Earth to publishers: Free is not unprofitable

Let's follow up on yesterday's post about the person who wanted to read an article in The Joint Commission Journal on Quality and Patient Safety. She had seen the abstract here on PubMed and wanted to learn more.

This seems like a really worthwhile journal. Here's the description:

Published monthly, The Joint Commission Journal on Quality and Patient Safety is a peer-reviewed publication dedicated to providing health care providers and quality and safety professionals with the information they need to promote the quality and safety of health care.

But let's say you want to read just one article. You find you cannot, without subscribing for a year at a cost of $319:


What's your option? Well, our friend crowdsourced on Facebook and found someone willing to share a copy.

@SusanCarr responded to my blog post with two tweets on Twitter, saying, first: Mixed feelings: proud that PSQH offers free subs & open access www.psqh.com. (See below.)


And then adding, And I know all too well that publishers must figure out some way 2 get readers 2 pay 4 content. Tough business these days!

Well, no, the issue is not that hard really. There are lots of options open to publishers who wish to consider them. A respected journal can have a sustainable paid subscription business model while allowing general access on reasonable terms to articles of public import or of specific interest to targeted audiences. Implementation of these options actually enhance the prestige and reach of those publishers.

For example, the New England Journal of Medicine allows full public access to its Perpectives articles and other selected articles of broad public interest.

The New York Times, which has moved to a paid subscription model for its electronic version, understands the need for some people to gain access outside of the payment plan:

For those who don't want to subscribe, the Times will offer 20 free articles per month - including blogs, slide shows, video, and other multimedia features. As you reach your limit, pop-ups will appear on the site. The paper will also provide unlimited access to the home page, section fronts, blog fronts, and classifieds. Those who comes to the Times via links from search, blogs and social media like Facebook and Twitter will be able to read the articles, even if they have reached their monthly reading limit.

In contrast, there are some organizations that persist in having a myopic view of how to maintain profitability and in so doing disenfranchise patients and consumers from a vibrant role in helping to design a more effective health care delivery system. The American Medical Association and The Joint Commission seem to be in this category. I guess I shouldn't be surprised about the latter, which collects best practices while charging accreditation fees to the hospitals that provide these stories, keeping this information in a locked-up library. How pathetic, too, that this occurs under the auspices of a delegation of authority by CMS.