The small number of medical journals that provide their entire content free online will soon be even smaller, and the loss will be significant. In August, the British Medical Journal announced that it will begin charging an annual user fee of £10 ($22) to £20 ($44) for annual access (2003;327:241-2). The change will take place in January 2005; access will remain free for 120 low-income countries and BMA members. BMJ will also be much cheaper than most restricted-access journals — the New England Journal of Medicine charges Can$14 for a single article and Can$40 for a day's unlimited access.
In an editorial, Web Editor Tony Delamothe and BMJ Editor Richard Smith said the decision was made by the board of the BMJ Publishing Group because of “anxiety over falling library subscriptions to the paper journal.”
They said the online fee is an attempt to introduce a new source of revenue as other sources begin to weaken. The editorial said that subscriptions account for only 12% of the BMJ's total revenue, compared with 61% for job advertisements. However, the latter revenue stream is threatened by a new National Health Service Web site. Advertising by drug companies is also threatened, with promotional spending by drug companies declining by 8% in the past year.
The editorial attracted dozens of rapid responses at eBMJ, and although most writers accepted the argument that new revenue streams are needed, there was also a hint of sadness that an era was drawing to a close. “You will be leaving the Medical Journal of Australia and the Canadian Medical Association Journal to carry the flag for the national medical society journals,” said Stephen Due, chief librarian at the Geelong Hospital in Australia. “Canada, of course, still leads the way with an impressive array of free electronic journals in the specialties, including the Canadian Journal of Surgery and the Canadian Journal of Psychiatry.”
Under the BMJ plan, all content will probably be free for “a week or two” following publication, and will then be placed behind access controls for a year or more.
CMAJ Editor John Hoey praised the BMJ for “its tremendous energy, foresight and leadership in providing free online access, which has made it a lot easier for the rest of us.” But at the moment, he said, “we have no plans to follow the BMJ's decision to limit access.” — Patrick Sullivan, CMAJ