College and Research Libraries LARRY AULD AND IRENE VOlT Library Group Practice A plan for library group practice bears several striking similarities to a medical group practice, both in rationale and in patterns of service. Library group practice is a means of enhancing professional achieve- ment, improving the rate of productivity in libraries, and thereby of- fering one way in which information can be marketed by libraries at an acceptable price. ACADEMIC LIBRARIES are changing. They must change. Library costs have risen while the rate of productivity has remained virtually the same, with the result that the information product has nearly been priced out of the market. 1 Librarians must devise new ways of pro- ducing their product so that it will be within the reach of users. Academic librarians are also faced with the issue of professionalism which has been forced by ACRL's adoption of the ccStandards for Faculty Status for College and University Librarians."2 · Faculty status, to be meaningful, must include the respect of the faculty and students. Professionalism and respect do not come automatically from the be- stowal of faculty status or a decree from ACRL, but from a recognition of quality and, equally, the level of work accomplished. True academic status requires greater professional performance and behavior on the part of librarians than patrons have generally been led to expect. El- dred Smith speaks directly to this point when he says of academic libraries: If anything, they have too many li- brarians now: most of them spend Mr. Auld is head, Technical Services, and Ms. Voit is reserve book room librarian at Oregon State University library, Corval- lis. 54/ the bulk of their time doing cleri- cal work which nonprofessional personnel can perform equally well for substantially less money. What academic libraries do need is fewer but better-educated librarians who can step into the collection-develop- ment, substantial-reference, and bibliographical-consultant positions that are now largely unfilled. 3 In other words, genuinely profession- al performance or the utilization of improved educational levels is a rarity. A different pattern, designed to recog- nize and make use of specialties rather than generalities, is required. 4 It is the purpose of this paper to pro- pose a plan whereby reference librari- ans can perform in a more professional manner and at the same time raise their level of productivity. SERVICE FUNCTIONS The public service or reference func- tion is to act as an interfaQe. among the three comers of a triangle-the collec- tion, the catalog and indexes through which the collection is made accessible, and the user. To make this interface ef- fective requires three levels of activity: Iocational advice, instruction and guid- ance, and in-depth assistance and consul- tation. I ~ Each level requires more and more specific knowledge, with the third level often requiring the skills of an infor- mation specialist. It is at this level that the user is in need of a co-worker to aid in locating information; a specialist to assist with a particular problem; or a consultant to confer with on how best to organize a search strategy, select appropriate informational tools and sources, or interpret, evaluate, and apply inform ation. In theory, in the legal profession it is assumed that, once a lawyer has quali- fied to practice la"v within a state, he is competent to handle all types of cases ranging from drawing up wills to civil suits and criminal cases. In reality, a quick survey of legal figures, past and present, makes it evident that specializa- tion does take place. Libraries follow a similar fiction in saying that the professional is pre- sumed to be equally capable of under- taking work in acquisitions, cataloging, reference, circulation, or administra- tion; or in humanities, social sciences, or science and technology. But, can the English major become the instant sub- ject specialist serving engineers or econ- omists? The medica l profession has ap- proached this matter rather differently and, it would seem, more effectively as well as more honestly. In a field where specialization has become the rule rather than the exception for a majority of physicians and ·· their supportive staffs, _there has been an attempt to free the doctor of .as many of the routine de- tails, procedures, and technical matters as possible. This leaves him with only those duties which require his profes- sional knowledge, training, and judg- ment. In order that his skills can be used most effectively, he will often fur- ther specialize and become concerned with only certain aspects of the · pa- tient's health. Increasingly, the general practitioner .acts as a referral agent for Library Group Practice I 55 the more specialized members of the medical profession. A universal ground- . ing in general practice provides a com- mon language to make possible commu- nications, referral, and consultation. "The need to make specialized prac- tice workable and adaptable to total pa- tient care" is one reason suggested for the growth of group practice in the medical profession. 5 In other words, physicians practiced as individuals until specialization made it desirable to work together. Librarians, on the other hand, work together even when specialization is so slight as not to be an influence. One explanation might be that the method of compensation and the own- ership of tools (books) dictates where and with whom librarians work. But, whereas physicians come together in or- der to better utilize their specializations, librarians are already together and have done little in the way of studying how best to utilize their collective capabili- ties. There are distinct similarities between a medical group practice and a library. The chief ones are: the client (patient/ user) comes in need; rapid increases in .accumulated knowledge have led to spe- cialization or the need for specializa- tion; specific practices, procedures, and services can be categorized according to the level of professional judgment re- quired; continuing growth of knowl- edge and technological development point to an even more complex future requiring even more specialization; and finally, the client expects that future services will exceed past services, espe- cially in quality. · The essential points of dissimilarity remain, but they really boil down to the treatment of disease vs. the servicing of information. This difference in content in no way invalidates the marked simi- larities in service patterns noted above. That beirig the case, we should consider which service features of the prosper- ous and successful field of medical 56 I College & Research Libraries • January 1973 group practice can be adopted by librar- ians whose prosperity and success are rather less notable. The medical group practice model evolved from a systematic sorting of medical and supportive activities accord- ing to the form and type of training re- quired-by the level of professional judgment required · to perform each ac- tivity. Each level of activity is staffed by persons specifically hired and trained to perform that level of activity. Thus, the medical group (and its supporting staff) may include such varied positions as neurologist, pediatrician, laboratory technician, pharmacist, registered nurse, receptionist, bookkeeper, and janitor. The guiding rule is that no one pre- sumes to offer judgments above or be- yond those he is professionally trained and qualified to make. Thus, a nurse may recognize the symptoms of a dis- ease, but only a physician gives voice to a diagnosis or prescribes treatment. This is a crucial factor in the success of the medical group practice structure in its day-to-day functioning for without a careful and systematic regard for this distinction among the many levels of professional judgment the group prac- tice structure would fail in its objec- tives. LmRARY GROUP PRAcriCE CoNCEPT Library group practice would also re- quire that activities be sorted systemati- cally according to the form and type of training required-by the level of pro- fessional judgment required to perform each activity. The group of activities surrounding locational advice is largely amenable to performance by nonprofessional per- sonnel since scant (if any) professional judgment is required to direct the user to the water cooler, the card catalog, the dictionary stand, or the director~ s office. The group of activities surrounding instruction requires more professional judgment than locational advice, bu:t not enough to require exclusively pro- fessional personnel. Much of the rou- tine instruction in the use of the card catalog, indexes, and other basic tools is highly repetitious and can be compe- tently handled by a trained library as- sistant or technician. (Indeed, this can often be recorded and made available on-demand to meet the user's specific needs.) . More detailed guidance requires some- what greater professional judgment in the form of a professional person but one with only a general and basic grasp of library science, i.e., the librarian lacking experience or a particular spe- cialization. There can be a close parallel between the librarian performing this guidance function and the general prac- titioner providing only basic and refer- ral medical services, for it is at this level that a determination must be made as to whether or not the patron is in need of research assistance or consultation which require professional judgment and often a high degree of specializa- tion as well. The most efficient way of supplying this highest level of service is to have well-trained and specialized professionals who are on call or avail- able by appointment to deal with spe- cific user needs. When a patient enters a medical group practice facility, he expects to be met by a receptionist who will direct him to particular persons and offices and who will make appointments for him. The professional is removed to a loca- tion where he can be more effective in working with individual patients with- out unnecessary distractions, noise, and confusion. Similarly the library user, on entering a group practice library, should expect to be met by an information clerk who will determine what levels of service are required, direct the patron to the person who can be of assistance, and set up an appointment with the appropriate con- sultant-specialist. Again, the profession- I I ~ al is removed from unnecessary distrac- tions so that he can function more ef- fectively and is free to exercise his oth- er professional responsibilities which may include going outside the library as a floating librarian. 6 For librarians to set up a group prac- tice, it will be necessary to reorder pri- orities and assumptions. A librarian will be required to function at the level for which he is trained and onJy at that lev- el. No longer can we insist that ''every user have contact with a professional li- brarian." No longer can · professionals absorb (willingly, eagerly, or otherwise) huge quantities of clerical routine ''be- cause it has to be done." No longer can the highly qualified and thoroughly ex- perienced specialist devote a substantial share of his time to ''sitting at the ref- erence desk." Group practice requires that instead of · everyone sharing and { sharing -alike, each assume the responsi- ' bility for that level of work for which he is professionally qualified. The ideal composition of the library staff and its organization would be cleri- cal-professional ratios of at least two- or three-to-one (as recommended by the Canadian Association of College and University Libraries) .7 ·The ALA state- m.ent on Library Educatil)n and Man- . power describes a logical and sound pro- gression from clerical assistant to senior librarian and, in a supplementary state- ment, equivalents are also delineated so that individuals lacking training in li- brary science but possessing an equal level of training in another discipline can be placed within the library struc- ture at a suitable level where they can work and be compensated appropriate- ly.8 The essential corollary is that each staff member understand that he must not overstep his training and compe- tence: he must not presume to offer ser- vice beyond the level for which he is qualified. Formation of a group practice must have the enthusiasm and support of the Library Group Practice I 51 professional staff if it is to be effective; the librarians in turn must promote the group practice idea. At first, it will be necessary to secure the sympathy, coop- eration, and understanding of academic administrators, boards of trustees, civil service commissions, and employee asso- ciations and organizations who must be convinced of the advantages of group practice. The mutual advantages to be gained from each person doing those tasks for which he is trained and quali- fied should become self-evident to them. Group practice will permit optimum use of each staff member,s training, ability, and experience. As the more ex- pensive professional is relieved of tasks which can be performed satisfactorily by other persons, the return per dollar invested will be improved. Also, such re- assignment will tend to enlarge the total reservoir of professional staff. The quality of service will have been im- proved, which should attract additional users. If not, it may be necessary to trim surplus staff. Either way, the per-unit cost of service will be held down. Clear- ly then, the group practice concept can· contribute directly to an increase in the rate of productivity of librarians and enhance the quality of service at the same time . SUMMARY The concept of library group prac- tice, the systematic working together of specialist librarians and supportive staff in a format modeled after medical group practice, has been briefly ex- plored. The purpose of forming a li- brary group practice is to enhance the service capabilities of the library by making optimum use of all levels of staff and thereby improving the cost- benefit ratio and increasing the librari- an,s rate of productivity. Technological and postindustrial so- ciety cannot exist without information; in fact, much of the commerce in such 58 I College & Research Libraries • January 1973 a society will be in information itself. There is no question: information as a utility will continue to exist. If li- braries are also to continue to exist, they must turn out a marketable product which the user can afford. REFERENCES 1. Frederick G. Kilgour, "The Economic Goal of Library Automation," CRL 30:307-11 (July 1969). 2. CRL News June 1971 and Sept. 1972. 3. Eldred Smith, "Academic Status for College and University Librarians-Problems and Prospects," CRL 31:11 (Jan. 1970). 4. John H. Moriarty, "Academic in Deed/' CRL 31:17 (Jan. 1970); Herbert S. White, "Professional Identity: Revolt of the Scien- tists," Wilson Library Bulletin 44:554 (Jan. 1970). 5. Group Practice: Guidelines to Forming or Joining a Medical Group produced as a com- bined effort of [the] American Association of Medical Clinics, [the] American Medical Association [and the] Medical Group Man- agement Association (1965). 6. Robert P. Haro, "The Floating Academic Li- brarian," American Libraries 2: 1169'-73 (Dec. 1971). 7. Canadian Association of College and Uni- versity Libraries. University Library Stan- dards Committee: Guide to Canadian Uni- versity Library Standards ([Ottawa?] 1965), p. 5. 8. "Library Education and Manpower," Ameri- can Libraries 1:341-44 (April 1970); "Sup- plementary Note," American Libraries 1:665 (July/Aug. 1970).