There have been many recent changes to PubMed to enhance its usefulness. Those changes include: LinkOut Libraries (local holding field), PubMed Central (full-text articles archived by the National Library of Medicine), and LinkOut (access to full-text articles right from the PubMed citation). Medical librarians should be aware of how these features work to best assist their clients. These new features offer the possibility of true desktop access for library patrons. Not only will patrons appreciate these new features, but their use in libraries will literally change what we do, who does it, and how it is done.