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Berquist.Thomas{at}mayo.edu
The scholarly journal business in the United States is a $45 billion industry [1]. In the September Editor's Notebook [2], I discussed the explosion of education materials available on the Web. The number of online journals has increased from a few in 1998 to thousands by 2004 [3]. We now have access to more medical information than ever before. Print journals are still available and are considered the medium of choice by some, especially health professionals of my generation. However, because of cost, individuals, institutions, and libraries are forced to constantly assess the affordability of print versus online journals. Multiple articles in recent years have reviewed this topic from the standpoint of institutional libraries. Library data suggest that given a choice (online vs print), the online versions are considered most useful when both print and online are not within the institutional budget [4]. How should the American Journal of Roentgenology approach the question of print versus online today and in the future? Does our readership data differ from that presented in the literature? Remember, most of the data in the literature are from academic centers. Only 15% of our readership practices in academic centers, whereas the majority (85%) of readers are in private practice settings.
Let us begin with a review the recent history of the AJR. Beginning in October 2003, review and submission of articles for the AJR could be accomplished online. Online submission became a requirement in January of 2005 [5]. These changes resulted in a significant increase in submissions and improved turnaround time. Although both print and online versions of the journal are still available, the online version became the official journal of record in January 2006 [6]. This fact is likely not appreciated by all our readers or authors.
Since July 2006, the online journal has provided many benefits to readers. Currently, each issue offers online-only material that allows increased page capacity, approximately 100 additional pages per issue. In this issue alone there are five articles, three Letters to the Editor, and three book reviews in the online journal that are not included in the print journal. Dr. Robert J. Stanley, Editor Emeritus, noted additional advantages to online educational materials in his Editor's Notebook, "Leading Change: An Editor's Challenge" [7]. Articles can be published more quickly and in some cases immediately after acceptance or ahead of publication of the print journal. Also, there is more flexibility to include color, increased numbers of images, and video, which cannot be accomplished in the print journal.
Currently, subscribers to the AJR can elect to purchase the online journal, print version, or both. To address the current and future direction of the journal, we should review certain aspects of readership from the past as well as current trends for print and online journals.
In the past, many of us relied on personal journal subscriptions for education and research, seeking assistance from the library when necessary. Data from the past reveal that 68–87% of health professionals relied on their personal subscriptions and 54–78% of scientists read print journals in the library [4]. In fact, in the early years of my career I spent countless hours reading my journals and relying on the library for the remainder of my research needs. I had the "rip, staple, and save" mentality when I received my five monthly issues of radiology and orthopedics journals. I would save only the articles that applied to my practice or to current or future projects. The unused portion of the journal would end up in the trash, a space-saving maneuver on my part. The literature suggests that medical professionals are no longer willing to pay for multiple personal subscriptions. The average number of print subscriptions for personal use dropped from 5.8 in 1977 to 2.2 in 2001 [8].
Information searches have changed over the years. In my early years, I would initiate a research project by placing a request with the library to search the literature for the last 5 years on the topic of interest. I would review the hundreds of paper abstracts the library provided and have them print the full text on those I selected. It would take a minimum of 2 weeks for all of the printed articles to arrive. Today, I go online and select articles as needed during the active writing process or when I want to address a practice-related question. The answers are immediate, and it is much easier to expand a search when browsing the Web. Granted, like many of my colleagues, I don't like to read an entire article on the computer screen. Therefore, after browsing the possible references I will often print the articles that provide the best references. Surveys indicate that 49% of cited articles are discovered when browsing the Web [8].
Immediate access to information is particularly useful for practice-related questions because we can get the answer "at the point of care." This leads to practice quality improvement. The literature also supports the move to online. Many health professionals today prefer performing online searches from their office or home rather than going to the library [9]. De Groote and Dorsch [10] reported that 85% of faculty used online sources for research purposes. Data from our 2007 readership survey were similar, indicating that 70% preferred the online journal. The majority of online activity occurred from the office (54%) or home (34%).
The initial questions were: Does our readership differ from that described in the institutional literature and what do we need to do as a journal going forward? Reviews of the literature and readership surveys suggest that although there may be some differences, they are not that dramatic. How can the AJR and the other radiology publications address the print versus online issue going forward? The timing couldn't be better: There are new requirements for maintenance of certification (MOC) and changes in training and certification examinations beginning in 2010. We have a window of opportunity to maximize journal content and delivery methods to better serve our audience.
How do we package this information to maximize the impact of the journal? Currently, we provide multiple resources (original research, pictorial essays, review articles, policy briefs, CME, and SAMs) using both print (AJR, AJR Integrative Imaging, and ARRS In Practice) and online (our online journals and ARRS GoldMiner®) approaches. However, in our ever-changing world, we must adapt to meet the needs of our subscribers and the entire audience of health professionals who rely on our journal. Requirements for maintaining certification have changed our approach to lifelong learning. Attending meetings to fulfill CME and the other requirements for MOC is becoming increasingly difficult. There are new training requirements, including physics, that we must address. The ARRS membership and our readership audience are evolving. There is new generation of radiologists and related health professionals who have changed their approach to learning. We must meet their needs with more innovative use of online and print products. In the course of change, we must also set a timeline and determine the proper approach for moving to an exclusively online product. As part of this process, we would appreciate hearing your thoughts. Drop me a line at ajrsubmit{at}arrs.org.
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  T. H. Berquist Online Versus Print: Responses Galore! Am. J. Roentgenol., January 1, 2009; 192(1): 1 - 2. [Full Text] [PDF]
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