I have been researching different pulmonary function topics for quite a few years. The medical libraries I’ve frequented were, of course, originally all paper-based and to be able to find an article the library or one of the department’s physicians had to subscribe to the journal in question. In the last fifteen years we have all seen an explosion in on-line publishing and it has become much easier to research articles. I vigorously applaud the pulmonary medicine journals (Chest, American Journal of Respiratory and Critical Care Medicine, European Respiratory Journal, Journal of Applied Physiology, Thorax) for having opened part or all of their archives to anybody who wants to search and download articles.
There are a number of other journals, however, that remain entirely behind paywalls. I was reminded of this recently while looking for an article on diffusing capacity from the 1970’s only to find that it would cost me $31 to access it (and then only for 24 hours). Although strictly speaking this does not prevent anyone from accessing these articles, anybody who does has to have deep pockets and this is acting as a significant barrier to the ability of individuals and institutions to obtain and to share information.
Science in general and medicine specifically has advanced and improved because of open collaboration where information, results and techniques are shared. Medical journals came into existence as the publishing arm of different medical societies for just this purpose. Over time it seems that medical journals have developed a life of their own and just how much they owe or belong to the medical society and the principals that created them has become questionable.
The field of publishing is in a rapid state of change and publishing houses everywhere are living in fear of these changes. There are now a number of open-access on-line journals that do not charge for reader access. There is also a movement of researchers and authors who are deliberately refusing to submit articles to journals that are kept behind paywalls by their publishers.
So why are medical journals so expensive? The journals and publishers would say that it is necessary to ensure that they are adequately compensated for their work and the role they play which is maintaining a scholarly reputation, arranging peer review, and for editing and indexing articles. They will probably also say that they can ensure fair access for developing nations through differential pricing or financial aid from the more developed countries.
It’s not so clear to me the costs are what they say they are. It used to be that typesetting was an expensive and somewhat arduous process but for some time now desktop computers and software have been able to do this job relatively quickly and inexpensively. Many if not most editorial staffs that review and select articles for publication are not paid. Authors are not paid for their work and I have heard that some journals are now charging authors “page costs” in order for their articles to be published. I would have thought that physically publishing a medical journal would be expensive but have found several on-line print-on-demand services that will print and bind a 100 page book for less than $3 each in quantities of 100.
This is not to say there are no costs and I would probably guess the time spent by reviewers and editors to be the most significant component, but the only thought I have been able to come up with for the rather exorbitant amount charged by the top tier journals is that it is because they are premium brands with a monopoly on archived articles and as such, very profitable.
The “brand recognition” factor for the top tier journals has been built over time and cannot be easily duplicated by any competing journal, particularly a new one. The top tier medical magazines are “premium brands” where it is far more likely for an article to be read by a wide audience and far more prestigious to have an article published there in the first place.
Does this prestige mean that the quality, pertinence or importance of the articles that are published in a top tier journal is that much greater than published elsewhere? To some extent the answer has to be yes. The top tier journals are usually able to attract a high quality editorial staff (even when they aren’t paid in dollars they are paid in prestige). Because they have a wide audience they also tend to attract more important and pertinent articles as well.
Does this prestige mean that the articles published in the top tier journals are always of high quality, pertinence and importance? No, it doesn’t. The top tier journals have been hit as often by scientific fraud as any of the other journals. Articles co-authored by physicians or scientists who have published in the same journal previously are more likely to get published regardless of whether anything new is being said (I have seen a half a dozen articles that all came from the same study, each given a slightly different spin, and published in different journals simply because one or more of the co-authors was a “name”).
Of greatest concern to me is the monopoly on older articles. I sincerely doubt that the original authors wanted their work to be sitting behind a paywall, and probably more so since they are not benefiting from the situation in any way. It may even be a negative benefit because one important measure of value that authors have is the number of other authors that cite their article and articles behind paywalls are less likely to be read and cited. But authors sign their rights away in the very beginning so they certainly don’t have any say (although it is not clear to me how legally valid this is since research is often paid for by government or institutional grants and the authors may not actually have the ability to sign away the rights to the research results, but then I most definitely am not a lawyer).
I would like to see all of the medical societies review and re-think their stance on their medical journals. The original purpose, which presumably was of collaboration and sharing, is not being well served by the current system. This issue is probably not particularly high on anybody’s agenda, however. I really have no idea how profitable a journal is for any particular medical society but it is likely that for every top tier journal there are a number of people involved that have a vested interest (whether it be political, financial, institutional or social) in the system as it currently exists. I am probably being cynical but I am not expecting any significant changes to come from the traditional medical journals. Unless they prepare for change however, they may well find that they have become irrelevant.
The most successful of the open-access on-line journals have taken an approach where the author pays but the reader doesn’t. In general these publication fees are based on which journal they are intended for and the country of origin. For PLOS Medicine, an article is $2900 for an author from the United States or Europe but only $500 for an author from a third-world nation and there is no fee for an author from a fourth-world nation. BioMed Central has a similar structure and for BMC Pulmonary Medicine the charge to an American or European author would be $2055 and for Respiratory Research it would be $2445.
These fees go to each journals peer-review system and for editing, publishing, maintaining and archiving the articles, just like the traditional journals. Although this system does impose a potential burden on the author (since many research grants require public dissemination of the results the publication fees are often included in the grant), the author retains the rights to their publication. There are also few limits on the size of the article and the addition of a study’s raw or supporting data is encouraged. Multi-media files, including video can be included as well.
Another approach that I should mention in passing is that a number of universities and medical institutions have established open-access repositories for their research and the articles written there. Although there are no author costs involved I think that this also tends to fragment information and may be too highly dependent on external search engines like Google Scholar.
Although it appears the author-fee system used by the open-access on-line journals keeps the overall costs low, most particularly for readers, it may be that in the long run a hybrid system, one that combines author fees and a (very) small reader access fee might be fairer and more sustainable.
We are still in a transition period between the traditional paper-based publishing systems and on-line publishing. I have been an ebook reader for several years and have watched the changes occurring in the mass-market publishing field during this time. I understand the concerns of both publishers and authors yet to be asked to pay the same for an ebook that somebody else pays for a hard-cover copy of the same book continues to rankle me. There are publishers that have embraced the ebook model and seem to be making a profitable business of it so medical journals should be able to do this too. What medical journals should not expect however, is business as usual and I think they would do well to remember what their original purpose was.
Open-access on-line journals:
BIOMed Central (www.biomedcentral.com/)
Directory of Open-Access Journals (www.doaj.org/)
Highwire Press (highwire.stanford.edu/lists/freeart.dtl)
PubMed Central (www.ncbi.nlm.nih.gov/pmc/
PFT Blog by Richard Johnston is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.