Open access: the alternative to subscription-based medical publishing.

Abstract

one of the world's first scientific journals, 2 the subscription-based journal has been the traditional model for disseminating scientific and medical knowledge.3,4 Granting access only through subscription can place significant barriers to information sharing, thus putting research, teaching and patient care at risk.While the internet age has made information universally available, medical and scientific knowledge has proven to be an exception.Subscription rates to scholarly journals continue to increase annually by 8-10%, far exceeding inflation rates measured by the Consumer Price Index.5,6 Publishing in science, technology and medicine is a seven-billion dollar global industry 7 with publishers averaging 20-30% profit margins.8 In 2003, the University of Iowa paid nearly 1.1 million dollars to Elsevier, one of the largest publishing companies in the world, and Cornell nearly 1.7 million.9 The University of California libraries collectively paid eight million to Elsevier and 64 million for all their scholarly material.8,10 With a growing number of libraries, including Cornell, Harvard, North Carolina and MIT, forced to cancel subscriptions, 11,12,13 it is clear that we are in a crisis situation.One potential solution is the open access model.According to the 2003 Bethesda Statement on Open Access Publishing, 14 an open access journal must fulfill two criteria: 1) the author and any

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