The Play

Pizza, red wine and cordon bleu all have one thing in common : they do not go through telephone lines. That's the reason we will continue to pay for them.

MP3, PDF and HTML do go through telephone lines, and that's why we will probably not pay for them in the future. The music industry will face a tough battle against millions of young people and seems to be left with just one alternative: ride the wave of Gnutellas and Co.... or lose!

Print editors in medicine may soon face similar problems. The medical community has begun to realize that it is surprisingly self-sufficient in distributing the information it produces. We all know the basics of word processing and Internet connectivity, and most of us are capable of making PDF files of our articles. So what will be the role of medical editors in the future?

Think about it:

• WE write the articles, mostly at night and during weekends. We neglect our families, sacrifice part of our vacation. Partly, we do that for vanity and for careers, but nonetheless, WE write the articles, and we do it for free.
• WE are the reviewers. How many times have we spent our evenings reviewing articles and writing comments! Again, we are performing a crucial part in the process of producing medical information, mostly at night and during weekends, of course. But we do it, and we do it for free.

To become a true medical editor, the only thing our medical community would need to do at this moment is to organize the reviewing process for incoming articles and produce an Internet frame to publish accepted articles. So the question, again, is: What will be the role of medical editors in the future? Do we still need them?

Let's take a look at the people involved in one of the most exciting games ever played in Medical Literature!

The characters of the play

Your curiosity alone qualifies you for obtaining the content of medical journals for free.

If you are a passionate reader of scientific medical articles, what can you do to promote the free availability of medical journals over the Internet?

• Promote true free medical journals with your friends and colleagues and among your students.
• Promote the idea that medical information should to be freely available to everybody, citing for example PubMed and other free medical content sites.
• Promote this idea with people of the media you know.

Once you have finished your article, you normally have in mind a couple of journals to whom you wish to submit. If two journals are roughly equivalent in terms of prestige and impact, and one journal is a true free medical journal and the other is not, submit your article to the free journal.

Many of us write and publish articles to enlarge our publication list, because this is generally crucial for careers. In the pre-Internet era, the more prestigious the journal was, the more readers you would have and the greater the impact of your article.

Today, this equation has changed, and free medical journals are, for obvious reasons, read more often than others. For your career, this may not be an important consideration, but if your are convinced and proud of what you write, you should aim at the highest number of readers. In the future, you will achieve this more easily with true free medical journals.

Once your article has been accepted and published by a journal that is not free, write a letter to the publisher. Ask him

• why the journal is not free
• if there are plans to make it free

Tell him that

• the impact of his journal would be greater if it were free
• new business models exist that can generate enough money to help the journal to survive in its current form even if the content is put free on the Internet

(if your journal is a true free medical journal, please refer to the section "Big Publisher")

If you are a publisher of a medium-size medical journal that does not generate a huge amount of money, we advise you to make your journal freely available over the Internet. There are several advantages to this approach:

• The news that your journal has become a free journal will spread like wild fire throughout the medical community and your visibility will be greatly enhanced. If your journal is already on the Internet, take any password protection away.
• If your journal is not online yet, buy the Acrobat reader (www.acrobat.com) and tell one of your students to prepare an even rudimentary web site. Don't bother about layout. What counts is the availability of your content.

If your journal is already a true free medical journal: Congratulations! Yours is a tremendous contribution to progress in medical science throughout the world, and we all owe you sincere admiration.

What more can you do? Pick up the phone and try to convince your colleagues from other journals to make their journals free, too. Tell them why and how you did it. Try to help find for them a solution to the economic problems that may be the reason for their journal still being closed to the public.

If your journal is not a free journal:

As a Big Publisher, you are already offering the content of your journal on the Internet. You are obviously the bad guy in this game, and you have plenty of reasons to explain why you had to put up walls around your content. Yours is a deliberate decision, and copyright considerations are on your side.

But, please, think about your future again, and future means visibility. Are you sure there is no way to make your journal available to everybody? Some journals are free, so why not yours? Are the wrong people deciding about the future of your journal? Have you had the wrong advisers? Why not contact Editors from true free medical journals to hear about their experience?

The Outcome of the Play

Over the next few years, many important medical journals will be available online, free and in full-text. The access to free scientific knowledge will have a major impact on medical practice and attract Internet visitors to these journals. Journals that restrict access to their Web sites will lose popularity.