I’m not sure why, but I have an affection for the Merck Manual. It’s not massively popular on TRIP (eMedicine is more popular). But it’s recently been updated to the 18th edition (most updates are 2005); the previous edition – 17 – was in 1999.

There’s something verging on ‘old fashioned’ about completely re-writing a book every 5-6 years. I suppose this reflects the ‘old media’ style approach to things. Some clinical areas move very rapidly while other move much more sedately. Surely it’d be better to have more frequent updates of the ‘rapid’ areas. I suppose the problem with that is that it pushes back the development of the ‘sedate’ chapters.

Still, it highlights the problem of ‘central control’. Merck retains control of the content – making it very expensive (no doubt) to update, making it rapidly out of date etc.

eMedicine, another eTextbook, takes a different approach. It retains control, but updates happen with fair regularity. It appears that a senior clinician is given overall control. I imagine if s/he hears of new information they’ll want it added to ‘their’ chapter.

Then we have wikis such as Ganfyd. Lots of doctors contribute and ‘own’ it – there is no central ownership, but likewise little resource. So contributions are made in the docs own time. As it stands there appears to be a lot of titles (they’re easy) and relatively few ‘solid’ articles. It’ll be very interesting to see how Ganfyd ‘matures’ over time.

Let’s compare the entries for hirsutism:
Merck Manual

Hardly a scientific test but the Merck Manual will possibly stay the same for the next 5 years, Ganfyd will change slowly, while eMedicine seems the most comprehensive/useful! In fact the Merck Manual (recently published) was last updated November 2005, while eMedicine’s last update was July 2006.

Anyway, that aside, I’ve got the Merck Manual to add to TRIP – only another 1,000 links to manually add!