Another medical journal goes online-only. That's good. Right? I think?

In 2024, The Annals of Emergency Medicine—probably the most prestigious academic journal in my field—will go digital only. No more print copies in our inboxes at home or at work. No more piles of read and unread back issues in our offices, bedrooms, and bathrooms. (You know it’s true.)

Like it or not, many medical journals are going online-only.

I have mixed feelings about this.

In defense of digital only.

Going digital-only has clear advantages for medical and other academic journals.

1. More environmentally friendly. Why cut down trees when we can use electrons. Why continue to accrue piles of unread issues in your life (and libraries)?

2. More practical. Most people read online anyway, so why waste money on a paper product that relatively few readers use. In fact, some really good medical journals might not be able to afford the business model that includes print publication. It’s better to keep them online-only than see them die off.

3. Easier to correct mistakes. Errors happen and they get corrected in future issues. But if something was wrong in the August 2023 issue of a medical journal, it’ll still be wrong in the print edition that got sent out for the rest of time. So if somebody picks up a hard copy lying around in 2024 or later, they’ll never know about the mistake. In the digital version, the mistake can be edited out.

4. Easier to track use and relevance of articles. Nobody really knows how many people read the print version. By going digital only, data on reader use will be even more meaningful. The number of page views, downloads, shares, and citations in future research will basically encompass all use, which will help authors and editors see what the readership seems to want and need.

5. Better interactivity. Right now, if a medical journal publishes a manuscript, Letters to the Editor might appear a couple of issues later. With the digital version, any letters and author replies can be linked to the original article, so that future readers can benefit from any debates or discussions. In addition, Comment sections have expanded in many journals, meaning that more voices can be heard. In the print version, there might be room for a couple of letters, even if dozens of good ones were sent.

6. Faster. The lag between drafting and publishing is excruciatingly long in the medical literature. That said, online publication “ahead of print” has largely solved that.

In defense of keeping the print journal.

I’m going to miss the print version!

Ironically, nearly 10 years ago, Dr. Scott Weingart and I wrote a commentary for a medical journal entitled “Future evolution of traditional journals and social media medical education” in which we argued that medical journals should eventually eliminate print publication and go online-only. Last year, my friend and colleague Dr. Lauren Westafer and I wrote about what journals like Annals need to do in order to keep both print and digital medical journals vibrant.

Deep down, though, I know Scott and I were right about the need for medical journals to eventually cease print publication (and Lauren agrees), for the reasons above.

Still, as much as I have always liked online resources (I probably do >90% of my reading on my computer, phone, or tablet), I’m surprised that in the year 2023, I continue to value the print version of medical journals. When Annals arrives in the “snail mailbox” at my home, I look at the front cover (which is literally the table of contents for that issue). Within 10 seconds, I know what’s in the journal and who the lead authors are. It’s a great barometer for what is going on in my field. For some reason, that format is hard to reproduce online, even on the Table of Contents page for each issue.

The other thing the print version allows me to do is flip through the journal and get a quick glance at an article. Flipping from page 20 of the journal to page 50, 51, 52, and beyond is actually faster and more enjoyable with a print copy. Sure, you can scroll down in a PDF version of the issue, but it’s actually more cumbersome. This is a rare instance of where using technology to access text is less efficient. The old way is nicer!

Political commentator Christopher Matthews used to talk about this. He loved the idea of chance discovery—the notion that as you opened the newspaper to continue reading a front page story, you might stumble across another article on the same page that you’d never have expected to be interested in. Next thing you know, you’re reading about some topic that you’d never spent a second in your life considering. These fortuitous discoveries can enrich and broaden one’s perspectives. While medical journals aren’t quite designed like newspapers (more like magazines), the nature of the bound paper volume does lend itself to this sort of thing. Losing that is sad indeed. On the other hand, social media feeds arguably replace that. By following a diverse list of experts in a variety of fields, I see things that I otherwise never would have. Some argue that this is a major loss for our intellectual lives in general.

I’m not sure the benefits are sufficient to make it worth keeping print versions of medical journals coming—and medical and general libraries sure won’t mind the decreased clutter. Perhaps those of us who are accustomed to the print versions could be grandfathered into receiving them? A pipe dream. As for the younger generation? They won’t know what they’re missing.

How do you feel about the print versus online debate for publishing? I’m curious to hear from people in medicine, other academic fields, other professions, or just readers in general. Chime in below!