Healthcare costs are already skyrocketing, so the last thing medical libraries need is a huge increase in the cost of acquiring the books and journals they require to keep clinicians well-informed.
Some medical libraries rely heavily on their version of the interlibrary loan program one finds at many public libraries. When the book in question is an e-book, however, that medical library has to negotiate successfully with the e-book publisher to permit interlibrary loans, which often take the form of producing a PDF of a particular journal article or chapter and providing just that PDF to the requesting medical library.
Some e-book publishers are having none of that, however, prohibiting interlibrary loans of their e-book titles. So the great benefits of e-books end up begin matched by the aggravating complexities of license agreements and digital restriction management. (Don't call it digital rights management.)
It came as a mild surprise to the medical librarian in question, Michelle Kraft of the Cleveland Clinic, that the new e-book that I'd learned of was being offered at the same price as the paper equivalent.
Kraft is a thought leader in this area, having presented to the Medical Library Association in 2010 on e-books. Kraft evaluates and implements online resources for use within the Cleveland Clinic health care system.