An unseen epidemic

Journal of Family Practice, May, 2005 by Jeff Susman

We are in the midst of an unseen epidemic. I am not talking about the Marburg virus or Chlamydia, not teenage pregnancy, and not the plight of our patients with disabilities and dwindling support from Medicaid.

This epidemic is spreading across the Internet, and point sources appear to be the editorial facilities of our major medical publications. As yet unvalidated, reports are being heard of rapid transmission among publishers and medical and specialty societies. What is this epidemic? Let me describe my encounter with it.

Recently, I started to update a talk on low back pain. On a yearly basis I review my file of clipped articles on the topic and do a new search on PubMed, TRIP, and similar evidence-based resources. What a joy it is to have at my fingertips the worlds' medical literature.

NOT!!!

You, too, may have discovered that access to actual articles is denied to we "riff-raff." With only a few exceptions, I was asked to pay an up-front user fee or to subscribe before access to a desired article would be granted. What has become of the promise of rapid communication of scientific information?

Now, you might say this was the state of affairs in the good ole days: after laboriously reviewing Index Medicus, you would pore through the stacks hoping your library subscribed to the journal of interest. And of course you can say that publishing companies, journals, and medical societies must turn a profit. If you work at a large university, as I do, you probably have access to many full text journals on line. There are even a few free, but limited, access points provided by commercial sponsors. But with deep disappointment, I contemplate our unfettered access to scientific information becoming more limited.

Let me propose a couple of measures to counter this epidemic. A few journals have allowed open access to the current issue, but limit access to the last year to subscribers only. Older issues are open. While not ideal, this option does make available articles "in the news" as well as older information.

Or, instead of providing us another pen or plush toy, why don't commercial sponsors support access to the top databases, references, and journals?

Perhaps, then, we can defeat this epidemic and regain rapid availability of medical information.