By Julian Fisher, MD
Illnesses that public figures have are much in the news of late -- Ronald Reagan and his Alzheimer's disease the most noteworthy -- and I recently came across a brief description in a neurology journal of a medical problem that Franklin D. Roosevelt began to experience as he looked toward his fourth term -- brief episodes of confusion that presumably represented epilepsy. These symptoms were thoughtfully explained in the article, written by a neurologist, Steven Lomazow, who has co-written a book on the subject.
But for any of you to read that article would cost you dearly. Why? The dirty little secret of scholarly publishing.
Let me explain how this obscure corner of publishing works (or doesn't) and let you be the judge. [Cautionary note to business school grads: The market has long been monopolized by mega-corporations making mega-bucks. But new business models abound. In the spirit of full disclosure, I started a not-for-profit to offer an alternative to the traditional models.]
You might argue that academic publishing affects only academics, but it does not. Anyone with an interest in or question about health or art history or building a house or running a business -- the list is endless -- might want to learn the newest knowledge -- something they might find in an academic article. Unless you already had a subscription (might run into the tens of thousands of dollars) to that specialty journal or had special access through a college or university, you might well have to pay anywhere from $20 to $50 for limited access to that one article. If you needed to look over several articles and were not sure which one would be of interest, the meter would tick up quite a toll and very quickly.
So why, you ask, is this so costly? The answer is relatively simple. In the pre-Internet age, when a professor needed to publish new research (publish-or-perish has long been a byword for success and promotion), the scholar needed to submit the findings in the form of an article to a journal where editors (scholars in the same area of study) assigned the article to reviewers (more scholars in the same area) to determine whether the piece contributed to advancing knowledge in that area and should be published.
Fairly simple argument so far? Now let's pull the curtain aside and look at costs. The scholar who submitted the article customarily had a grant or salary that funded the research, and there was never an expectation that the journal would pay the scholar for the article (as opposed to a commissioned article in a magazine like The Atlantic or similar). The journal editor generally works without additional remuneration - the honor of being editor of an important journal in that field - and the reviewers (also unpaid) similarly view their activities as part of their academic duties, to advance the field.
So why do you have to pay $50 to see the article? In the old days, publishers had to print it -- something academics did not know how to do or want to ... and the publishers printed the articles (in journals). You the reader had a choice: subscribe to the journal or pay by the article. Either way, it was a good business -- for the publisher, with percentage profits well in excess of any major computer company.
What are the costs in this new Internet age? As you might suspect, they have plummeted (an article I wrote several years ago here is helpful), to roughly 1/100 of what they were if you produce the article as an electronic document only rather than in print. Print is no longer necessary or even desired. Why, then, the $30-$50 financial firewall that you need to pay to see the article I want to show you? In part, tradition. In part, publishers keep doing what they do and the scholars do not complain much, since their subscriptions come through their grants or university libraries. But the libraries complain, individuals like all of you reading this should complain, and everyone in the developing world complains.
There are some initiatives to change this situation. The National Institutes of Health now insist that research they fund, when published, must be made available somewhere at no cost. Some journals are made available online selectively to lesser developed nations. But there is no mad dash to change the system, even with the open-source software that supports the online publishing process and even multi-site synchronized archiving. The traditional publishers continue to make their traditional profits, and I still cannot show you the article. But you can buy the book about FDR for 1/10 of the cost of the article. Now isn't that a great idea?
Julian Fisher, MD is a Boston-based neurologist and medical information entrepreneur.