Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
BMJ Internet Access
- Colin A. Mackenzie (1 August 2003)
-
Free-actual versus free-virtual - August 1, 2003
- Phillip J. Colquitt (1 August 2003)
-
Paying for bmj.com
- John P Allen (1 August 2003)
-
Who should have free access to the BMJ
- Judith Ronat (1 August 2003)
-
Bad news
- Giuseppe Giocoli (1 August 2003)
-
BMJ.com Access : £12 Per Year
- Joseph .C. Obi (1 August 2003)
-
free access to bmj.com
- julian.g turner (1 August 2003)
-
I will pay
- Christian Weymayr (1 August 2003)
-
Researchers will submit their articles elsewhere
- Gunther Eysenbach (2 August 2003)
-
Paying for access
- Joseph More (2 August 2003)
-
To pay for B.M.J on line?
- kurri Pakira Reddy (2 August 2003)
-
It is very important to keep the independence
- José J. Santonja-Lucas, José J Santonja-Lucas (2 August 2003)
-
Re: Who should have free access to the BMJ
- Philip Smith (2 August 2003)
-
BMJ IS PROPERTY OF THE WORLD
- RAFAEL GONZALEZ (2 August 2003)
-
Access to bmj.com for specialists
- Eckehard Stuth, Milwaukee Wisconsin 53226 (2 August 2003)
-
A reasonable solution
- Aubrey Zabow (2 August 2003)
-
Thank-you For The Access
- Jim Harwood (2 August 2003)
-
Where are we heading?
- Disa Hoehne (2 August 2003)
-
Paying for BMJ.com
- P.C. Ghosh (2 August 2003)
-
A sensible surprise
- Christine Porter (2 August 2003)
-
Joining the others
- Linda MAnn (2 August 2003)
-
BMJ .com should be free to read for tropical countries
- himmatrao saluba Bawaskar (2 August 2003)
-
should include free medline access.
- dr.manan vasenwala (2 August 2003)
-
What happened to the 'author pays' model?
- Adam Jacobs (2 August 2003)
-
Close the site for doctors, keep open for the public ?
- Lára Halla Maack, 0 (2 August 2003)
-
bmj.com has got to be worth much more than £20 per year…
- Alan Walker (3 August 2003)
-
Sad News For Knowledge Exchange
- Rafael M Galliez, Cipriano Barata (3 August 2003)
-
The BMJ will experiment with the "author pays" model
- Richard Smith (3 August 2003)
-
Different models of "author pays"
- Richard Smith (3 August 2003)
-
Other kinds of "input fees"
- James E. Till (4 August 2003)
-
Re: Sad News For Knowledge Exchange
- Wladimir K de Paula (4 August 2003)
-
A marketing problem
- Debra Pannowtiz (4 August 2003)
-
Exemptions
- Halina M. Iwanowska, 170 77 Solna (4 August 2003)
-
6 month block is enough
- Fiona McLean (4 August 2003)
-
Relieved of Guilt
- Patrick M. Kelly (4 August 2003)
-
Its OK
- Martha L. Rogers, PhD (5 August 2003)
-
Sad end to a decade
- susanne steens, n/a (5 August 2003)
-
Patients learn also
- John Madura (6 August 2003)
-
Paying for bmj.com
- Graham P Beck (6 August 2003)
-
A Great Pity
- Antony F Sara (6 August 2003)
-
Please keep it free for developing countries
- Jai B Sharma (6 August 2003)
-
I understand that it is reasonable - nothing is for free
- Anna Belozerova (6 August 2003)
-
It is absolutely reasonable to charge bmj.com
- Catalin Popescu (6 August 2003)
-
Re: A marketing problem
- Ramesh Patel (7 August 2003)
-
Libraries and bmj.com
- Stephen C Due (7 August 2003)
-
thank you for a decade of generosity
- Rahimah Jafry (7 August 2003)
-
Think before you pay
- Murat Acar (7 August 2003)
-
A real shame
- Jessica C Lewin (7 August 2003)
-
Evolutionary Change in Medical Publishing
- John H. Lange (8 August 2003)
-
Re: 6 month block is enough
- Robert Munro (8 August 2003)
-
A case of a disappearing article – a sign of the Times? – August 9, 2003
- Phillip J. Colquitt (9 August 2003)
-
BMJ on Line
- Timothy M Southwood (9 August 2003)
-
fiscal need
- william s. craig (9 August 2003)
-
Another bubble deepens, later than many
- Adrian K Midgley (10 August 2003)
-
Thanks, but sad
- Francisco E. Fernandez (11 August 2003)
-
please keep it easy
- Thomas L. Perry (11 August 2003)
-
Thanks BMJ
- Patricia W. Njuguna (11 August 2003)
-
Re: 6 month block is enough
- Chris J.R. Willmott (12 August 2003)
-
Re: A case of a disappearing article – a sign of the Times? – August 9, 2003
- Robert Munro (12 August 2003)
-
Unfortunate
- sree kumar (12 August 2003)
-
Why a Free Medical JOURNAL?
- Walid Elias Kai (12 August 2003)
-
Confusion over "free"
- Michael J Brown (13 August 2003)
-
From a Non-Professional's Point of View
- Mark Hans (13 August 2003)
-
Sign of the times but said with thanks
- Morag Martindale (15 August 2003)
-
Independance first
- DIANOUX Jean-Louis (16 August 2003)
-
Scientific literature’s half-open sesame?
- Clarence C. Tam, Ben A. Lopman, and Dina Handan (18 August 2003)
-
It costs much more than ten pounds
- Marco Antivalle (4 September 2003)
-
The wrong emphasis
- Ian Miskin (5 September 2003)
-
Go the whole hog
- David Kerr (5 September 2003)
-
Re: Go the whole Hog
- Susana Askew (5 September 2003)
-
Free BMJ access helps to make medicine more democratic and accountable
- N Portman (6 September 2003)
-
Share and share I like
- Brian K Saxby (13 September 2003)
-
Clear Presentation of Basic Statistics
- Albert J. Starshak (14 September 2003)
-
For love not money.
- Richard Piper (17 September 2003)
-
What will happen to my links to BMJ.COM?
- Stephen D. Simon (10 October 2003)
-
Another year
- John Hopkins (7 November 2003)
-
Own goal of greed
- Alexander J N Jablanczy, P6A 4C9 955Queen St E Sault Ste Marie Ontario Canada (10 November 2003)
-
what do we pay for
- Alex J Jablanczy, Sault Ste Marie Ontario P6A 4C9 (10 November 2003)
-
Unfortunate Decision
- Jaiganesh Viswambharan (15 November 2003)
-
Charging for access
- Michele C Harms (25 November 2003)
-
Amazing
- Jose Pinto (5 December 2003)
-
The Drive Towards 'Data-driven Medicine'
- Jonathan D. Wren, William H. Hildebrand (11 December 2003)
-
Mesothelioma
- Lee A Murphy (10 February 2004)
-
Pay to Play
- Belynda Ramsay (2 March 2004)
-
What a shame
- adrienne jj garner (23 March 2004)
-
Charges for access to site
- John D Baines (24 March 2004)
-
eBMJ is not just read by doctors.!
- James G. Allison (25 March 2004)
-
falls in older adults
- Stephen Benedict FitzGerald (26 March 2004)
-
Why become monetary?
- Clayton Petty (27 April 2004)
-
Other options
- Robert Howells (19 May 2004)
-
Mexico needs BMJ free access.
- Martha K. Jalomo (15 November 2004)
|
|
|||
|
Colin A. Mackenzie, Retired Family Physician Santa Cruz, CA, 95060-1444
Send response to journal:
|
As a regular user of BMJ online, the news that BMJ will require fees in the
future is important.
The reason for my use of the Journal online has been the cost of the printed journal, though living overseas the ability to avoid postal delay is also a bonus. I fully understand the reasons for this decision and am quite willing to pay for access online. This will only be a successful move if the pricing of the online journal is appropriate to the market. As a retired physician the cost I am willing to afford is less than the cost that a working physician will afford. For this reason I hope that there is more than one catorgory of pricing available so that the use of the Journal will ensure its continued wide disemination. Competing interests: None declared |
|||
|
|
|||
|
Phillip J. Colquitt, RN Independent Comment
Send response to journal:
|
Friday morning in Brisbane, Australia, and at about 0800 hours I left behind your previous “spooky” issue as the new one eerily appeared. It appeared, but it was not “free”. Reading BMJ Online always costs. Australia’s main telephone company, Telstra, charges individuals a princely $38.95 AUD/month under “Megaplan” - conditional upon a 700 Megabyte download maximum, with $0.20/Megabyte thereafter. Though time online is not limited, the Telstra service is not rapid. Speaking of which, BMJ’s more entertaining part, the Rapid Responses, at times displays such imperfections in typing and spelling, that “free” might best refer to the corresponding author’s relaxed relationship with the keyboard. These responses should be free. In hospital settings BMJ is potentially most immediately useful, yet access to sites such as yours is extremely limited. As I experience it - the home, the Internet shop, the university campus, and even the airport terminal – these all outperform hospitals in terms of BMJ access. Formal evaluation of access to Internet based medical journals in public hospitals is needed, differentiating between hospital management’s claims of provision [virtual], and successful attempts to enter sites [actual]. Phillip J. Colquitt Competing interests: Access |
|||
|
|
|||
|
John P Allen, Retired GP none
Send response to journal:
|
As a BMA member for many years and reader of both the paper and electronic version of the BMJ I think your new policy is very reasonable. There are numerous exceptions, would-be subscibers have plenty of time to save up (as you say), but £10 should not take long.I have long wondered if subscribers are subsidising every one else out there. Competing interests: None declared |
|||
|
|
|||
|
Judith Ronat, Medical Director Rosner CMHC of Rishon L'Zion
Send response to journal:
|
I believe that retired physicians should have free access to the BMJ, as should medical students. I believe that the need for “verifying credentials” presupposes that your readership is dishonest. That is a serious implied allegation which we resent. Competing interests: None declared |
|||
|
|
|||
|
Giuseppe Giocoli, EBM Working Group Associazione Microbiologi Clinici Italiani Via C.Farini, 81 20159 Milano (Italia)
Send response to journal:
|
I understand your reasons, but these are bad news, anyway. BMJ, CMAJ, MJA are our guiding lights in our continuous searching of EBM implementation, and we cannot afford subscriptions to everything. Thanks,
Competing interests: None declared |
|||
|
|
|||
|
Joseph .C. Obi, Chief Consultant Wellness Clinics
Send response to journal:
|
I would (most certainly) be exceedingly prepared to pay up to £12 a year for unlimited BMJ.com access...provided that Dr Richard Smith honourably resigns from post, and a new breed of 'down-to-earth BMJ Editor' gracefully steps into his highly embattled shoes. 'Access-Limitation' obviously has it's fair price, these 'tuppeny days'...and 'value for money' must reign supreme... Competing interests: Dr Joseph Chikelue Obi MBBS MD MPH DSc FRIPH is also the Chairman of the General Wellness Assembly (GWA); an International Professional Body for Independent Wellness Consultants. WellnessClinics.co.uk |
|||
|
|
|||
|
julian.g turner, retired locum work in uk
Send response to journal:
|
I happened on this free access almost by mistake. I live in South Africa for 9 months of the year, where the post is unreliable and am heavily reliable on electronic access. Unfortunately access to your subscription service for the BMJ is as bad as access to BMJ.com is good. I tried 4 times to pay for the BMJ by E mail, but to no avail.Either the address was returned as being wrong (I had keyed it in correctly) or your staff do not answer E mails. This may be cultural as my experience of the Brits replying to E mails is pretty nondescript. Perhaps a more efficient administration would increase your membership rate! Competing interests: None declared |
|||
|
|
|||
|
Christian Weymayr, free medical writer Germany 72070 Tübingen
Send response to journal:
|
Sir – As a medical writer I attentively study bmj each week. What makes bmj especially valuable for me is its independence from industry. For a book (from Klaus Koch and me) about the possible benefits, limitations and harms of cancer screening bmj was one of the most important sources. To support further independence of the journal I will readily pay the moderate amount for the online access. Competing interests: None declared |
|||
|
|
|||
|
Gunther Eysenbach, Associate Professor, Dept of Health Policy, Management and Evaluation Toronto, M5G2K5
Send response to journal:
|
Sad. While I was not naive enough to believe that the BMJ would stay free forever, I had hoped that the BMJ would at least set a trend by keeping its open access policy and adopting an "author pays" model. As a researcher I would be more than happy to spend money from my research grants for an article processing fee at the BMJ. With closing the door and making the BMJ once again a subscription journal the BMJ loses much of its appeal for researchers to submit their high-quality papers to the BMJ. At least for non-Brits the high (international) visibility of articles published in the BMJ may have been the main motivation to submit something to the BMJ. Researchers are interested in global impact, not in impact on BMA members alone. The BMJ - dubbed the "Better Medical Journal" by Richard Smith - becomes the "British Medical Journal" again. Competing interests: I am editor and publisher of an open access journal (J Med Internet Res, http://www.jmir.org) |
|||
|
|
|||
|
Joseph More, Service Medical Director Connecticut Valley Hospita, Middletown, CT 06457
Send response to journal:
|
It would be fair to charge for use. It would be laudable if dependence on drug advertising could be reduced. Competing interests: None declared |
|||
|
|
|||
|
kurri Pakira Reddy, Retired on Medical groumds Not applicable
Send response to journal:
|
I am glad to note the B.M.J on the net was free for 10 years! I was a full B M A member for more than 20 years when I was actively practicing. Unfortunately I had to retire on medical grounds about 3 years ago. I cancelled my membership for obvious reasons. Soon after I found the free B M J on net. I use the site every week and send the relevant articles by e.mail for my friends through out the world. It is a wonderful service free of charge! Now we are going to be charged for the service. Those of us who live in the so called developed countries should be able to pay a modest price for this service. I would say about £10 that is more than 100% of last year cost for individual for the service. I am very glad that still so many countries in the world who are less fortunate than us will get the service FREE of charge. We should thank the B M A for their generousity. LONG LIVE B M A AND LONG LIVE B M J. Competing interests: None declared |
|||
|
|
|||
|
José J. Santonja-Lucas, Hospital General Universitario- Obstetrics and Gynaecology 46014- Valencia ( Spain ), José J Santonja-Lucas
Send response to journal:
|
To support the independence of the journal is a very important task. For 7 years I have been enjoying the journal so I now think that it is right to pay a moderate fare to maintain a good and independent medical information Competing interests: None declared |
|||
|
|
|||
|
Philip Smith, SpR Community Child Health Cheltenham General Hospital GL50 3EW
Send response to journal:
|
I feel the BMJ's policy on free internet access is a very sensible one, I am more than happy to subsidise low income readers (the poorest 120 countries)and I understand the hardships of student life. I consider the proposed annual charge of £10-20 to be very reasonable, and would consider paying that on top of my current subscription for the convenience (though I wouldn't mind losing my paper copy for a reduction too!). It also has to be bourne in mind that many other journals charge $30 upwards (some £20) for time limited access to single artcles or issues. I would still see the BMJ representing good value for money at this price. As for 'having to “verifying credentials” presupposes that your readership is dishonest' I can't quite see the logic behind this one - when I go to a bank to withdraw money they ask for my credentials, they aren't implying my dishonesty, but protecting my interests. The BMJ is a business, even though it is trying its best to be ethically sound it should not feel obliged to allow people to take advantage when they can clearly afford the modest fee that may be involved. Competing interests: None declared |
|||
|
|
|||
|
RAFAEL GONZALEZ, professor FACULTAD DE MEDICINA, UNIVERSIDAD NACIONAL AUTONOMA DE MEXICO
Send response to journal:
|
When I read BMJ in Mexico, I get access to a scientific work of high quality that is fundamental for my clinical and teaching activity. BMJ is a fundamental source for my practice. So, when I read that in January 2004, BMJ will be a journal accesible only if we pay for it, I feel that I am losing one of the my most important sources of knowledge. At the same form that many physicians in the third world don't have access to electronic publications of medical journals (JAMA, The Lancet, NEJM, Bone, Diabetes Care, etc. etc.) now, with this decision BMJ goes far of us, and I think this is not just. I will like to read in your pages that BMJ "is one of the high quality journals that proudly continues the tradition of the free disemination of science". Competing interests: None declared |
|||
|
|
|||
|
Eckehard Stuth, Associate Professor of Anesthesiology Medical College of Wisconsin, Milwaukee Wisconsin 53226
Send response to journal:
|
Dear Sirs: I have been an enthusiastic reader of bmj.com for many years. I screen almost every issue, although I am an anesthesiology consultant rather than an internist. I have found many of your articles quite stimulating, even though any direct impact on my daily practice is marginal. I regret that you will lose me as a regular reader, if access becomes restricted. As a specialist who already subscribes to anesthesia specialty journals I would be reluctant to pay for access to bmj.com. I hope you will consider similar situations when you start to limit access. Thank you very much for the valuable service you have provided to my residents and me over the years, Sincerely, Eckehard Stuth, MD Competing interests: None declared |
|||
|
|
|||
|
Aubrey Zabow, Medical Director Neoth Margalith Psychiatric Hospital , POB 81 Rishon Le Zion ,Israel l
Send response to journal:
|
The BMJ online provides a broad spectrum of issues in modern medicine, irrespective of one's speciality or work. In to-day's highly specialised and technologaical society, it succeeds in using this technology to maintain the human aspects of dealing with sick people and not only illness. If a reasnable fee will enable it to continue this invaluable work, I for one would be more than happy to pay. Competing interests: None declared |
|||
|
|
|||
|
Jim Harwood, IS 79 Central Avenue HA5 5BU
Send response to journal:
|
As someone who is not a medic, but nonetheless undertaking research into functional gastrointestinal diseases I find online access to the BMJ (and other journals) invaluable and very much appreciate it. I quite understand you need to raise revenue. Perhaps you could extend the free period to 4 weeks after publication. Those of us not in the medical profession take holidays! Good luck for the future and thank-you. Competing interests: None declared |
|||
|
|
|||
|
Disa Hoehne, med. student 18752
Send response to journal:
|
It is with sadness and frustration that I read the article about payment for bmj.com access. Not because bmj-readers soon enough will need to pay a negligible sum of money for viewing quality articles and communicating with physicians around the globe, but because of the alarming fact, mentioned in the article, that many scientific journals are facing falling subscription revenue. This is a serious problem, not only for the scientists themselves, having to find new and strange ways of distributing their works, but for the society as a whole as well, for reasons irrelevant to mention here. For those who know, no explanation necessary. For those who don't, none will do. Competing interests: None declared |
|||
|
|
|||
|
P.C. Ghosh, navy physician 98312
Send response to journal:
|
This very on line journal has become a very essential part of our clinical information portal that it is difficult to give up. However, since some of us may have retired by 2005 would you consider a reduced rate subscription or one time fee for life time's usage. Competing interests: None declared |
|||
|
|
|||
|
Christine Porter, Learning Designer Ithaca, New York, USA 14850
Send response to journal:
|
Ironically, I saw this announcement when double checking the BMJ URL while writing a sentence in my MA dissertation that said "Some journals, such as the British Medical Journal, are currently available free online to the general public." The section, however, is about access for health professionals in developing countries. I congratulate and admire your decision to keep free access for lower and middle-income countries while collecting from those more able to pay. My only concern is that you may not be charging enough to sustain your services, cover the administrative costs of collecting subscription fees, and still be able to support services such as INASP-Health! Best wishes, Christine Porter Competing interests: None declared |
|||
|
|
|||
|
Linda MAnn, General Practitioner Summer Hill , 2130 Australia
Send response to journal:
|
BMJ is joining other prestigious journals (notably New England Journal of Medicine). If you really keep the cost at less than $AUD50, I'll subscribe, with joy, as I read you weekly. NEJM is over $AUD299: exchange rates kill us first world Euro poor GPs who earn one third what Brits do. Competing interests: None declared |
|||
|
|
|||
|
himmatrao saluba Bawaskar, Bawaskar hospital and reasearch center Mahad , raigad , maharashtra India 402301 Mahd Raigad maharashtra India 402301
Send response to journal:
|
sir i am working in rural India. Every friday morning i read BMJ on internet. It does add to improve the clinical and management of patients in rural areas. Even i have courage to administer thrombolyis to acute AMI cases which reach within golden hours to my clinic. This is because i read the importance of early administeration of STK at peripheral hospitals (prehospital) in BMJ. Transaction facilities are not available in rural India. hence it is difficult to pay in pounds. at least for developing nations, BMJ.com should be free for few more years to come. hope Editor understands real difficulties and know that the paramount donation in life is knowledge. Competing interests: None declared |
|||
|
|
|||
|
dr.manan vasenwala, consultant-cardiologist(non-invasive) k.k.heart center, aligarh-202002.india
Send response to journal:
|
a nominal subscription would be alright.however, it should include free access to medline as it is for BMA members. Competing interests: None declared |
|||
|
|
|||
|
Adam Jacobs, Director Dianthus Medical Limited, London SW19 3TZ
Send response to journal:
|
I fully accept that the BMJ has a need to increase its revenue. After all, we all have to make a living. And I will be perfectly happy to stump up the proposed £10-20 per year, which I would regard as excellent value. To put it into perspective, this is about the going rate for the price of a single article from many other medical journals. However, I am a little surprised that the BMJ is seeking to charge readers, rather than authors, given that it is only 3 months since the BMJ published an editorial singing the praises of the 'author pays' model [1]. Perhaps Delamothe and Smith could explain why they have now rejected the model that they were so enthusiastically in favour of only a short time ago? References: 1. Delamothe T, Godlee F, Smith R. Scientific literature's open sesame? BMJ 2003;326:945-6 Competing interests: None declared |
|||
|
|
|||
|
Lára Halla Maack, Forensic psychiatrist Pbox 264 Reykjavík 121, Iceland, 0
Send response to journal:
|
If there was a way to keep the BMJ open to the public everywhere and make doctors pay for their access that would be the best. Doctors know they get good value for their money in the BMJ but the public does not necessarily know. Firstly it is dramatic, at least here in Iceland, how much better informed the media is on medical matters since good medical journals became accessible on the net. Secondly, it is very useful to ble able to refer patients easily to articles/ guidelines in medical journals. I, for my parts, love my paper copy, and I intend to continue paying 120 pounds for my treasured BMJ as my favorite reading on the bus to and from work. Competing interests: None declared |
|||
|
|
|||
|
Alan Walker, Independent Consultant Weybridge, KT13 9QZ
Send response to journal:
|
Smith and Delamothe have indicated plainly that free access will remain available for registered BMA Members and those in countries listed as low and lower middle income countries. For others £10 to £20 per year is amazingly good value for money, especially when considering how much one has to pay for some websites. (See Adam Jacobs’ earlier comment about "perspective") Economist.com access charges are: Annual: $69.00, Monthly: $19.95, 5 -article Pay Per View: $9.95, Single-article Pay Per View: $2.95 [1] And gaining access to full data content results on the 1901 Census (www.census.pro.gov.uk) costs a minimum of £5, based on metered views at 50p and 75p per search result [2]. The key here is that searching is for free, and only when one finds something of interest does a charge get deducted from a user-defined maximum spend amount. Perhaps an exception to paid-for quality sites is the 'fully free content' www.bbc.co.uk. However the remit of the BMJ is not primarily public service, although “the public” is a factor within the BMJ Publishing Group Ltd’s mission statement [3]. The BMJ is not a charity. Some sites however offer a choice: Pay or ‘Sponsored Free’, as is the case with www.192.com where the user is invited to pay or to opt for a suitable sponsor payer [4]. One is then free to choose to accumulate user credits. Perhaps then an option for those qualified health care professionals, who might wish to continue to receive bmj.com for free, is to elect to be sponsored by a particular commercial partner. This in itself provides bmj.com -and its readers- with a route to satisfy all parties concerned: readers who prefer a commercial free environment can pay for it, while those who do not wish to pay at all can trade-off in an appropriate and industry code of practice compliant way. Thus for bmj.com the funding required to continue to provide and further improve its product is quite possible. Whether doctors would eventually prefer Sponsored Free to paying £20 one can only guess – an online poll in the meantime might provide a guide to help BMJ find the best way forward. That apart, to have an option to be able to select between ‘pay’ or ‘sponsored’ might be something that would be welcomed by bmj.com users wishing to choose according to their individual conscience. bmj.com is a multi award winning product, well regarded even in the non-medical sector having beaten FT.com to be Best Business Product or Service web site in 2000 [5]. While it may be disappointing presently for those who would like to see bmj.com stay free, the fact is that its existence is an amazing achievement on the part of Delamothe and HighWire. bmj.com now simply needs its readers to help pay for the product they use and value. References: 1. https://www.economist.com/subscriptions/index.cfm accessed August 2, 2003 2. http://www.census.pro.gov.uk/help/chargesv1.html accessed August 2, 2003 3. http://www.bmjpg.com/template.cfm?name=bmjgroup_abt#Mission accessed August 2, 2003 4. http://www.192.com/upgrade.cfm?icdaction=sponsored accessed August 2, 2003 5. Periodical Publishers Association - PPAi Interactive Publishing Awards 2000 Competing interests: Disclosure: respondent was once employed by BMJ Publishing Group and -having been made redundant- has no interest in bmj.com any different from that of any site user who will have to pay. |
|||
|
|
|||
|
Rafael M Galliez, P Rua vinicius de morais 281/101 rio de janeiro RJ 22071-030 Brazil, Cipriano Barata
Send response to journal:
|
A giant wave of sadness leapt through my mind the moment I read the news that BMJ is going to lock the access with charge, the journal that in my 6 years of study has worked as the lighthouse of correct medical Knowledge, every week the acess for the website brought good reflection and material for a better medical practice. In the last 6 months, I have seen BMJ rising as the most important general medical journal, bringing to the front debates that have been always in the backstage of the medical world. The edition about the pharmaceutical industry was a Bright moment. But then came the edition about the magic pill, and from that moment I thought that something was happening, like an internal reaction about the political leadership that the Journal was acquiring about the medical problems and the right for free (in the sense of freedom) Knowledge circulation. And now it is the end. There will be no BMJ Free (LIVRE LIBRE), and thinking about ways of funding the publication of scientific knowledge maybe I prefer to think about an international fund with OMS and ONU to work in terms of digitizing the medical knowledge and keep it free for the world, as must be said that free access for knowledge is one of the most important things for human developement. Now what is the diference between BMJ and NJM? Maybe the sad news for today may came soon with the understatement that we must work hard in the creation of the international fund for the freedom of knowledge Rafael Mello Galliez Competing interests: Works for human Development |
|||
|
|
|||
|
Richard Smith, Editor BMJ
Send response to journal:
|
The BMJ will experiment with the "author pays" model. As our editorial said, our intention is to continue to pass the long versions of original articles to Pubmed Central. This means that original research will continue to be available for free. This gives us an opportunity to experiment with the "author pays" model. I'm currently thinking about how our experimentation might go, and I'd welcome suggestions. I foresee three stages. 1. We'll start with qualitative research among authors, testing their thoughts on the "author pays" model. My experience is that many authors don't understand the concept straight away. Many think first that it is vanity publishing. They also see it as an extra cost to the academic community--not understanding that it should eventually stop publishers ripping off the academic community. We'll also explore authors' reactions to different models. My ideas on different models are described in an accompanying rapid response. 2. We then proceed to a quantitative stage where we ask authors whether they would be willing to pay and which model they prefer. 3. We then experiment for real with different models--perhaps offering authors the choice of not paying and so not having their paper passed directly to Pubmed Central. Richard Smith, editor, BMJ Competing interests: I'm the editor of the BMJ and responsible for all it contains and its finances. |
|||
|
|
|||
|
Richard Smith, Editor BMJ
Send response to journal:
|
The "author pays" model has the potential to allow the power of the market to operate in scientific publishing where it has not operated before. I can think of various different models, and we at the BMJ are keen to experiment with them. The model currently advocated is that authors pay for peer review and the posting of their articles only if they are accepted. This seems to me to create an uncomfortable conflict of interest. Editors and publishers will be rewarded financially for accepting material. Another model might be that every author pays a little on submission, meaning that those who have their papers rejected in some ways support those who have their papers published. This might mean that inexperienced authors support experienced ones, a regressive measure. All of this is of course irrelevant if institutions simply pay a flat fee to have all papers submitted by their employees reviewed--although a snag with this model might be that publishers cut costs in order to make a profit. To some extent this happens already. The BMJ--like other major journals--has around 6000 papers a year submitted. Yet we publish only about 600. I tell our editors that we should invest our resources in the papers we are going to publish not in those we reject. This means that we are quick and brutal with many of our rejections. I can imagine a model in which authors have a choice in paying for various services. They might pay $10 for a rapid no, $100 for a detailed rejection with ideas on how to improve the study for submission elsewhere, $150 for external review (more for more reviewers) with us passing on some of the money to the reviewers, and $250 for a detailed report from our editorial committee. They could then chose whether to pay to have their paper technically edited, perhaps even with a choice over how extensively, and chose whether to pay for us to prepare a short version for the paper journal. The beauty of a properly functioning market is that resources will flow to where they add most value. I imagine too a hybrid model where authors pay for what matters to them and readers pay for what they value. So research papers--which often matter more to authors than readers--might be paid for by authors and made available free to everybody, whereas material that editors produce--by writing themselves or commissioning--would be paid for by readers. This would mean that editors would have to make sure that they were meeting the needs of readers not indulging themselves. At the moment the market functions poorly. Publishers make money from value they do not originate and by restricting access to ideas that will breed more ideas if shared. They make bigger profits by keeping their costs to a minimum and by pleasing authors not readers. By bundling their products they promote the importance of quantity not quality, and the anti-competitive nature of the market works against the smaller publishers, many of whom have the potential to perform best. A move to a market where authors and readers pay for what they value should produce a much healthier market, but authors tend to react negatively when they first here about the author pays model. Their first thought is that it is a move to "vanity publishing," but importantly authors pay not for publication but for peer review--and for publication only if the paper passes peer review. The next worry is that the poor will be disadvantaged. This is a legitimate worry, but publishers might want to make their services free to those from the poor world (as at the moment they make access free). Plus this problem would be avoided if institutions rather than individuals paid--just as it's mostly institutions rather than individuals who currently pay for subscriptions. Richard Smith, editor, BMJ This is an edited extract from my book, The trouble with medical journals, which will be published next year by Cambridge University Press and which I never tire of promoting. I should benefit financially from more people buying the book, but if I was in it for the money I would have made more by spending the time working in Tescos. Competing interests: I'm the editor of the BMJ and responsible for all it contains and its finances. I'm also in this rapid response promoting my book, as I've explained above. |
|||
|
|
|||
|
James E. Till, Senior Scientist Emeritus University Health Network, Toronto Canada M5G 2M9
Send response to journal:
|
Richard Smith's comments about various kinds of "input fees", or, "article processing fees" (APFs) do not incorporate some aspects of the version of this business model pioneered by the Florida Entomological Society <http://www.fcla.edu/FlaEnt/>. According to its Instructions to Authors, the "Florida Entomologist" currently charges (in US$) $100 per article, $58.33 per printed page, and a surcharge of $20 per figure or table. Immediate open web access to "electronic reprints" is included in these charges. For an additional $45, authors with articles online can add a link to a file of the author's creation, such as complete data sets. (But, at least one author must be a member of the Florida Entomological Society). Competing interests:
I have no personal experience with the "Florida Entomologist", but am an occasional contributor to the Open Access News weblog, |
|||
|
|
|||
|
Wladimir K de Paula, MD IPSEMG - Brazil - 30130110
Send response to journal:
|
I think the medical information access should be kept free of charge but BMJ´s honesty, that helped to make it one of the most respectable medical journal of the world, in explaining the reasons why the free model is not self sustainable has convinced me in paying for the access. I think the annual fee that is to be charged is within the possibilites of most medical doctors and libraries of the world except perhaps the poorest. Not relying solely on pharmaceutical industry makes for a not compromised approach on the peer reviewing process. To conclude: I think this is a very honest move and I´ll support it. Competing interests: None declared |
|||
|
|
|||
|
Debra Pannowtiz, nutritionist 123 Australia St Newtown
Send response to journal:
|
I value the free access to BMJ no end. The modest sums you detail for a subscription seem fair, provided we do not see higher fees later. I have no problem with you recouping costs nor a modest profit, however you are likely to see a sharp fall in people visiting the site due to their inability/unwillingness to pay. Does this further the cause of science? The drop in site visits will mean an increase in price for us (those who would take an initial subscription) and guess what some of us will no longer subscribe. Thus just as you have so proudly "disentangled" yourself from the pharmaceutical industry so shall you "disentangle" yourself from your readers, lets hope not so proudly... I hope those 120 countries all have computers at their fingertips! Good luck and happy marketing...raising prices is never as easy as dropping them. Competing interests: None declared |
|||
|
|
|||
|
Halina M. Iwanowska, retired surgeon home address: Bergshamra Alle 33, 170 77 Solna
Send response to journal:
|
Sir, I understand the problem your journal faces but I think that the exemption has to cover also the retired doctors--as you may read from many responses. Also I think that it is not the best idea for authors to pay; the publishing in BMJ has to be absolutely free only on the scientific value of it. At the end I salut you: the journal is really interesting not only because of the most important scientific articles but also it transmits a special way of thinking which has appealed to us for so long. Competing interests: None declared |
|||
|
|
|||
|
Fiona McLean, Senior Library and Information Officer CancerBACUP, 3 Bath Place, Rivington Street, London EC2A 3JR
Send response to journal:
|
Mainly to feedback from a library perspective that blocking full content for 6 months would be enough to make subscription essential for most libraries, if their users need more than the research on PubMed Central. It doesnt need to be 'at least a year' for this, so why not make it shorter? Also, can you please consider maintaining free access via the collected resources? At least with the full research articles that would be on PMC anyway, plus some details of the others? They are a useful way of referring users to articles on their search topics. Its a sad tho understandable decision that BMJ will stop being free full text to all. Fiona McLean Competing interests: None declared |
|||
|
|
|||
|
Patrick M. Kelly, Consultant Psychiatrist,Cavan, Ireland Cavan, CN
Send response to journal:
|
Sir, The BMJ on line, with all of its links, is a great source of e- learning. Being a non-subscriber to the print version which itself is not too expensive, I will feel more entitled to browse when paying your very modest intended fee Competing interests: None declared |
|||
|
|
|||
|
Martha L. Rogers, PhD, I don't have one Self-employed 92780
Send response to journal:
|
You cannot imagine the joy in being able to access your publications weekly without having to pay for every article. I use BMJ as one of my primary ways of keeping up. Here in the U.S. virtually nothing is free, and for a private practitioner without institutional access, it is an expensive burden to conduct needed research and to keep up. I think your proposed cost for on-line readers is more than fair. I will gladly sign up and pay to continue my access. Competing interests: None declared |
|||
|
|
|||
|
susanne steens, retired cf 24 3pf, n/a
Send response to journal:
|
The BMJ is worth its weight in gold. It is sad though to see the end of freely exchanged knowledge via the journal and to see that some will have privileged access over others. Hopefully we are not going to return to the days when medical journals were closed to all but the few. Horrendously in the 21st century there are still some journal editors who would prefer to keep their's closed to those outside their discipline. One way of achieving this is to make it subscription only on proof of membership. This excludes the sort of debate opened up by the BMJ. It worrying though that the Editors seem unaware that levels of poverty in the UK as well as specified 'lower and middle income countries' mean that many cannot access the paper BMJ - it is only kept in the larger city libraries - and they certainly do not have access to computers--only some libraries are on-line for free as yet. Lay readers need the information provided by the BMJ, they are not waiting at the portals in any prurient way but use the journal for research and information which is not accessible through other means. There are thousands who have no access to further education or specialist journals. So yet another ideal of free access to knowledge and information on an equal basis through the net, goes by the way. Although understandable this is a sad way to end a decade. Competing interests: None declared |
|||
|
|
|||
|
John Madura, patient Parlin, NJ
Send response to journal:
|
Patients too read the various articles and learn. We use that information to help us work with our physicians. I can think of a few times where info read here has translated to better care for myself and others. Doctors cannot know everything and when I find ones that are willing to learn from the info I show them, well then we all benefit. Having said that, I would subscribe to your journal since I KNOW it has helped my recovery. Competing interests: None declared |
|||
|
|
|||
|
Graham P Beck, Consultant Anaesthetist New Cross Hospital Wolverhampton WV10 0QP
Send response to journal:
|
So the response to a fall in subscriptions to the BMJ of 9% in just one year is to introduce charging for BMJ web content. Some editors might respond to such poor performance in a more honourable way. Meanwhile, might I suggest targeting a more relevant readership: doctors. Competing interests: I find the BMJ has become increasingly irrelevant to me as an NHS consultant |
|||
|
|
|||
|
Antony F Sara, director of clinical informatics, south east health Prince of Wales Hospital
Send response to journal:
|
A great pity. But I am sure that we can all understand the commercial realities of the decision. Nevertheless, a great experiment, from in my view the world's best medical journal, that saw my rate of journal surfing greatly increase. Competing interests: None declared |
|||
|
|
|||
|
Jai B Sharma, Assistant Professor in Obst & Gynaecology All India Institute of Medical Sciences, New Delhi 110029
Send response to journal:
|
Although the decision to make free BMJ on line payable is a necessity , the decision to continue it free for middle and low middle class countries is a welcome move which should include India. The free availability of BMJ on line has been instrumental in making it one of the most popular journals in the world even ahead of New England Journal of Medicine and Lancet.We eagerly await for Friday when we can go through the new issue of the journal on line. Kindly continue the free access in the developing countries as a noble cause for improving health care in the world especially developing countries. With good intention financial constraints will be sorted out with time. Competing interests: None declared |
|||
|
|
|||
|
Anna Belozerova, MD Republican Tuberculosis Hospital, L.Tolstogo, 40, Petrozavodsk, 185035 Russia
Send response to journal:
|
I just wanted to say, that I am really happy, that during last 6 years (after Internet appeared in my town) I have this pleasure - to read BMJ on-line. Printed version is extremly expensive for me (my monthly salary is around 200 Euros). But fortunately now I can enjoy BMJ for free even after the year 2005. I live in Russia. But I clearly understand, that it is extremly expensive gift. Even I could pay something - for example - 5-10 Euros per year. Anyway, thank you for exellent information source and educational tool. Competing interests: None declared |
|||
|
|
|||
|
Catalin Popescu, Lecturer in Dermatology Universitatea de Medicina Bucuresti, Spitalul Colentina
Send response to journal:
|
Dear Sir, I've enjoyed very much reading the BMJ and it was the free access provided for so many years that allowed me to do so. I understand that you would need to charge for the access to bmj.com and I appreciate that you've informed the readers 18 months in advance. The proposed charges sound very reasonable to me and, although I may qualify for free access because I'm living in a low-income country, I am prepared to pay 15 Euro/year. The only regret I have is that your initiative was not followed by other high-impact journals, although there are some that are currently providing limited free access for low-income countries (eg NEJM). Catalin Popescu
Competing interests: None declared |
|||
|
|
|||
|
Ramesh Patel, Director Brainsell Ltd, London, W5 3TX
Send response to journal:
|
If the full content remains free for a week or two before it is placed behind access controls, the number of people visiting the site is not likely to drop significantly. In theory it’s a case of the more, the merrier. The more subscribers there are, the lower the price that the BMJ can afford to charge per subscription. The positive comments, willingness to pay, gratitude for free access, appreciation of honesty, and the levels of sadness and disappointment expressed in these rapid responses are all a testament to the strength of the bmj.com brand. I’ve always thought of bmj.com as a “loss leader, brand breeder”. The BMJ has an opportunity to introduce a range of profitable bmj.com services (or information-based brands) which would be valued by users and industry alike. If these opportunities are uncovered and valuable services developed, the profits would help to keep access charges down and fund further development. Competing interests: I run a specialist healthcare brand research agency. I was previously employed by BMJ Publishing Group and worked on the bmj.com brand. |
|||
|
|
|||
|
Stephen C Due, Chief Librarian, Barwon Health Geelong Hospital Library, PO Box 281, Geelong, Vic 3220 Australia
Send response to journal:
|
When you abandon unrestricted online access, you will be leaving the Medical Journal of Australia and the Canadian Medical Association Journal to carry the flag for the national medical society journals. Canada, of course, still leads the way with an impressive array of free electronic journals in the specialties, including the Canadian Journal of Surgery, and the Canadian Journal of Psychiatry. Libraries benefit from free electronic journals. As you suggest, having free online access enables them to reduce their paid print subscriptions. However you yourself have shown there is a problem with declining library subscriptions generally. Library budgets are tight, but there are other contributing factors, one of which is the high ‘institutional’ prices libraries are commonly charged for subscriptions. Why not consider a pricing policy which positively encourages libraries to subscribe? More library subscriptions might also generate more interest from individuals. Libraries provide a lot of exposure for medical journals. Generations of readers in this library have torn the little cardboard subscription forms from the printed issues of journals on display. These days we often direct new readers, many of whom are potential subscribers, to journal websites. Librarians would like you to support libraries, not just to see them as rich institutional customers. We want you to treat us as partners in the larger enterprise of getting the article to the reader. Like you, we support the important humanitarian principle of ready and equal access to scientific information, which lies at the heart of modern medical progress. Like you, we want the BMJ to flourish. Competing interests: I am a medical librarian with an interest in promoting medical libraries |
|||
|
|
|||
|
Rahimah Jafry, Hospital Director Hospital Queen Elizabeth Sabah Malaysia
Send response to journal:
|
I have been reading every single BMJ on line for the last four years. I have learnt a lot about new developments in medicine, healthcare as well as the profession itself. I thought it was too good to be true when I could access your excellent journal right here in my house and office. I have advised many a new house officer and also patients to visit your website for latest medical information. We feel close to UK because of the weekly BMJ. Unfortunately Malaysia is not on the list for free access in 2005. I am sure many of our struggling general practitioners in the rural areas especially in former North Borneo (the highest poverty level in Malaysia) are going to miss you badly. Competing interests: None declared |
|||
|
|
|||
|
Murat Acar, Rehab Physician 2077
Send response to journal:
|
I was excited when BMJ first became full text online. I had hoped it would set the way for other journals to do the same; of course they didn't. Although the cost of BMJ subscription will be relatively cheap my experience is that you always think twice about using a service that costs. Realistically, when you consider everything else one has to pay for, and the plethora of information on the net, it will be easier for many readers simply not subscribe and look elsewhere. I hold no grudges, as the BMJ obviously must make ends meet. I would have thought advertising to an international audience might have been able to subsidise costs. I thank you for the service to-date. I will of course send my invoice for this rapid response (my intellectual property) to the BMJ Board. Competing interests: None declared |
|||
|
|
|||
|
Jessica C Lewin, Senior Medical HR Officer Tatchbury Mount, Soton, SO40 2RZ
Send response to journal:
|
Whilst I appreceiate the need to control costs, I think that it will be a real shame to make the BMJ subscriber only. Not only will the NHS patients, and often students who are not doing medicine as a first degree, not be able to access free up-to-date information, but as an NHS employee, responsible for a medical personnel department and involved with consultant contracts/new deal etc, these journals have been the best way to keep up to date with understanding what doctors views are. Unfortunately, being on a site without a library, tight budgets may restrict subscription to such a resource where other things take precedence. In addition, it is possible that applications for medical posts will decline, particularly from overseas doctors or simply doctors who don't get the paper copy and only have time to do a search on bmj.com as lack of time. Anyway, hope we see a reduction in advertising fees due to potenital restricted access?!!! Competing interests: None declared |
|||
|
|
|||
|
John H. Lange, Environmental and Occupational Consultant Envirosafe Training and Consultants, P.O. Box 114022, Pittsburgh, PA 15239 (USA)
Send response to journal:
|
It is truly a shame that BMJ.com in 2005 will began charging a fee for access (1). However, nothing is for free. BMJ.com along with CMAJ and MJA created a novel concept of free access to their journals. Such access has been discussed for years as a way of widely disseminating scientific information. Like any evolutionary process, change must occur. As with BMJ.com this change is occurring again. Economics drives science and medicine whether we like it or not and to maintain the journal an evolutionary economic change is now about to occur. This is not out of greed or profit, but necessity. The cost of access proposed is small. Maybe this change will allow the survival of the journal permitting other journals the opportunity of similar adaptation. Regardless, thank you for the open and free dissemination of information over the last 10 years. I hope many will accept this change and purchase an on-line subscription. By doing this, evolutionary access to journals may once again change. References 1. Delamothe T, Richard Smith R. Paying for bmj.com . BMJ 2003;327:241-242 Competing interests: None declared |
|||
|
|
|||
|
Robert Munro, Web Editor, Nursing Times Mornington Crescent, London NW1 7ej
Send response to journal:
|
I must admit to being puzzled for a number of years at the BMJ's model of simultaneous publication of the entire journal for free online. I suppose when it was first devised, internet access was a relative rarity and free content an affordable philanthropy. Our website model of delaying online publication of clinical material for two months and offering additional content that does not appear in the print version provides the nursing profession with a valuable resource, enhances the standing of the brand and does not damage copy sales. Competing interests: I am a member of Nursing Times editorial team |
|||
|
|
|||
|
Phillip J. Colquitt, Writer-Reader Independent
Send response to journal:
|
Editor, Robert Munro, Web Editor of “Nursing Times”, draws comparison between your respective journal web sites in addressing the problem of revenue, and confesses long-standing puzzlement about your policy of not delaying full-access to current issues[1]. Comparison thus invited, I draw the attention of readers to what seems to be a case of a disappearing article at the Nursing Times website. As follows. In the BMJ Rapid Response of 22 October 2002[2], I gave the reader a supporting link reference to a 2000 article by Andrew Rouse[3] in Nursing Times, entitled “How reliable are sphygmomanometers? (accessed on October 15 2002). I confirmed retrieval of the Rouse article at Nursing Times by keyword search. Today, less than a year later, I can’t find the Rouse article at Nursing Times, neither by hyperlink nor keyword search. Other disappearances have come to my attention with electronic medical journals. Being able to search for Rapid Responses, tends to distinguish BMJ from other “free” healthcare journals. Will you change this in future? Perhaps Munro can comment on disappearances. Phillip J. Colquitt References: [1]Munro R. Re: 6 month block is enough - 8 August 2003. http://bmj.com/cgi/eletters/327/7409/241#35485 [2]Colquitt PJ. Sphygmomanometer luer slips cost lives - 22 October 2002. http://bmj.com/cgi/eletters/325/7369/905#26382 [3]Rouse A. How reliable are sphygmomanometers? - Posted on 09/12/2000. http://www.nursingtimes.net/features/fipage.asp?story=nt20000911f04&gutter=features_index_gutter Accessed on October 15 2002. Competing interests: Access |
|||
|
|
|||
|
Timothy M Southwood, GP Nailsea BS48 4BA
Send response to journal:
|
As a member of ther BMA I would be very happy to receive an electronic copy on line. Surely it would be quite reasonable for the electronic version to be suscribers only with students & Drs from 2/3 world having free acess (Recognised by their email adresses) Competing interests: none |
|||
|
|
|||
|
william s. craig, retired obstetrician sudbury regional hospital
Send response to journal:
|
I enjoy the bmj; especially if it can remain independant.
You deserve to be paid. I'm sure you could help Canada with obstetrics.
Competing interests: None declared |
|||
|
|
|||
|
Adrian K Midgley, GP Exeter EX1 2QS
Send response to journal:
|
Responses have focussed on cost and value, apart from the drive-by insult. I regret this response to market forces for another reason, that of usability of the medical web. The closer we get to a seamless flow of information, and the connections and transitions between items of information, the better. But much of the "medical web" is isolated in little bubbles with an access barrier to be negotiated, and much of it is not indexed by the search engines. The journals hosted on the Highwire servers are already in a bubble as far as search engines go, for realistic reasons of bandwidth and load, but it is a pity the BMJ's content is about to retreat deeper into the foam we all struggle through. I don't keep the paper copies any more, as I can more quickly find a paper or item through the web, and as a reputable and sensible web-publisher I do not anticipate that bmj.com will remove items or move them around after I bookmark them or link to them. I expect this trend accounts for the drop in subscriptions to the paper copy. Despite efforts since at least 1960 (Ted Nelson's xanadu system and the open sourced derivative Udanax, BT Click&Go, PayPal, Two cent's Worth and eGold we do not have a widespread convenient and reliable system for linking micro-payments[2] to articles. The consequence is that authentication and the need for collecting money impair the function characteristic to the Web (and hypertext publishing systems in general[2]) of linkage between items of information, and reduce the usability and therefore the usage of the system as a whole. The move proposed seems to be the one that is an emerging consensus in newspaper publishing, but perhaps my colleague from Wolverhampton would like to see the editor of The Independent resign as well. Personally I'd expect that an editor who creates and grows a new area of business and profit centre would be admired for it, but some doctors are funny. Nielsen predicted this change in the Web in general in 2001 and several large and widely accessed journals had made the move in 1998 so those of us not sleeping at the back can hardly sound surprised, nor is the BMJ rushing ahead carelessly or reacting instantly to fashion. If we have to have a charging system to maintain the profits to the BMJ and the BMA then OK - I'd throw in another fiver to give my share of open access to the world as well, but those who demand the BMA act as a pure trade union might demur - but can the journal that innovated in open medical web publishing ensure it is innovative in maintaining the flow and connections despite its payments, please. [1] Drexler on hypertext http://www.foresight.org/WebEnhance/HPEK1.html#anchor326330 viewed 10 August 2003 [2] Nielsen on micropayments 1998 and revisited 2001 Competing interests: Worked for a while for a company trying to improve access through the foam. |
|||
|
|
|||
|
Francisco E. Fernandez, General Practiotioner Health Center. Cochabamba. Bolivia
Send response to journal:
|
I was trained as General Practitioner in the U.K., and now working in Bolivia. BMJ is my "daily butter" for a week. What can I do from 2005 onwards?. Ther internet server provider can't work properly for more than five minutes (just only five). It is only on Saturday or Sunday night when I just manage to get through for half an hour. We all understand BMJ is not a charity organitation, but may I say it is unfair?; probably not. Thanks, anyway. Paco Fernandez Competing interests: None declared |
|||
|
|
|||
|
Thomas L. Perry, Dept. of Medicine, University of British Columbia Vancouver, B.C. V6R 2P1 CANADA
Send response to journal:
|
I'm willing to pay modestly, but I don't want to get stuck as I do with other services: unable to to access what I have paid for because I can't remember my "user name" or my "access code"! Even worse, my hospital requires that the code be changed frequently. The last time this happened, the server would only accept one unpleasant 4 -letter verb. Colleagues told me I had inadvertently chosen the world's most common password! You may add royalty to the site, merge with the EU, submit me to watching pictures of Tony Blair and George Bush golfing together, or whatever new trends may emerge, but please keep it simple for us troglodytes. Tom Perry Vancouver Competing interests: computer illiteracy and declining memory |
|||
|
|
|||
|
Patricia W. Njuguna, SHO WTRL/KEMRI, P.O.Box 230, KILIFI, KENYA
Send response to journal:
|
I have been a reciepient of the e-BMJ for the last 2 years. It has been of tremendous benefit to myself in the work place as it covers a wide range of topics. It encourages critical thinking in reading some of the articles. The advise on CV writing has been helpful to colleagues who have opted to work in the UK in applying for jobs. I realise it will be difficult for doctors in my country to continue to benefit wth the new user fee but if as you say it will be less than twenty pounds it may be affordable in the long term where a group of colleagues may be able to contribute and enjoy a group subscription for the year. Competing interests: None declared |
|||
|
|
|||
|
Chris J.R. Willmott, Lecturer in Biochemistry University of Leicester
Send response to journal:
|
I do not feel that the exchanges thus far have given adequate consideration to the use of BMJ.com by non-medical students. I regularly recommend articles to my Biochemistry students, particularly regarding bioethical issues - which are becoming an increasingly important component of biology curricula. It would be a shame if they were denied the benefits of your online edition. The model of free electronic access after six months seems to work well for journals published by the American Society for Microbiology, including Antimicrobial Agents and Chemotherapy. Subscribers get the benefit of earlier access, but the material becomes free to all after six months and can then be recommended by lecturers to their hard-up students. The delay is sufficiently long that the library here still takes paper copies, but the convenience of e-access is retained. Chris Willmott Competing interests: None declared |
|||
|
|
|||
|
Robert Munro, Web Editor, Nursing Times Mornington Crescent NW1 7EJ
Send response to journal:
|
Indeed I can reply to Phillip J. Colquitt's question. When the website was relaunched in November 2002 with a free searchable online clinical archive among other new features, a decision was made based upon the results of extensive consultation to limit the database to those articles which have appeared in our clinical pages. The reason for this is that other content, namely news, features and opinion do not tend to be used widely for academic and professional research by nurses. The piece by Rouse was published in our features section and is therefore not held in our online archive in its current form. This also reinforces my original point that exclusivity of some content to either web or print ensures the survival of both. Competing interests: I am a member of the Nursing Times' editorial team |
|||
|
|
|||
|
sree kumar, Medical Officer in Charge, Block Primary Health Centre, ( Kerala State Health Services) Block PHC, Vechoochira, Pathanamthitta, Kerala, India.
Send response to journal:
|
I am a Public Health specialist from the state of Kerala (India). I am a regular reader of the electronic version of BMJ. I think it is highly unfortunate if you are going to charge for accessing the electronic version of BMJ and sincerely hope that you will change your mind. Competing interests: None declared |
|||
|
|
|||
|
Walid Elias Kai, MBA, PhD Candidate eHealth Economics Sweden, Kalmar eHealth Institute, France, Universite Paris Dauphine
Send response to journal:
|
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. Well Well Well, Opening access to Free Medical journal is and will still empower patients, doctors and all health professionals. Health Management and IT professionnals will as well stay here to Evaluate and Create new needs and approachs. Free for All and Your British medical journal will always survive and provide us with their knowledge and great online offline medical themes and series. I think BMJ will and always be the best for a Free medical journal. Thank you Competing interests: None declared |
|||
|
|
|||
|
Michael J Brown, Information Architect Liverpool School of Tropical Medicine, L3 5QA
Send response to journal:
|
Some of the responses plead for a reversal of the Board's decision to charge for access to BMJ content - however they should be aware that: "We can, however, assure BMA members (including student members) and users from the World Bank's list of 120 low and lower middle income countries that access will remain free to them." This means that the majority of people who *can't* afford access will still be able to get free access under this new arrangement. With best wishes Competing interests: None declared |
|||
|
|
|||
|
Mark Hans, Patient 33624
Send response to journal:
|
I am neither a professional physician, nor a student; I am only a patient with a disorder. I like the fact that the BMJ has been free online. It is a tremendous resource as I have been able to do my own research on past and current studies to become a well-informed patient. While I am not against paying for a service. I truly and humbly request that the pricing structure includes patients (not in the 120 under -developed countries) who cannot afford the normal professional subscription rates. Some other journals online, while not directly trying, tend to GOUGE people like myself who are merely wanting to become more adept in what their disorder is as well as obtaining information on possible treatments and lifestyle changes that could affect their disorders. I am a patient who likes to be informed and able to talk intelligibly with my physician about my impairment. Thank you. Competing interests: None declared |
|||
|
|
|||
|
Morag Martindale, Registered Nurse/Health Promotion Waikato and Age Concern North Shore
Send response to journal:
|
I was very disappointed to read that the BMJ online access will be changing in the near future. I was thrilled to have discovered the website and for some time now have enjoyed reading the exceptionally stimulating articles, research and hard work carried out by health professionals around the globe. I am sure that the BMJ website is perused and absorbed by many people at all levels within and outside the health profession. However it is a sign of the times that nothing comes for free and all your hard work cannot be done on a philanthropic basis. May I ask that the subscription be set at a reasonable rate, even if it is tiered as was suggested in the original article, so that all your readers can continue to enjoy the excellent information. The value of the website for all users and viewers cannot be overstated. The community service that you offer is of the highest importance in uniting like minded people, dedicated and motivated in their search for improving the quality of lives for others. With thanks, Morag Martindale Competing interests: None declared |
|||
|
|
|||
|
DIANOUX Jean-Louis, gp france
Send response to journal:
|
Well, it's a long time we are paying in France, and rather much (200€/year), for the monthly magazine "Prescrire" (prescibe). It is the only fully independant magazine I know in France, and that is absolutely necessary: see informations about menopausal treatments, about which this magazine was everytime suspicious, against many "opinion leaders" (competing interests: never declared, at least in France !). Well: I will pay ! Competing interests: None declared |
|||
|
|
|||
|
Clarence C. Tam, Clinical Scientist Health Protection Agency Communicable Disease Surveillance Centre, Ben A. Lopman, and Dina Handan
Send response to journal:
|
The BMJ is to be commended on its recent editorial highlighting the benefits of barrier-free access to scientific research,1 which attracted an interesting, if mostly negative, set of responses. Much of the opposition to open access reflects a general misunderstanding of this publication model within the scientific community. The unfortunate use of the term “author pays” in the editorial also focused much of the ensuing discussion around economic rather than far more fundamental ethical issues. Traditional subscription-based publication is highly inequitable. Although wealthy nations spend millions annually funding research into the world’s health priorities, the majority of this research is published in expensive journals that are largely inaccessible to the clinicians, researchers and policy makers to whom the findings are often most relevant. As a worrying consequence of this inequity of access, subscription-based publication constitutes a great obstacle to research independence by less developed countries and perpetuates their reliance on wealthy nations for biomedical research. While there is a growing and welcome trend for research into health inequalities resulting from differential healthcare or social circumstance, little if any formal analysis on the health consequences of our inequitable publication tradition has been done. A common misconception about subscription-based journals is that authors publish their work for free. In truth, there is no such thing as a free paper. Most major journals charge for additional pages, colour images or reprints, often at a combined cost greater than that for publishing in an open-access journal. In addition, traditional journals impose hidden charges on authors, such as the need for article length restrictions. Although word limits encourage concise writing, manuscripts suffer from lack of detail, particularly regarding study limitations.2 The marginal cost of electronic publication space can do much to improve the quality of scientific reporting. Transfer of copyright to publishers is an additional intangible cost - major journals require authors to define their contribution to a piece of research, yet see no problem in claiming ownership of works into which they have no intellectual input. The suggestion that article-processing fees will cause researchers to indulge in ‘vanity publishing’3 is misguided and rather ironic given the current state of publishing. Our over-reliance on impact factors to assess the quality of individuals’ and institutions’ research4,5 is currently the major source of such vanity, in which pressure is put on researchers to publish in prestigious (expensive) journals at the expense of achieving wider dissemination of their work and of maximising its capacity to influence practice. Indeed, Delamothe and Smith’s statistics show that the BMJ’s impact factor has nearly doubled since 1990.3 Undoubtedly, most of this increase is attributable to the doubling of its circulation since providing free online access,3 rather than to a two-fold increase in the quality of its articles (however measured). These figures are a clear indication that free online access can of itself considerably widen the reach of scientific research. Given these arguments, it is hard to find a case for maintaining the status quo, even for economic reasons. While some authors shirk the thought of paying $500 to publish an article with BioMed Central, this is merely because the true costs of publication are only just becoming clear to us. Publication has never been free - for years, the unrestricted access to scientific information that many of us take for granted has been subsidised by libraries and institutions at a huge expense largely invisible to authors. Under the open-access model, each article is paid for only once, subsequently becoming freely available to everyone (with internet access). This point is not being lost on funders. In the United States, the Public Access to Scientific Information Act seeks to place all scientific research substantively funded by government in the public domain.6 Currently, the US Government spends $45 billion annually on scientific research, the results of which are largely unavailable to taxpayers. The privatisation of scientific information by publishers undermines the accountability of funders and the scientific community to the intended beneficiaries of such research – the public. Over the past decade, the BMJ has shown its commitment to widening access by providing universally free online content and reduced subscriptions for those in resource-limited settings. Given its support for open access, it is regrettable that, in the face of falling paper sales, the Journal should opt to squeeze subscriptions for the few years they have left instead of fully adopting the more progressive open-access model. This leading medical journal can do much more to open the door to scientific information, by influencing competitors, funders, institutions and individuals, and working with independent researchers and those in under-resourced settings towards a more equitable form of publication. For the moment, this door remains ajar. Conflicts of interest: The authors believe scientific research should be made freely accessible to all and are associate editors of a soon-to-be-launched online, open- access, peer-reviewed journal. References 1. Delamothe T, Godlee F, Smith R. Scientific literature's open sesame? BMJ 2003;326:945-6. 2. Horton R. The hidden research paper. JAMA 2002;287:2775-8. 3. Delamothe T,.Smith R. Paying for bmj.com. BMJ 2003;327:241-2. 4. Seglen PO. Why the impact factor of journals should not be used for evaluating research. BMJ 1997;314:498-502. 5. Williams G. Misleading, unscientific, and unjust: the United Kingdom's research assessment exercise. BMJ 1998;316:1079-82. 6. McLellan F. US bill says government funded work must be open access. The bill also wants to break up and redraw the rules on scientific publishing. Lancet 2003;362:52. Competing interests: The authors believe scientific research should be made freely accessible to all and are associate editors of a soon-to-be-launched online, open-access, peer-reviewed journal. |
|||
|
|
|||
|
Marco Antivalle, Rheumatology Unit L. Sacco University Hospital - 20157 Milano - Italy
Send response to journal:
|
Well, we all knew it was to happen (1). We all understand the reasons leading to this decision. And we all agree that a £10 to £20 fee for online personal subscription is highly reasonable. Nonetheless, most of us feel sad and somewhat uncomfortable. The question goes far beyond paying for online access to an excellent medical journal. The BMJ, and a few other publications, have leaded a revolutionary change in biomedical publishing. Since its first appearance on the web (2), the BMJ has been our companion in a long journey. We have long praised BMJ determination to explore new horizons (3). We have acclaimed Harold Varmus' E-biomed early proposal (4) and witnessed the birth of PubMed Central (5) and BioMed Central (6). We have signed on to the Budapest Initiative (7). We have rewarded the BMJ for its courage with a rising impact factor (1). The web of freely accessible, shared knowledge has steadily grown, though at a slower pace than originally envisioned. We still believe in it, and this is why we cannot accept to pay for access to BMJ online. It's not about paying ten pounds a year. It's about giving up a vision. We sincerely hope that the BMJ will reconsider the question, finding different, less traumatic ways to maintain a satisfactory revenue level. References 1. Delamothe T. Paying for bmj.com. BMJ 2003;327:241-242. http://bmj.com/cgi/content/full/326/7396/945 2. Delamothe T. BMJ on the internet. BMJ 1995;310:1343-1344. http://bmj.com/cgi/content/full/310/6991/1343 3. Delamothe T. Developing www.bmj.com. BMJ 1997;315:1558. http://bmj.com/cgi/content/full/315/7122/1558 4. Original Proposal for E-biomed (Draft and Addendum). E-BIOMED: A Proposal for Electronic Publications in the Biomedical Sciences. URL: http://www.nih.gov/about/director/pubmedcentral/ebiomedarch.htm [accessed 02 Sep 2003] 5. PubMed Central. URL: http://www.pubmedcentral.nih.gov/ [accessed 02 Sep 2003] 6. BioMed Central. URL: http://www.biomedcentral.com/home/ [accessed 02 Sep 2003] 7. Budapest Open Access Initiative. URL: http://www.soros.org/openaccess/view.cfm [accessed 02 Sep 2003] Competing interests: None declared |
|||
|
|
|||
|
Ian Miskin, specialist in family medicine Tel Hashomer Hospital, Israel
Send response to journal:
|
The current debate on the demise of free access to the eBMJ merely serves to bring up an old, but much mentioned topic- total access to e- publications. The current resident or specialist needs wide access to journals, as well as the freedom to download pdf versions. He is willing to pay for this privilege, but does not know where his search is going to take him and so cannot know in advance what to subscribe to. From here the need for total access:
The BMJ is ideally placed to initialise a scheme such as this, before setting up its own paying user base. Today, many physicians have to access major publications via their medical libraries and thus allowing home access such as this will vastly simplify our research and thus improve our level of patient care. One password will enable almost unlimited access. This would seem to be the next stage after unlimited free access. Ian Miskin MD
Competing interests: None declared |
|||
|
|
|||
|
David Kerr, Consultant Physician Bournemouth Diabetes and Endocrine Centre
Send response to journal:
|
What is statistically more likely: 1. Finding weapons of mass destruction in Iraq?
My money's on (2). Competing interests: I am not a member of the BMA |
|||
|
|
|||
|
Susana Askew, Associate Specialist Bath BA1 3 NG
Send response to journal:
|
What is "Queen of the South"? Competing interests: None declared |
|||
|
|
|||
|
N Portman, patient Tunbridge Wells, Kent
Send response to journal:
|
As a relatively impoverished patient I was disappointed to hear that free access to the BMJ's website would cease in the near future, although I do of course understand the commercial realities of the world in which we live. The issue is not just about funding. Widening access to medical journals ultimately helps to make medicine more democratic and doctors more accountable. The BMJ's rapid response system has been particularly important in this respect as it is available to patients as well as the medical community. In the past doctors could exaggerate the popularity and effectiveness of a particular treatment without fear of contradiction from the patient community. However thanks to the easy access to vast amounts of information provided by the internet, and the numerous opportunities that the internet gives for individuals to express themselves (such as the BMJ rapid response system) it is getting increasingly hard to get away with misrepresenting the views of patients. Of course some doctors (and indeed other professionals) feel threatened by this. However I believe that more open access to information and ideas must untimately benefit both doctors and their patients. Doctors often complain that medical information available on the internet is inaccurate or even dangerous. What better way to counteract this than to provide free access to legitimate medical journals on the web? Going back to the main issue, could I suggest a compromise. Would it be possible to provide free access the the BMJ's website only at certain limited times during the day or perhaps for only a few (perhaps randomly chosen and regularly changed) days per month. I believe that wealthy doctors living in developed countries and medical libraries would be more than willing to pay for the convenience of 24/7 access. However the rest of us would not mind the inconvenience of having to wait a few hours or days to receive a free service. Competing interests: None declared |
|||
|
|
|||
|
Brian K Saxby, Research Psychologist University of Newcastle Upon Tyne, NE1 7RU
Send response to journal:
|
However unwelcome the change, you could argue that when BMJ.com becomes subscription only, it will simply fall into line with many other services that charge for access to material for which they hold the copyright, such as those provided by the music industry. If this is the case, then will it be subjected to the same breaches of copyright? Perhaps the idea of unscrupulous academics selling pdf files on copied CDs from a suitcase at conferences is a little extreme. But what about the legality of peer-to-peer file-sharing using software such as Kazaar? Is it not legal to make a copy (photocopy or electronic) of a work for research and private study? I'm not advocating the deliberate breach of copyright, but if publishers continue to squeeze more and more from what is essentially a captive audience, then maybe the methods for avoiding the price of knowledge will become more inventive. Competing interests: In the unlikely event that my institution declines to subscribe, I will have to pay Inter-Library Loan fees for the articles I need. |
|||
|
|
|||
|
Albert J. Starshak, Instructor Dunwoody College of Technology, Minneapolis MN
Send response to journal:
|
A link from David Lane brought me to your website. I now reference it in a basic statistics section when teaching auto mechanics at Dunwoody. See: http://classes.dunwoody.edu/starshak/D'3Fall/D'3fS3Auto/Assmts/D'3fS3c3Printing/D'3fS3c3Printing.htm Will this general statistics section be part of the "for fee" or of the "for free" section of BMJ? Many thanks for the use of your site now. Al Starshak A&S Instructor Dunwoody College of Technology Minneapolis MN 55403 astarshak@dunwoody.edu Competing interests: None declared |
|||
|
|
|||
|
Richard Piper, Senior Staff Specialist, Senior Lecturer Royal North Shore Hospital and University of Sydney
Send response to journal:
|
Health is a information-based industry, and access to information is the cornerstone of our core business ... caring for patients. The BMJ has in this respect been a pioneer amongst medical publishers in placing the availability of information -- in the interest of patient care -- ahead of profit. Fortunately, the Australian and Canadian Medical Journals will continue with this ethic. We can only hope that the BMJ will reconsider its position. Competing interests: None declared |
|||
|
|
|||
|
Stephen D. Simon, Research Biostatistician Kansas City, MO 64108, USA
Send response to journal:
|
I have a series of web pages that try to explain Statistics and Research Methodology in simple language. I like to cite real journal articles as examples, and I have given preference to articles where the full text is available for free online. I have included dozens of links to various papers, editorials, and letters at BMJ.COM. I understand that I might not be able to link to new content after 2005, but what about the decade's worth of content currently available for free? Will that material remain free after 2005? I don't mind subscribing myself, but I doubt that most of the readers of my web pages will subscribe. Steve Simon, aka Professor Mean http://www.childrens-mercy.org/stats Competing interests: The success of my web pages depends on being able to link to free content at other web sites. |
|||
|
|
|||
|
John Hopkins, GP Jubilee Medical Group Newton Aycliffe DL5 4SE
Send response to journal:
|
Dear Dr Smith, Every autumn, we go back to the place we spent our wedding night, Edinburgh. Prince’s street is beautiful at this time of year. The crowds have gone. The air is mild and tastes of malt. Walking from the Caledonian, past the Art Galleries to the Scott Monument, the sun is high and clear and warm. Leaves collect round public seats bearing the names of strangers who felt at their best on this particular pavement. Like Christmas this weekend seems to come round about once every six months. And its not the only marker of passing time. I can’t believe it’s a year since I last filled in a reader’s survey to get onto the BMJ web site. Yours sincerely, John Hopkins Competing interests: None declared |
|||
|
|
|||
|
Alexander J N Jablanczy, MD private office hospital old age homes, P6A 4C9 955Queen St E Sault Ste Marie Ontario Canada
Send response to journal:
|
It's simple. As I have spent tens of thousands of dollars on several computers most of them useless or no longer salvageable several hundreds on books CDs disks etc etc etc I have at the very start of my computering made a firm decision that I will never ever pay for anything anytime for any reason whatsoever. So I no longer read the New York Times never did the Lancet nor the NEJM nor Lyon Medicale nor did down load all of the classics from an Australian site I believe that would have cost $11,000 though I cannot remember if it was in Canadian or Australian dollars. As if they owned Horaces Odes which I have anyway in four languages or wrote personally the Aeneid or Rerum Natura. The hell with them or rather may Hades welcome them as they drown in Styx Phlegeton Cocytus and Lethe. Whether literature science religion medicine history philosophy or fine art I will not pay for something that is in the public domain. All these proscriptions and limitations are self defeating anyway. Once I tried to get all the paintings of the great Canadian painter Emily Carr and her own museum refused it or was it the Vancouver or Victoria Art Gallery but the other site supplied everything even preparatory sketches ad nauseam, more extensive than a catalogue raisonnee. Too bad. I agree with the boycott of any unreasonable and exorbitant price gouging. They evidently are not interested in spreading knowledge enlightenment but just making money. Which is where I say good bye. I enjoyed and found the BMJ informative at times frustrating but always provocative and sometimes I even learned something new. The worst are the French sites except for a few exceptions, they must follow their print media. I always love it when an extreme left magazine charges one hundred franks a copy for its issue, I guess nowadays it's Euro -- No doubt all clochards sleeping under the bridges of the Seine or on the benches in Avignon eagerly await the next issue of the NRF. When a bottle of good French wine costs ten euros and the deepest analysis of the destruction of the health scare system world wide one hundred, the choice is easy. If a Canadian MD would not even consider paying for NEJM or BMJ how would one in Bangla Desh Lithuania or Haiti afford it? Competing interests: None declared |
|||
|
|
|||
|
Alex J Jablanczy, nil Office, Sault Ste Marie Ontario P6A 4C9
Send response to journal:
|
I hesitate to write this for I am terrified that some day such horrors may come to pass. Let's not give them any ideas. Some day we may have to pay for air if we dare to take a deep breath. Or if we dare to step on the pavement to go for a walk. Or look up at the sky if the stars will be still visible which I doubt. None of it is free. Hence we will have to pay for it all. As now of course we have to pay for water, parking, sports, music. These used to be free two hundred years ago. Just imagine people listened to Ludwig's nine symphonies in succession for free at a public concert. Did people pay for the Cambridge Oxford boatrace? They could admire Michelagniolo's sculpture for free. Why you could watch a lovely execution for free in those days. No doubt we no longer have capital punishment as it is not cost effective or lucrative. Pity. There is something fundamentally offensive about charging for airy nothing. For what? A few electrons and photons on a screen. If I buy a paper subscription I have something real, something material palpable in my hands. An electronic subscription is what? Information. Nebulous vacuous void. No I don't think charging for electronic noise is defensible. Which is of course why people "steal" music off the internet. It's just not the same as a book a record a CD or a musical instrument. They have material reality, weight mass color heft tactile presence sound. Electronic noise is just not the same order of reality. I am charging ten euros for my sneer. Competing interests: None declared |
|||
|
|
|||
|
Jaiganesh Viswambharan, Gen Surg Resident Jipmer.Pondicherry
Send response to journal:
|
Respected Sirs, Yours is a very good journal.The "impact factor" is what you should be worried about.Think.Why did you start your journal?To make money or for better health? It is appropriate that you have identified low income countries for whom access will be free since majority of your online friends are from these countries. Better marketing strategies may be the answer to your problems. Open doors and windows and keep them open. Competing interests: None declared |
|||
|
|
|||
|
Michele C Harms, Scientific and Clinical Editor of Physiotherapy Chartered Society of Physiotherapy
Send response to journal:
|
Whilst I understand the financial balance that needs redress in light of the falling subscriptions for paper copies, the BMJ is in the advantaged position of publishing many jewels in the research crown. The egalitarian approach that has allowed open access is comendable and ethical. Surely advertising revenue provides a healthy income without the need to levy charges for reading articles? Competing interests: None declared |
|||
|
|
|||
|
Jose Pinto, Assitant Professor Universitat Pompeu Fabra
Send response to journal:
|
Dear Sir I am quite surprised about all this fuss about the paying issue. Is it the case that people are complaining for a €24 per year? This is less than one spends in just one dinner! I think it is more than fair to charge this symbolic amount. Are you sure it is €24? Maybe I made a mistake and it is €240? Competing interests: None declared |
|||
|
|
|||
|
Jonathan D. Wren, Research Scientist The University of Oklahoma, Norman, OK 73019, William H. Hildebrand
Send response to journal:
|
The real controversy is not as much free electronic access to journals, which all have compelling commercial requirements for survival, as it is to medical data, including studies and surveys, where there is no such compunction. The term “data-driven biology” was coined to reflect the paradigm shift caused by technologies such as microarrays[1], as they change the limits of experimentation from asking specific questions such as “does gene A affect gene B?” to asking general ones such as “Does gene A affect any gene?”. Medicine faces a similar discovery paradigm now, in that electronic patient records, studies and surveys are all components that can be used to answer more general questions. The number of new studies published in MEDLINE each year has been growing rapidly, yet access to these resources is not always freely available. In biology, as large-scale datasets became more common, the research community experienced a shift in journal requirements for publication: Deposition of data in a publicly available forum for access. The first example of this was DNA sequence deposition in Genbank, and more recently microarray data in NCBI’s Gene Expression Omnibus[2]. Unfortunately, there is no corollary in medicine for these large-scale datasets on patient and survey data, but certainly not due to lack of desire. We recognize the barriers to integrating large medical datasets: Database costs, non-standardized methods, and rules concerning the release of patient information must be considered when maintaining medical datasets. However, HIPAA guidelines stipulate that health information can be databased for research applications through routine IRB mechanisms and HIPAA privacy rules allow researchers to “grandfather” datasets created prior to a compliance date without an IRB informed consent waiver. Efforts such as NIAID’s Bioinformatics Integration Support Contract (BISC) are moving us towards data-driven medical research, and the medical community stands to benefit greatly from better access to such data. “Better access” means: Free, electronic and preferably organized. The rationale is simple: People are asking questions all the time – it’s getting the answer that’s hard. Lack of access can prove to be a very real deterrent in beginning a new research study; even if it is of interest to an investigator. Studies have shown that papers that are freely available online receive more citations[3], and this recognition/usage trend likely applies to medical datasets as well. 1. Bassett, D.E., Jr., M.B. Eisen, and M.S. Boguski, Gene expression informatics--it's all in your mine, in Nat Genet. 1999. p. 51-5. 2. Edgar, R., M. Domrachev, and A.E. Lash, Gene Expression Omnibus: NCBI gene expression and hybridization array data repository, in Nucleic Acids Res. 2002. p. 207-10. 3. Lawrence, S., Free online availability substantially increases a paper's impact, in Nature. 2001. p. 521. Competing interests: None declared |
|||
|
|
|||
|
Lee A Murphy, banking bn11 2qa
Send response to journal:
|
Having parents that both died from Mesothelioma I like to keep up to date with information. Your site seems to be the only useful up to date information available and it would be a shame to loose free access. Many people still know little about it and after trying to find similar cases we have come across few avenues of compensation.
Competing interests: Having parents that died from Mesothelioma and knowing little about the disease, having access to somewhere where up to date information is available is a god send. More research needs to be done into mesothelioma and other so called uncommon diseases and access should be free. |
|||
|
|
|||
|
Belynda Ramsay, Student GERIMED, NHS, B38 8JN
Send response to journal:
|
I already pay to receive the BMJ, I use this web site as a suplement to it, so why should I pay for both?
If you start charging for the web site as well you will lose customers and I will be one of them, not only will I not subscribe to the web site but also to the journal! I'll just wait to be given it at work!
Competing interests: None declared |
|||
|
|
|||
|
adrienne jj garner, locum GP hp42pn
Send response to journal:
|
I have been a member of the BMA since 1972. For many years I kept all my back copies of the journal, later I filed particularly interesting articles. I have thrown out all the old journals, not saved any articles for the past few years and have been relying on bmj.com. I am deeply upset at the thought of this wonderful source of information no longer being available. Competing interests: None declared |
|||
|
|
|||
|
John D Baines, British Liaison Physician RUISLIP HA4 7HB
Send response to journal:
|
I feel that a non-member should be charged for access to most of the site - health education relevant to the general public should be free. A member has already paid either for the BMJ with free membership, or paid for membership with free BMJ, so alternative access should be an option at no extra charge. Competing interests: Member of BMA (ex-divisional Hon. Secretary and ex-divisional President) |
|||
|
|
|||
|
James G. Allison, Disability Member of Social Security Benefit Tribunals Cumbria and Lancashire
Send response to journal:
|
I am disabled due to MS, formerly I worked as a Disability & Welfare Rights Specialist. I can no longer do this work, but sit on tribunals with a doctor and a lawyer hearing appeals from claimants refused social security benefits for disability and/or chronic ill health. I find the eBMJ of great help in this work. All at my fingertips without the hassle of getting to a medical library from a rural area. I can only work one day per week, often less. I think there should be different scales of charges, although I would agree that a subscription of £10 to £20 would be well worth it to me. Competing interests: None declared |
|||
|
|
|||
|
Stephen Benedict FitzGerald, gp principal radlett herts The Red House Surgery WD77JQ
Send response to journal:
|
editor-chang et al include environmental modification as one element of intervention for preventing falls. in the hospital environment i wonder if the morbidity from falls could be decreased by using softer sprung floor surfaces instead of unyielding vinyl flooring over concrete.anyone who has dropped crockery on tiles and on cork will be well aware of the improved survival characteristics with the softer cork.a simple trial could be done by comparing surfaces in different hospital wards of the same hospital unit. Competing interests: None declared |
|||
|
|
|||
|
Clayton Petty, Adjunct Professor of Anesthesia 84720
Send response to journal:
|
If you can let physicians access the journal without going bankrupt, then you will provide a great service to people like me. I have been on one medical mission to Africa and intend to go again. It is a blessing to be able to access the text of articles published by such an esteemed journal as the BMJ. You have now idea what it is like to try and access recent information in a Medical School library in Africa. Only in South Africa can you get anything that is current. Please, if possible, allow access to medical information that can save lives, educate others, and keep me current on topics of interest to all in medicine. Clayton Petty, M.D. Adjunct Professor of Anesthesiology Competing interests: None declared |
|||
|
|
|||
|
Robert Howells, Web Dev Officer at SCIE SE1 2HB
Send response to journal:
|
Please consider the alternative payment option used by websites such as www.slashdot.org. Their website contains free articles for all to read. They have a subscription option and for those that pay a subscription there are no adverts displayed on the page. This is fair because those subscribers shouldn't have to wade through reams of adverts which are also providing revenue for the website. Consider running this as a test to see if it generates enough revenue from the mix of advertising and subscription to be sustainable. PS. Another reason for fall in journal sales is the exponential rise in the cover price of journals and the number of journals in circulation. Competing interests: None declared |
|||
|
|
|||
|
Martha K. Jalomo, medical doctor and postgrade student Secretaría de Salud Integral, Oaxaca y Mina s/n, C. P. 63 000,Tepic, Nayarit, México.
Send response to journal:
|
México needs BMJ free access. BMJ is one of the most important source of scientific knowledge in our state (Nayarit). It would be so difficult for students and medical doctors as me to have access to a pay suscription to BMJ. This is a reality. Please continue free access for Mexico. Thank you. Competing interests: None declared |
|||