Bah. Humbug, balderdash. A Christmas fairy tale. In the expanding world of electronic medical journalism, content is king. The exchange of print and electronic.
conveyor belt for data, is not one that I recognise. I invite them both to join the Lancet team for a few days. We might then ask whether their triumphalist tone heralding "the collapse of traditional journals" is an original vision or simply a dreamy albeit modern Oasis.
*Franz Ingelfinger was a former editor of the New England J'ournal of Medicine who laid down that journal's policy, since adopted by others also, that it would not publish papers that had already appeared in print in some form elsewhere. This has become known as the Ingelfinger rule.
A Christmas fairy tale George D Lundberg JAA$4, Chicago, Illinois 60610, USA George D Lundberg, editor
Bah. Humbug, balderdash. A Christmas fairy tale. In the expanding world of electronic medical journalism, content is king. The exchange of print and electronic information among scientists and clinicians (as well as person to person) will continue to coexist side by side. Some methods are better for some things; others for others. Evolution in this process is occurring and will continue. We are monitoring numerous objective and subjective markers as we design this evolution prospectively. The only way to predict the future is to create the future. This we try to do every day. It may be helpful to remind scientist La Porte and
lawyer Hibbitts that clinical research information published in medical journals is different from new information in music, mathematics, astronomy, and the law. Lives actually depend on it. Real doctors use this information to help decide how to take care of real patients every day. Medical journal editors have relationships of trust with many publics, beginning with the reader and the author, extending through the owner and the sources of financial support but, most especially, to patients. In medical information quality of content will continue to be king for the benefit of all of us as patients.
To market, to market Frank Davidoff Annals ofInternal Medicine, Philadelphia, PA 19106-1572, USA Frank Davidoff, editor
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Let's face it, LaPorte and Hibbitts are talking marketplaces-not science, not intellectual freedom. Leave aside their blithe assumptions that the Beatles are "dismayed" over Michael Jackson's ownership of most of their songs; that this is an "artistic tragedy." (The Beatles may be creative, but they're not dumb; it's just possible that they decided to take their billions in lump sums, and leave behind the hassles of dealing with copyright lawyers.) No, LaPorte and Hibbitts' real concern is with middlemen-a fantasy of Blue Meenie publishers, bloated with money (their words: "[societies] derive considerable revenue from the publication of biomedical journals") and obsessed with power (their words: "journals have monopolised scientific communication") who control not only the intellectual lives but also the livelihood of scientists. Shades of the 1960s! Can it be an accident that their broadside is interlarded with Beatles' lyrics-used, presumably, without permission? Dissolve to 1969: we thirtysomethings too had decided that middlemen were the scourge of the earth. Why should farmers slave to produce our daily bread, only to have their livelihood controlled by the cold calculations of (bourgeois) retailers? We'd form a cooperative, go right to the wholesalers, bring the food directly to our tables. Everything would be cheaper, fresher; we'd get what we wanted, not what stores offered; and we'd be in control. So we talked, organised, acted. And we,learned. Firstly, there were the schedules: Who would decide who got up at 3 am to drive to the wholesale markets 30 miles away? And who would resolve the scheduling disputes, find the replacements when people didn't show up? Then, we needed a place. Where were we going to bring the 30 pound blocks of cheese, the 50 pound drums of peanut butter, all the stuff to be divided up, parcelled out, with us as "free" labour? And we needed a money person, a miraculous hybrid cashiertreasurer, careful, trusted. And on and on. Yes, it was fun to short circuit the system, but the cooperative lasted about a year, then died, quietly. Hard lessons. Supermarkets aren't "just" stores, any more than
scientific journals are "just" messengers. Both are enormously complex organisations; they provide incredible amounts of service and convenience; and the economic margin, at least for most of them, is razor thin. Sure, scientists who want to can simply bypass the journals right now, become their own publishers on the Internet. So why don't they? Is it really fear? Or maybe they've learned that it's actually valuable to have their work published in journals? That editing and peer review are worth a lot? And that they'd really rather spend their time being .scientists, rather than editors, and reviewers, and publishers, and librarians-and businessmen? For the 1960s also taught us that copyrights are no different from any other rights, and that with rights come responsibilities-for example, billing systems, copyright lawyers, the works. And when it comes to their fantasies about the economic realities of scientific journal publishing, LaPorte and Hibbitts really are in Sargeant Pepper land. Most scientific journals, particularly the smaller ones, lose money and require subsidies. True, some large journals are self supporting, even bring in net revenue, but only with enormous subscriber bases plus page advertising; the former is rare, the latter unreliable. Marketplaces come in all shapes and sizes, from the starchy, like New York's Tiffany, to the turbulent, like Cairo's Kahn el Kalili. Certainly, there can be more than one marketplace for scientific information; and, sure, it's useful from time to time to rethink how that marketplace might work better. But it's an open question whether scientific information is best hawked in the white noise of the Internet marketplace, or in one with a little more order, a bit more stability. Could scientists trash the scientific journal system by responding to LaPorte and Hibbitts' call for intellectual civil disobedience? Sure: scientific journal publishing is vulnerable; its economics, and its complex core of mutual benefits, built up over many decades, are fragile. And it's always easier, and more fun, to smash systems than to build them. We still sometimes go to farmers' markets; they're groovy. Remember groovy? BMJ VOLUME 313
21-28 DECEMBER 1996
