the hospital library it is necessary to examine how it libraries, with more than 14,000 volumes. began and how it has evolved in more than 200 years. This During this era, the growth of medical publica- paper identifies five developmental periods in which As as John major strides were made: the colonial years through the tions was already apparent. early 1881, 19th century; World War I to the Great Depression; Shaw Billings warned of conditions to be expected World War II and the 1950s; the 1960s-the Great a century hence, should the steadily increasing Society and the Medical Library Assistance Act; and the production of medical books continue [6]. Billings 1 970s, an era of growth for hospital libraries. noted that there were approximately 850 medical periodicals published each year, with almost 20,000 substantive articles [7]. THE HOSPITAL LIBRARY of today has roots By the end of the 19th century, many of the extending from Colonial America. Its growth has earlier medical collections were evolving into out- paralleled the social transformation of medicine as standing libraries as the hospitals that they served identified by Harvard sociologist Paul Starr [1]. grew into teaching institutions affiliated with medi- Five major developmental periods are discussed: cal schools. Medical societies, among them the (1) the early years when hospital libraries were Medical Chirurgical Society of Maryland and the developed mainly through the efforts of local physi- Boston Medical Library, also supported large cians; (2) World War I through the Great Depres- libraries for their members. This period was one of sion; (3) World War II and the 1950s; (4) the informal beginnings, with small privately sup- 1960s-the Great Society and the Medical Library ported libraries that began to grow as both the Assistance Act; and (5) the 1 970s, an era of growth medical profession and its institutions responded to for hospital libraries. the growth of the country. According to Doe and Marshall, there were some twenty-four medical COLONIAL AMERICA THROUGH THE 19TH CENTURY libraries in hospitals and twenty-four libraries in medical colleges in the United States when the The earliest medical libraries in America were Medical Library Association (MLA) was founded outgrowths of private collections. Physicians often in 1898 [8]. pooled their resources to develop libraries for their Unfortunately, for these years there is a lack of hospitals. The first medical library, in the Pennsyl- survey data on hospital libraries in the United vania Hospital, Philadelphia, was founded in 1762 States, what they included in their collections, and through contacts made by Benjamin Franklin. By the number of trained librarians who administered 1790, it published the first catalog of medical them. It was during this period that the stage was library holdings, with 528 titles listed [2]. A collec- set for development of the modern hospital we tion founded by John Winthrop for New York know today. Hospital was later transferred and formed the library of the New York Academy of Medicine, WORLD WAR I THROUGH which by 1898 had over 23,000 volumes [3]. THE GREAT DEPRESSION Other outstanding older libraries include the In early America, hospitals were principally Treadwell Library of Massachusetts General Hos- institutions to which the sick and the destitute 32 Bull. Med. Libr. Assoc. 73(1) January 1985 HOSPITAL LIBRARIES IN THE UNITED STATES: HISTORICAL ANTECEDENTS came only with serious illnesses and often only to Frankenberger reported to the American College die. In this pre-Flexnerian era there was relatively of Surgeons that the purpose of the medical library little in the way of a hospital component to medical was to provide house staff and interns with a basic education, and except in a few great centers there working collection of the latest authoritative text- was little that hospitals could offer in the way of books and well-recognized reference works in the scientific medicine. One of these centers, the pre- various branches of medicine. He envisioned cursor to the Mayo Clinic, hired a librarian as early library service as well as collection development, as 1907 to meet the needs of specialty training and and he believed that the librarian could render to "organize a library to do editorial work in great assistance by compiling references, locating connection with the publication of papers" [9]. The specific articles, and scanning the contents of jour- Flexner Report of 1910, although directed toward nals for current information as they were received medical education, led to the development of full- [12]. time, hospital-based clinical departments affiliated In 1932 the American College of Surgeons pub- with medical schools. Hospital accreditation began lished its first list of books recommended for use in about this time, when the American College of the hospital library. Its Manual of Hospital Stan- Surgeons issued its Hospital Standardization Pro- dardization, published in 1940, includes a mini- gram in 1918 to improve hospital care. Thus, as mum standard for hospital libraries that covers hospitals assumed greater roles in patient care and resources, housing, personnel, extension facilities, in education, the inadequacy of private collections and a library committee. Although the standards became apparent. With the development of hospi- call for "the supervision of a qualified librarian," tal-based internships and residencies, libraries the sentence which follows-"She shall act as grew to meet their needs. custodian of its contents"-indicates a lack of understanding of the role of a librarian or the Services to Patients qualifications required [13]. An important development during this period The first formal gathering of members of the was the growth of library services to patients. As American Hospital Association (AHA) and affil- early as 1904 McLean Hospital (Waverly, Massa- iated groups interested in hospital libraries was chusetts), a private mental hospital, developed a held in Philadelphia in September 1934. At this patient library under a trained librarian. Massa- meeting the importance of the hospital library in chusetts General Hospital (MGH) was also one of patient care was stressed. In September 1936 when the earliest general hospitals to have a patient the AHA met in Cleveland, the Library Committee library with regular book service. The McLean and issued its Quarterly Book List. In the same year the MGH examples served as impetus for Iowa State to American College of Surgeons recognized the hos- authorize appointment of a supervisor of state pital library movement and at its Philadelphia institutional libraries [10]. The American Library meeting sponsored a formal roundtable discussion Association (ALA) issued two publications in of hospital libraries, led by Perrie Jones [14]. 1913: A Manual for Institution Libraries (C. E. One of the first formal medical librarianship Scott) and A Thousand Books for the Hospital programs, a course in hospital librarianship, was Library (E. K. Jones). developed in 1937. The University of Minnesota World War I brought development of patient Division of Library Instruction organized a lecture libraries in military hospitals. By June 1919 there course that included six weeks' internship in an were 145 librarians and six supervisors in the ALA approved hospital. Lecture topics included selec- War Hospital Service in America and 121 orga- tion of books for patients and medical reference as nized patient libraries in France. Having demon- well as hospital and medical library administration strated the value of books for recreation, education, [15]. and therapy in hospitals, librarians paved the way World War I was followed by a ten-year period for later development of hospital libraries, includ- of prosperity in America before the onset of the ing standardized library service in Veterans Great Depression that lasted until mobilization for Administration hospitals [11]. World War II. This was a period of retrenchment for the medical profession and hospitals as the nation attempted to cope with problems of unem- Early Development ofStandards ployment and feeding the population. Federal sup- It was during this period that standards for port of bibliographic services dwindled. The Index hospital libraries began to be formed. In 1931, Medicus, 1st series, which had been published Bull. Med. Libr. Assoc. 73(1) January 1985 33 PATRICIA A. WOLFGRAM continuously since 1879, was replaced in 1927 by Development ofStandards-Joint Commission the Quarterly Cumulative Index Medicus, pub- on Accreditation ofHospitals lished by the American Medical Association. It By 1952, with the cost and scope of the hospital was not until after World War II that hospital accreditation program outgrowing the administra- libraries experienced a great period of growth. tive capability of any one organization, the Joint Commission on Accreditation of Hospitals WORLD WAR II AND THE POSTWAR ERA (JCAH) was established. Initially it had represen- OF THE 1950s tation from the American College of Physicians, World War II proved unequivocally that the American College of Surgeons, American Hospital and practice of medicine was a team effort and that Association, American Medical Association, medicine had roots in sciences other than biology. the Canadian Medical Association (which later Johnson reflected: "We were confronted with a new withdrew). In December 1952, the Hospital Stan- orientation in medical practice, in medical research dardization Program of the American College of and in medical administration.