The first issue of a new medical
journal based in Canada is now available — but
on the web. Open Medicine, created by a group
of CMAJ editors who quit or were fired after
last year's editorial-independence scuffle, is a true
journal of the new millennium. Besides publishing online
only, it provides open access for readers around the
world, permits authors to hold the copyright to their
own work, and bans all pharmaceutical or medical-device
company advertising.
Open Medicine is the newest
addition to the open-access, or OA, movement, which
aims to make scientific research more accessible —
primarily, as in the case of the prominent OA journals
published by the Public Library of Science, by making
all research available free of charge and forgoing press
embargoes.
"It's an ideological principle,"
says co-editor Dr Stephen Choi, the former deputy editor
of the CMAJ. "What we're really hoping to do
is reach out to a wider audience," says Dr Choi. "Many
journals seem to us to be geared towards academic physicians
who work at teaching hospitals. We'd like to reach out
to the non-academic community as well — they're
the majority and most important audience because they
see most of the patients."
Only a fraction of the world's
scientists and citizens have access to the latest science,
adds Dr Choi. "Not just in third-world countries," he
says, "even in this country, many FPs who don't work
at universities. They may only subscribe to one, maybe
two journals — to us that's not right. Ultimately
it comes down to patient care." Providing free and immediate
access to medical research, he says, is in keeping with
what Open Medicine's editorial team feels is
the "spirit of science."
FIRST
'ISSUE'
The journal officially went live — at www.openmedicine.ca
— on April 17. The inaugural issue includes research
articles on rural students in urban medical schools,
an Alberta prostate cancer screening initiative and
the accuracy of databases at identifying hypertensive
patients. Also published is the largest-ever review
comparing the cost of healthcare in Canada and the US
to patient outcomes. The review concludes that the US
healthcare system pays twice what the Canadian system
does for the same results.
But as Dr Choi explains, in the
future Open Medicine will not publish 'issues'
per se. Instead, articles will be published online as
soon as they're peer-reviewed and finalized. "Other
journals take a long time to publish sometimes," says
Dr Choi. "We think information about medical care ought
to be available immediately." The practice of numbering
issues and pages will continue, but only for indexing
and citation purposes.
NEW
BEGINNING
Open Medicine's staff is primarily composed of
former CMAJers. Dr Choi served as interim editor-in-chief
briefly after the incumbent Dr John Hoey and deputy
editor Anne Marie Todkill were fired for lashing out
against the CMA over allegedly compromising the journal's
editorial independence. (The CMA suppressed portions
of an investigative article on pharmacists impeding
prescriptions of emergency contraception, the editors
said at the time, and also demanded changes to a news
article about federal health minister "Two-Tier" Tony
Clement's support for healthcare privatization.)
Dr Hoey and Ms Todkill are both
associate editors for Open Medicine. They'll
be writing and reviewing manuscripts, says Dr Choi.
The other co-editor is Dr Anita Palepu, a Vancouver
internist who resigned her associate editor position
at the CMAJ last year. John Willinsky, PhD, a
UBC education professor and author of the 2006 book
The Access Principle: The case for open access to
research and scholarship, has been named publisher.
Among the international team of
editors, one particular name brings with it significant
intellectual weight. Dr Jerome P Kassirer, former editor
of NEJM, has been appointed a member of the board
of directors. A former member of the CMAJ board,
he headed up a committee to review the CMAJ's
editorial autonomy policy in March 2006, at Dr Hoey's
request (before Justice Antonio Lamer's panel). Dr Kassirer
resigned from the CMAJ board that month over
concerns that editorial autonomy would not be respected
in the future.
FINDING
FUNDING
Without pharma ads as a funding source, the journal's
editors have pieced together private donations and grants
to keep them afloat. Also contributing is Simon Fraser
University, which has donated web hosting on its servers.
Even with their help, Open Medicine's budget
is miniscule, admits Dr Choi.
"Believe me, we are not striking
a goldmine," says Dr Choi. "We want to promote integrity
in science, independence, and open discourse in medicine
and healthcare."
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