Open (Access) Sesame

Miles, the central protagonist in the movie “Sideways,” is a writer who is down to his last gasp at publishing fame. When he receives the bad news that his masterpiece has been finally and irretrievably rejected, he drinks the spittoon at the winery where he is exercising his remarkably sensitive palate. Not all writers take such desperate measures after their work has been rejected. Indeed, a segment of the publishing industry, the “vanity press,” will publish any work for a fee, and some of these publishing houses will even market the work for the author. Unfortunately, according to my friends in the publishing industry, as publishers are increasingly languishing in the economic doldrums, we may soon be left with fewer outlets for reviewed and accepted work, and a greater proportion of fiction as well as nonfiction will be published only on a fee-for-service basis.

In contrast, when a scientist or medical investigator submits work to a scholarly journal, the manuscript is reviewed by experts in the field (peers) before acceptance (or rejection) for publication. Although medical and scientific societies, such as the ACR, publish journals on a nonprofit basis, there is a thriving for-profit publishing sector that also publishes peer-reviewed work. The Nature Group, Elsevier, Springer, and others all publish well-respected medical and scientific journals that are profitable. The business model to date has been to charge author(s) a fee to cover expenses and pay for reprints or other related costs, while the bulk of the revenue and profits are derived from subscriptions. If you have spoken with the librarian at your institution, you will understand that these subscriptions are quite expensive. Access to many of these journals is limited, and unaffiliated members of the public or physicians and scientists without access to a large library frequently have a great deal of difficulty even reading articles published in these journals without making some sort of payment.

Open Access Publishing

More recently, online, open access publishing is gaining acceptance in the medical and scientific community. In the open access paradigm, there is no cost for access to publications over the Web, and the revenues to support peer review and other costs, as well as profits, are derived from fees (quite hefty at times) paid by the authors. This business model satisfies our growing expectation that everything we want on the Web is free and provides the public with direct access to this work.