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Predictions that technology will do away with the librarian have been around for decades. In the 1957 movie Desk Set , Spencer Tracy plans to replace Katharine Hepburn and her staff of research librarians with a computer. Hepburn, with usual aplomb, shows him the error of his ways. But Hepburn didn’t face today’s challenging mix of economic factors and a scientific publishing industry that has been described as dysfunctional. The pressures on hospital and medical center library budgets are greater than ever. More than 40 states are reporting budget deficits, which translate to cutbacks at state universities and their medical schools. Endowments for private universities are suffering as the U.S. economy staggers its way out of recession. As if budget cuts weren’t enough, librarians are buffeted by yearly price hikes for subscriptions to the scientific journals and information services that their physicians and researchers rely on most. (See Online journal access: How much will you pay? in the October 2003 issue of Medicine on the Net .)