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We need open access to published medical research

August 5, 2010

Free Access to U.S. Research Papers Could Yield $1 Billion in Benefits via Medically Mind Numbing

I’m not sure about the validity of this study.  Quantifying how much money will be saved by increased efficiency due to open access seems like fuzzy math at best.  However, we do need better access to medical journal articles.  As a researcher, I’ve constantly fought the battle against firewalled journals.  I am fortunate to be part of a university that has excellent access to most of the published medical research I need.  But I still come across what is the researchers’ equivalent of the “blue screen of death”:  the “login or purchase this individual article for $30” screen.

Before I go on, why do I have to pay $30 (or more) for a single article?!  Isn’t that a bit excessive?  I would consider paying $2 or $3, but $30?!  Do you realize I would pretty much have to write a separate grant just to gather the background research I need at that price?

Fundamentally, the publishers must realize they need to adapt.  Just like the music industry and now the newspapers and magazines, medical journals must figure out how to leverage technology to deliver their content more efficiently.  They also need to understand their customers better.

I am a relatively large consumer of published medical research.  I use it for writing research articles, researching topics for clinical application, keeping up with the latests developments in certain fields and, occasionally, blogging.  Do you know what happens when I come up against a login screen that wants to charge me $30 for a single article?  I find another article (from another journal) to use in its place.  And smaller journals, this is where you are really losing–most medical institutions buy subscriptions to the major journals.  Since I’m more likely to have access to these big journals and they are more likely to carry the most important published research on any given topic, I do cite them more often (regardless of whether or not they are open access).  So, small journal, when you are lucky enough to publish a major paper and I go to your website to find it–running up against the inevitable login screen asking for $30–I don’t end up reading it, which means it doesn’t get cited.  And the major factor in determining a journal’s impact factor–citations.

So, what should the publishers do?

  1. Stop printing journals!!  Is this not obvious?  It’s expensive, labor-intensive, not environmentally friendly and inefficient (both in delivering content and for consumers to manage content; stacks of journals are not searchable).  Some people will still want to hold print copies in their hands.  Charge them the equivalent of $30 an article!  A “print” subscription should be at least 20 times more expensive than an “online only” subscription.
  2. Get together and form a consortium to deliver content electronically over a unified platform.  The goal here is to create the medical journal equivalent of iTunes.  This platform must have the following functionality: (1) the ability to search all participating journals and save searches (think the ease of Google with the comprehensiveness and functionality of PubMed); (2) the ability to purchase (or activate) subscriptions and individual articles (like purchasing albums and songs on iTunes); (3) a research library management system that integrates with Microsoft Word to build bibliographies (EndNote is what you’re aiming for here); (4) a PDF reader that will allow you to highlight and annotate articles within the program; (5) the ability to share research libraries with colleagues easily; (6) an RSS feed reader (the goal is to have a simple way to view Tables of Contents from the user’s selected journals each time new content is added, RSS feeds are the easiest way to currently do this); (7) a way to flip through content as though it was an actual electronic copy of the physical journal (people who like traditional journals will appreciate this); (8) cross platform development so that content can be properly viewed from computers, smartphones, iPads and other tablet devices (the key word here is “properly”).  A good start for accomplishing this goal would be to buy up Mendeley; these guys have the right idea.
  3. Make content open access after a given period of time.  It seems the government may be moving towards a 6 month embargo (from the current 12 months) for NIH funded research.  If you implement the changes above and make individual articles cheaper (which will be possible under a unified platform), the government may be more likely to leave it at 12 months.
  4. Become leaner.  It’s a reality for all media companies.  In the era of shrinking budgets, you will lose subscriptions if you can’t increase your value.

Dealing with subscriptions and firewalls only creates inefficiency.  Total open access is the dream.  However, we live in a real world where things need to be paid for.  Journals are not compiled, peer-reviewed and edited by volunteers.  Medical journals need to be more proactive in their approaches to making access more open.  Having a completely closed system is not forcing researchers to sign-up for subscriptions or pay $30 for a single article.  It’s forcing them to be inefficient and use other sources.

5 Comments leave one →
  1. August 5, 2010 10:33 am


    The “we” is researchers in all fields, not only citizens concerned about our health, nor only researchers and practitioners concerned about our health.

    The interest and commitment of some of the supporters of Open Access (OA) is derived from and motivated by the importance of making health-related research accessible to those who need it: patients, family, researchers.

    This is certainly an important component of OA, and perhaps the aspect that most directly touches our lives. But if OA is seen or portrayed as being mainly a health-related matter, it not only leaves out the vast majority of OA’s target content– which is all research in all research areas, from the physical and biological sciences to the social sciences and the humanities — but it even under-serves OA’s potential benefits to health research itself.

    Even the “tax-payer access” aspect of OA, though important, is not quite representative, because the primary benefit of OA to the tax-payer who pays for the research is not that it makes the research freely accessible to the tax-payer (although it does indeed do that too!), but that it makes the research freely accessible to the researchers for whom it was mostly written, but many of whom cannot afford access to it — so that they can use, apply and build upon that research, in their own research — to the benefit of the tax-payers who funded it and for whose sake the research is conducted. Again, a focus on the need for direct public access to health-related research leaves out the vast majority of research that is not health-related and that the public has no particular interest in reading — but a great interest in making accessible to those who can use and build on it so as to increase research progress, which may in its turn eventually lead to applications that benefit the public.

    Paradoxically, it is in recognizing and supporting OA’s much more general research enhancing mission that we can also best support its health-related potential.

    Harnad, S. (2008) Waking OA’s “Slumbering Giant”: The University’s Mandate To Mandate Open Access. New Review of Information Networking 14(1): 51 – 68 a

    Harnad, S. (2007) The Green Road to Open Access: A Leveraged Transition. In: Anna Gacs. The Culture of Periodicals from the Perspective of the Electronic Age. L’Harmattan. 99-106.

  2. August 10, 2010 7:54 pm

    I am an Internal Medicine physician and have shared your plight in trying to find access to research to help drive my clinical decisions for patients with rare or complicated problems. I often am looking for case studies and recurrently will find multiple similar cases, but rarely can access them without paying a fee.
    My frustration grew to the point that I have now started a website where medical research, case studies and posters can be posted for free, commented on for free and accessed for free. It is not perfect, but it is a start. Hopefully, it will be a repository for research/case studies that would not have been shared due to the peer review process, or for research that has been rejected by the peer review process. I hope others find this resource to be useful. So far, there has been much interest from around the world, but being only 2 months old the database is building slowly. Feel free to check out the site, as a user of research I would love to have your opinion on how it can be made better. The site is and is on twitter under researchvault.

  3. Ashwinikumar permalink
    March 20, 2011 6:44 pm

    I am from India.I had one interesting case ‘Chondroblastoma coracoid process of scpula mimicking osteoclastoma’ .Mind you, I have scanned whole internet many times but I have not found a single such case.I wanted to share it with others but many national and international journals refused to publish it giving one silly reason after another.And one day while I was browsing I found out and thanks to them I have published it. I hope some people have read my case.I congratulate for their effort.All the best for .By the way there was good journal of Orthopaedics Update India which used to publish many papers sent to them but it is no longer published now


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