Adjusting to progress: interactions between the National Library of Medicine and health sciences librarians,...

Most health sciences librarians would agree that the National Library of Medicine's (NLM's) leadership and its services have been highly beneficial to the field, but this does not prevent specific NLM actions--or lack of action--from being perceived as annoying or infuriating. Over the past forty years, NLM's interactions with health sciences librarians have been affected by significant additions to NLM's mission and services, the expansion of NLM's direct user groups, and the growing range of possible relationships between health sciences librarians and NLM. The greatest friction between NLM and health services librarians occurs when there is a fundamental change in the way NLM carries out its mission-a change that adds to the web of relationships that link librarians and NLM and prompts corresponding changes in the way other libraries do business. Between 1961 and 2001, there were two such fundamental changes: the implementation of the National Network of Libraries of Medicine and the development and promotion of services targeted toward individual health professionals. On a lesser scale, each new service that connects NLM and health sciences librarians is another potential source of irritation, ready to flare up when the service is interrupted, changed, or eliminated. Other factors--including strong personalities, mistakes, and poor communication--add to, but do not cause, the intermittent problems between NLM and its most longstanding and engaged user group. These problems are in essence the price we pay for the leadership and vision of NLM's directors and for NLM's success in developing excellent services and in enhancing them based on advice from librarians and other users.