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In the good old days the BJGP (or the JRCGP as it was then called) routinely took as long as 4 months to publish a letter in response to an article, after which another 4 months would elapse before you could see the reply from the original author, and so on. Such correspondences would jump-frame down the seasons like stills from an Errol Flynn sword-fight: December's withering cut hanging agonisingly until March's answering thrust. Then you held your breath all summer for the falling leaves to bring the longed-for parry.
To say all this has changed with the coming of the internet is a ludicrous truism. What is less obvious, and much more interesting, is that these changes are continuing. We are in a state of gross disequilibrium; as well as producing a wealth of new opportunities, the new situation has produced new problems which we have hardly identified, still less resolved.
One such problem struck me the other day when I wanted to pass on the news of an article in this journal in the way that has now become such a matter of course with other kinds of publishing. The article in question was June's leader by Mangin and Toop, ‘The Quality and Outcomes Framework: what have you done to yourselves?’ — in my opinion a piece of extraordinary importance and insight which merits the widest and most urgent attention.
So what I wanted to do was email a number of people and include the URL (web address) of the article in the email. The first problem was that, unlike a similar article in the national press which can be viewed immediately by clicking the link in the email, here the article can only be read by non-members of the college or by non-subscribers if they first pay a fee, currently US$32 plus tax. So, even if my correspondents were prepared to pay this perhaps smallish amount, they would be most unlikely to go through the lengthy payment process required each time they received an email of this kind, especially as their first requirement would be to glance quickly at the article and while the security of internet purchases remains problematic.
The next possibility, therefore, was to download the complete article through my College membership and then include it as an attachment to my email. But this raised two further problems: first the difficulty of actually navigating the RCGP website (reportedly now being fixed) and secondly, the fact that such distribution is actually illegal without specific permission. And this is not permission from the authors, but permission from the journal; strictly speaking, from the moment of being accepted for publication, authors are not allowed to distribute their own articles except in the form of the old-fashioned reprints which are still offered on the copyright form they are obliged to sign.
So what we have is a situation where scholarly, authoritative, carefully researched and thought-out articles like this one by Mangin and Toop are selectively excluded from what, for better and for worse, is now the main mechanism by which hot topics get discussed. Meanwhile, internet conversation is dominated by ephemera and trivia.
To make sense of the madly-changing information scene with its new slant on the old dilemma (faced in every schoolroom there has ever been) that freedom of talking causes impossibility of hearing, perhaps we should go back to relatively simple questions. Does parallel publishing on the web actually help or hinder the sales of hard copy? Is the ‘information superhighway’ primarily about disseminating and developing ideas, or must it be subservient to the modern mantra that everything must make a profit? Is publication in the BMJ more or less beguiling since they reinstated access controls; and if authors find that their work is less visible on the BJGP's web pages might they not submit instead to more open access journals?
In my opinion, the traditional outlets with their experience and their journalistic professionalism remain best-placed to fulfil the vital role of selecting quality material and helping readers choose where to direct their attention. My worry is that with the way the economic model of professional publishing is set up at the moment, the very articles that ought to be head of the queue for that all-too-finite attention are being consigned to relative invisibility.