Andrew N. Wilner, MD; Diana M. Schneider, PhD


July 16, 2012

Editor's Note:

Electronic journals and textbooks may be the best way to capture and update information in the rapidly changing field of medicine. In an interview with Andrew Wilner, MD, Diana Schneider, PhD, president of DiaMed LLC/DiaMedica Publishing, gives a historical perspective on the pros and cons of print and electronic medical publishing and takes a look at the future of this growing field.

Dr. Wilner: How has the world of medical publishing evolved during your long experience?

Dr. Schneider: When I started in publishing in 1975, we were publishing a fair number of conference proceedings that were considered serious books. But after a while, it seemed anything could be published, including junk, so the move was back to standard edited textbooks. The single-authored text has become a thing of the past, with a few rare exceptions, because almost no one has the time these days to sit down and write a book. The edited book is now what medical publishing is about, except for a small number of monographs.

Over the years, the sales of a book have been steadily declining because more and more people are getting their information on the Internet. Journals were the first to make the transition, and now paper journals run a very distant second to the online material. The primary reason for that is that whereas books have a relative permanence, journals by definition publish primarily new information, and new information really lends itself to electronic publishing.

Dr. Wilner: Are we seeing the disappearance of the old-fashioned hardcover textbook, or are those still important?

Dr. Schneider: They are still important. Many textbooks are no longer in hardcover. Because of all the rapid changes in medicine, textbooks are considered more transient, and medical students and residents are much more likely to get their information electronically. But you definitely lose something when you choose the information you need electronically. The advantage of using a textbook is that someone has compiled the important information and put it in an order that makes sense, so that when you come away with a textbook, you come away with a broad base of knowledge rather than isolated segments.

The negative side of Internet access is that you get it when you need one specific fact. You lose serendipity, and you lose the breadth of information. The world is changing, so few people have time for the explosion of information, the sheer volume of what's available.

Dr. Wilner: I was one of the editors of a new textbook called Atlas of the Epilepsies, and in addition to the 3-volume hardcover version, you can get an online subscription to the Atlas. Do you think that this is the way to go -- to have a hardcover version but also online access?

Dr. Schneider: Yes, and I think slowly, over a period of some years, we may see the disappearance of the hardcover version. One thing that I think is very exciting is the appearance of interactive reference lists. If you want to know more about something after you have read through a chapter, you can click on a hyperlink in the references and go to that particular article. You just cannot compete with that in print.

Over time, younger physicians are going to be online more and more for all their textbook needs. Where we still see a need for a printed book is in the area of more patient education. That is a very different field, where people still like to hold books, although ebooks are beginning to catch on.

Dr. Wilner: Patients are becoming more and more educated, and of course they are using the Internet. What about the market for patient education books? Is that growing, or is it shrinking?

Dr. Schneider: It is growing because patients need the information. This is almost a self-defense against a medical profession that patients see as not spending enough time with them and not caring as much. The average physician visit now is between 10 and 20 minutes, and you just do not get what you need. The big thing here is that we are gradually seeing a move to electronic information, but in the form of ebook downloads, and I think that's going to continue.

Dr. Wilner: What is DiaMedica doing?

Dr. Schneider: DiaMedica is working in a variety of areas. Our largest area is neurologic disease. We have books on migraine, fibromyalgia, and Parkinson disease. We also have a growing list in oncology and some emphasis on physical medicine and rehabilitation, with books on arthritis and neck pain.

Dr. Wilner: Are these for physicians or for patients?

Dr. Schneider: They are all for patients.

Dr. Wilner: Doctors seem to be getting busier and busier. Do they still have time to write books?

Dr. Schneider: The ones who do have time do it because they love it. Our best authors are really dedicated physicians, sometimes combined with either a patient or a nurse. The ones who write the books seem to have a passion, but the vast majority of physicians don't have the time or the interest.


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