Journals distort evidence and restrict access to research for the public who fund it. In the digital age, subsidising traditional publishers is no longer necessary or justifiable.
For supposedly clever people, we academics are complete mugs. Not only do we give away our research for publishers to make a profit1, our institutions pay hefty subscriptions just to access it, or pay even more if we want to make it freely available. Bizarrely, we also voluntarily staff the editorial and decision making processes of their journals. Meanwhile careers (and egos) demand recognition in ‘luxury journals’2, which often privilege novelty over solid science and finding answers to questions that matter to patients.
Until recently the journal system represented the most efficient way to disseminate discovery. But in the internet age, publishers’ grip on science has become an ever more anachronistic impediment to science. That supposed innovators remain unquestioningly infatuated with a publishing model as redundant as leeches and blood-letting would be merely ridiculous, were the consequences not so dire.
Preventing almost everyone from accessing research is manifestly unjust. Research outputs are never really ‘ours’ to give away, the work is subsidised almost entirely by public and charitable funding and relies on the goodwill of the patients who participate so that others may benefit. Modern medicine’s avowed commitment to patient empowerment surely rings hollow if we even won’t share information freely, with the insinuation that patients must just ‘take our word for it’.
As well as being elitist and unfair, donating knowledge to be locked away is utterly stupid. Shutting out researchers from institutions, many in low and middle income countries, which can’t afford journal subscriptions is only hindering science. And, while we castigate politicians for being evidence-illiterate, the researchers who prepare science reports for MPs have to rely on what they can find for free on-line3.
So what should we do about it?
In the short term, we should be lobbying all funders to require (and enforce) that research is published in journals which are either open access, or allow unrestricted dissemination of original manuscripts. In the longer term we should have the ambition to liberate research from the publishing industry altogether.
State funders of research can begin to establish the infrastructure to vet, catalogue and host freely available research. Publication decisions based solely on scientific integrity and ethical acceptability would be a major step in addressing publication bias and the replicability crisis. In time, funders will be able to insist that publication occurs only in these public repositories and editors and reviewers will follow. Eventually global integration of national catalogues could be undertaken through international collaborations, perhaps overseen by the World Health Organization.
Most popular journals would continue to thrive and could reproduce research of interest, from the public repositories. Some titles might migrate or integrate into the public system creating a mixed economy albeit on the basis of unhindered access and cost containment.
Some might question how the importance of research would be recognised if not by the traditional journal hierarchy. A range of reviewer and crowd based metrics can be implemented and refined. Though any attempt to quantify subjective quality will always be flawed, transparent metrics would surely be preferable to the entirely reductive4 and apparently negotiable5 methodology of journal impact factors.
Our publishing model is unfair, entrenches bias and represents poor use of public and charitable money. We already give away our work for free – we should demand it is made open and dare to imagine research beyond journals.
This blog inspired by a discussion with Dr Bethany Shinkins and was informed primarily by Chris Chambers’ book, ‘the seven deadly sins of psychology’, Princeton University Press 2017
References
Conflicts of Interests: I have published in non-open access journals and have chosen to publish in journals based on impact factor. As well as being employed as a GP, I am undertaking a PhD funded by Cancer Research UK and I receive payment for occasional work with the GMC on the PLAB examination. I serve without payment on a NICE committee and on the executive committee of the Fabian Society, a political think tank.
Biography: Stephen Bradley is a GP and a clinical research fellow researching lung cancer diagnosis at the University of Leeds. He is also interested in addressing inequalities in health and health policy
Carl Heneghan In 2019, EBM Live set out to identify and fix some of the problems with how research evidence is developed and disseminated to end-users. Issues outlined in the
David L. Sackett (1934-2015) was a Clinical epidemiologist, pioneer of evidence-based medicine and the founder of the Centre for Evidence-Based Medicine. The David L. Sackett Fellowship provides awardees with EBMLive