|
|
|
In recent years the cost of biomedical journal subscriptions has increased rapidly. The recent American Libraries* index of periodical prices shows two of the categories with the largest price increases since 1984, Chemistry and Medicine, are those that most affect the biomedical literature and the medical library. The Medicine category increased 317.8% from 1984-1998, while "Chemistry and Physics" increased 364.2%, and the average increase of all periodicals was 265.2%. The 1998 figures are not yet available, but the Consumer Price Index increased only 54.5% from 1984-1997, while the Higher Education Price Index increased 78.4% in the same period.**
The Medical Library has developed an innovative serials use tracking mechanism to help determine actual use of the collection, and this has enabled the library to cull underused journals for many years. (See Francq, Carole. "Bottoming Out the Bottomless Pit with the Journal Usage/Cost Relational Index." Technical Services Quarterly 11, no.4 (1994):13-26., and Ralston, Rick and Carole Francq. "Subscription Statistics for Collection and Budget Decisions." Indiana Libraries 14, no.3 (1995): 65-71.) A sample of the product of these studies is Table 1, "Use and Cost of Expensive Journals at RLML".
Despite these efforts, the effect of journal price increases on the Medical Library budget has been substantial. The attached table, Table 2, Journal Subscriptions and Costs, 1991/2-1996-7, shows that the Medical Library serials budget has increased by 74.87% in the past six years, while the number of journals the Library subscribes to has declined or stayed even.
Several recent developments offer some long-range possibilities for cost reduction described below, but the overall pace of biomedical innovation, and the participation of the medical school in the forefront of research in many areas will require the Library to maintain access to these important scientific resources for our faculty.
One long-range possibility is the development of evidence-based (EBM) medicine methods. These methods are aimed at providing the medical practitioner with the best documented research in each medical field without forcing the practitioner sift through complex research literature. The EBM approach is also aimed at improving the practitioner's evaluation of medical literature. According to a definition at the McMaster University Evidence Based Medicine web site (http://hiru.hirunet.mcmaster.ca/ebm/ ):
Evidence based health care promotes the collection, interpretation, and integration of valid, important and applicable patient-reported, clinician-observed, and research-derived evidence. The best available evidence, moderated by patient circumstances and preferences, is applied to improve the quality of clinical judgements and facilitate cost-effective health care.
The Medical Library teaches EBM methods in its recently developed Medical Informatics clerkship for 4th year medical students (see the page "Medical Informatics Clerkship at http://www.medlib.iupui.edu/informatics/). The Medical Library has also developed a set web pages, EBM - Evidence Based Medicine at http://www.medlib.iupui.edu/ebm/, to provide resources for the study of Evidence-based Medicine.
For libraries, this means that compilations may replace the journal literature for some types of use. This fall the Medical Library will add an evidence-based medicine database to its online database system. On the same system (at http://www.medlib.iupui.edu/medweb ) the Library already provides major medical and nursing indexes with direct links to online articles to facilitate the structured approach to the literature required by EBM. The Medical Library will also add online medical textbooks and reference books that provide similar summary medical information.
A second long-range possibility is that libraries may begin to purchase more biomedical literature by article rather than by journal. The Medical Library already balances the cost of journal acquisition with the cost of obtaining a few articles from that journal from outside sources. With the development of electronic equivalents of our paper journal collection, the Library can track use by article. Eventually payments to the publishers might be linked to actual use of articles in particular journals. Faculty reaction to the Library's existing online journal collection indicates that many faculty still prefer to browse and search by journal title, as well as by author or subject descriptors. The software developed to review the online articles soon added features that facilitate browsing by journal table of contents to meet this faculty demand.
The journal as an organizational concept and filtering mechanism retains a strong hold on faculty use. Even so it's conceivable that payments to the journals might eventually fluctuate with the popularity of the articles. The largest drawback to moving to article pricing would probably be the reluctance of both libraries and publishers to move from fixed annual costs to fees which might fluctuate wildly. However given the dramatic increases in journal costs in recent years, libraries may be more and more willing to move to trusting an open market of articles.
Health care, medical education, technology, and requirements for faculty tenure all effect the way medical literature is used and all these arenas are experiencing major changes. The trends toward educating for lifelong learning, evidence-based health care, electronic journals, and the technology to enable remote distribution of documents will profoundly change the way medical literature is used.
Journals in the traditional page format will continue to be needed by clinical and research faculty for some time. At the same time, these same journals in electronic screen format will be valuable additions to the academic biomedical library because of the remote access. There will be a demand for adding journals in new disciplines and the print tradition as well as electronic journals will continue to increase in number as well as cost. Established titles in each subdiscipline will continue to be valued by faculty because of tenure requirements.
The present pricing arrangements for electronic journals by many publishers is that the print subscription must be maintained with a percent of the print costs added on for the electronic version. The add on cost for the electronic version is most commonly twenty-five percent of the print. Electronic journals do NOT reduce the cost of journals at this time and as journal prices continue to rise, libraries are canceling titles, the publishers hike the prices to recover lost revenue, and the cost spiral continues.
Market forces may alter the format of publishing and the traditional journal may be replaced by an electronic format that will have a totally different pricing structure. At this time many biomedical research associations are exploring electronic publishing as an alternative to the journal. Clinical practice guidelines, consensus statements, and patient education are now commonly distributed through the Web and researchers share information through email and Web sites. With developing technology and rising journal costs, the traditional format for distributing research information is bound to change drastically in the next decade.
J. Morgan, with contributions from C.Gall, F.Brahmi, M. Richwine and R. Ralston.
*Alexander, A.W. and Dingley, B., "U.S. Periodical Prices - 1998", American Libraries, May 1998, pp.82-91.
** Ibid., chart A.
For further information about this page, contact Jim Morgan (morganj@iupui.edu).
URL: http://www.medlib.iupui.edu/rlml/rlmljcosts.html