Editor's Preface

eCMAJ

As the old cowboy says to the Dude in the film The Big Lebowski, "Sometimes you eat the bar and sometimes the bar eats you."1 We're not quite sure what this means, but we do know that replacing the word "bar" with "Web" makes us feel uneasy. It seems inescapable that, sooner rather than later, all medical journals will have to make their contents available to users over the Internet. The pace of change is so fast that sometimes we can't even keep up with ourselves. Even as our editor was complaining that CMAJ was not available in a full-text version on the Web,2 our July 13 issue became the first to be posted online in a full-text version (www.cma.ca/cmaj). We think this is progress, but the sheer size of the Web and question of survival in the new economics of Web publishing are enough to make anyone nervous.

According to Netcraft, a consultancy based in Bath, England, there were 7 million Web sites as of August this year, up 1 million from the number reported in their Web Server Survey just 3 months earlier.3 How luminous can CMAJ expect to be in such an overcrowded galaxy? In addition to electronic versions of pre-existing print journals there is a growing sector of medical publications starting up de novo on the Web. Companies such as Medscape, WebMD and others are aggressively competing for Web traffic with resources that far exceed ours. For example, the broadcasting giant CBS recently purchased a one-third stake in Medscape for US$150 million. As if that weren't enough, E-biomed, recently renamed PubMed Central, will be launched in January 2000. Free to users, it will contain the full text of scientific articles published in many medical and health sciences journals.

In the virtual stampede to electronic publishing it is hard to see how a small medical journal will survive. Already medical journals are touting their achievements: The British Medical Journal cheerfully reports that eBMJ is, according to Netscape, in the top 3573 most popular Web sites; this ranks it within the top 0.05% of the Web.[4, 5] We could remind them, however, that they have a way to go to catch Playboy, listed as number 104.6 Perhaps if they could get an eBMJ link on Playboy's home page?

Our eCMAJ strategy is to use the electronic version for what it is: a wonderful way to store, retrieve and link information. But we wonder whether the very nature of electronic journals may encourage a less discursive way of thinking about medical information. If this is true, the nature of medical practice will be altered, and may well be damaged. In his justly acclaimed The Gutenberg Elegies: The Fate of Reading in an Electronic Age, Sven Birkerts says that it is the writing that is important, not its connectedness:

My core fear is that we are, as a culture, as a species, becoming shallower; that we have turned from depth ... and are adapting ourselves to the ersatz security of a vast lateral connectedness. That we are giving up on wisdom ..., and that we are pledging instead to a faith in the web. ... It would be wrong to lay all the blame at the feet of technology, but more wrong to ignore the great transformative impact of new technological systems - to act as if it's all just business as usual.7