COMMENTARY

Open-Access Medical Knowledge: Where Are We Currently and Where Should We Be Going?

Rick Kulkarni, MD

Disclosures

January 09, 2009

 


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Healthcare providers the world over strive to provide care of high quality to their patients. To do so, they must be well informed on current best medical practice and recent biomedical advances. To be well informed, practitioners need easy and affordable access to new medical information.

Is easy and affordable access to medical knowledge currently a reality? Well, yes and no.

Yes, because referenced content such as that offered through eMedicine and Medscape is available free of charge via a computer and an Internet connection.[1,2] No, because, apart from a few open-access pioneer sources, full-text, immediate access to primary source medical journals is not available.[3]

Most publishers of medical journals have stuck to a 400-year-old model of fee-based publication. Such fees are downright prohibitive to much of the world. Why is this tolerated by medicine and the general public? I believe that this knowledge belongs in the public domain. After all, taxpayers fund a significant percentage of medical research in most developed countries.[4]

Why is it, then, that medical publishers can retain copyright and limit access? Recently, pressure from proponents of the open-access concept has resulted in the emergence of some open-access publication models.[5] For example, several publishers now allow full-text access after a defined period of time, such as 1 year after publication.[6] Should physicians and their patients have to wait 1 year before access to important medical advances? I think not.

We need leadership to push for immediate, full-text access to all clinical literature and we need that leadership now. To paraphrase a mentor, "Knowledge [should] be in the domain of the seeker."

That's my opinion. I'm Dr. Rick Kulkarni, Medical Director of eMedicine.

 


 

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