Cutting Muscle and Bone

One of our favorite movies is Raising Arizona.  We can sit back and watch it any time and we often quote movie lines to each other when it fits a situation.

In Raising Arizona, Nicolas Cage plays  H.I. “Hi” McDunnough and has quite a few interesting expressions and quips. One has been on a loop in my brain lately.  It one that in the first few minutes of the film. “These were the happy days, the salad days as they say, and Ed felt that having a critter was the next logical step. It was all she thought about.” A few moments later, Hi’s voice says, “Our love for each other was stronger than ever, but I ‘preminisced’ no return of the salad days.”

Sometimes I wonder if there were ever a salad days in medical libraries.  I know medical libraries had budgets, the money just wasn’t falling from the sky.  However, it seems these last few years medical librarians have seen their budgets continually cut.  Even “lucky” libraries who have had a flat budget for the past few years, are being told to cut their budget by a percentage.  Those are the lucky ones. They have weathered the storm well until now. Hospital reimbursement from the ACA are impacting the hospital budget, they are seeing less reimbursement.  Less reimbursement means less money, less money means they are cutting budgets.

Yet as hospital library budgets have been cut, the cost of resources have continually increased.  Depending on the vendor it could be anywhere from the rate of inflation to a 75% increase.  Librarians have done their best to watch all of their resources and cut anything that is under performing.  Journals that cost more per use than ILL fees…gone. Databases that don’t have a certain cost per use…gone.  Resources that up their prices to align with competitors because the competitor is more expensive…gone  If medical libraries were a steak, they would be the leanest toughest piece of leather on the plate. There is no fat left.  There is no chef’s steak sauce to compliment the “unique” flavor.

So what happens when you have trimmed the fat?  You trim the muscle and the bone.  The cuts in medical libraries have caused librarians to cut things we would never have cut 1-2 yrs ago. Guess what…We have now cut all of our under performing resources. We are now cutting products based on price alone.

Of course, what else can you do when you don’t have the money?  Donors like to fund projects they could put their name on, not operating budgets or resources that are annual.  A bake sale ain’t going to work. Yet the prices of resources continues to rise. Vendors have told me about the “VALUE” of their product and how important it is.  Big flipping deal.  I know it is valuable, I wouldn’t be talking to them if it wasn’t. Don’t talk to me about value.  But they persist, as if hammering me about the “VALUE”  will magically cause me to find money to pay for their 30% increase.  My answer: My car is a value to my job and my life.  But, if it breaks down and my family budget cannot pay for repairs or a new one, I have to take the bus.  Do I want to commute 1 1/2 hours each way via public transportation every day? Hell no, but if that is all I can afford that is what I do.

If I can’t afford your “VALUED” product, I am going to make do without it.  Sorry, but it could be the most valuable thing on the face of the planet but if I can’t buy it, I can’t buy it.

I know of a few great medical librarians, who are looking for new jobs out of librarianship.  They aren’t looking because they were laid off (although there are those too).  They are looking because they see no future in medical libraries.  The shrinking budget (even in well funded institutions) and rising cost of resources makes them feel like they can’t do their job.  Some question whether the rise in costs will inevitably force libraries to shift the costs to the institution as a whole. Thus the shift of the product’s cost to another cost center.  What will happen when that happens for every resource, in the library?  Don’t laugh, at 15%, 20%, 30% price increases when faced with a 3%, 5% or 10% budget cut, the pot of resources gets smaller and smaller.

It would be interesting if there was a survey where librarians could anonymously mention what percent their budget was cut and list the resources they cut as a result.  They don’t have to list costs.  Just the percentage they lost in their budget and the products that were dropped as a result.  I know the resources cut will vary by institution, but it would be interesting to see if there was a pattern.  What things people are holding onto until the bitter end?  What type of vendor cannibalizing is happening within the library?  Not only will it be interesting to see what products are eating the other, but what two (or more) products from the same company are eating each other.  For example: Does a rise in the cost for UpToDate effect LWW titles purchased?  Does a rise in the cost of AccessMedicine effect AccessSurgery (or other Access database)?  It could be any resource or vendor.

The funding model is unsustainable for hospital libraries.  Time will tell whether the reduction in reimbursements from ACA will make shifting the library resources cost to another department in the hospital unsustainable.  Who wants to take on another department’s cost for a product when they are also rquired to cut a certain percentage out of their budget?

In my Sacred Cows and Heretical Librarians post I mentioned we need to think evaluate our sacred cows.  At the time I meant services or how we do librarianship, but we probably need to apply the same principle to our resources.

 

 

One thought on “Cutting Muscle and Bone”

  1. I have cut 2% every year for three years. My library is the most non-functional library in the history of libraries, but I was forced to cut the money for renovations out so I could continue to pay for ClinicalKey.

    The first two years of cuts weren’t that hard because there was a lot of waste, especially when it came to print journals, but now it’s down to cutting things like office supplies, postage, and mileage reimbursements.

    I guess we don’t need to make copies, the OBGYNs don’t have to get their ACOG articles, I can drive all over central Alabama to my hospitals and not get reimbursed for it…

    Those are the things that are going through my head now. There are no resources left to cut; EVERYTHING gets used and used a lot.

    I cut my 2014 budget by $5000 on Monday and I’m terrified it’s going to come back saying that’s not enough. I don’t know what I’m going to do because EBSCO won’t lock in any of my prices nor will they give me an idea of what the increases are and there is no way I can budget a resource based on the fact that I hope I will be able to renegotiate the price.

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