Paying for bmj.com

Editor—By 21 November 77 readers had responded to Delamothe and Smith's editorial.¹,²

Most of them were sanguine about the decision to charge a reasonable fee (£10-20 ($17-34; €14-28)) for access to bmj.com, although the question was raised whether subscribers to the paper journal actually subsidised web users worldwide. Some expressed their thanks for having had free access for so many years and wondered why other journals had not followed suit. The idea that charging was a way to keep the BMJ independent and maintain the breadth and width of subject matter was welcomed.

Several readers from outside the United Kingdom used the website in preference to the paper journal for reasons of cost, although telephone charges across the world vary, as well as the difficulties with telecom infrastructure in some countries.

Nearly all correspondents recommended that different categories of fee should be introduced for different users, not only countries. Correspondents who had reached retirement age were especially anxious that this should be taken into consideration.

The idea that web readers should provide access credentials was viewed with criticism, implying dishonesty on the part of web readers. Several expressed the hope that the access fee might result in a reduced amount of pharmaceutical advertising in the journal. In practical terms, the consensus seemed to be that six months' blocked access after publication, rather than a year, was long enough.

One reader thought that rapid responses and access to Medline should remain free. Others thought that specialists might be made to pay, whereas the public should have free access—a question of influence, whose potential loss worried several correspondents. Worringly, £20 might not be enough to maintain the quality. Sponsorship was one possible alternative.

Among the negative reactions were warnings that subscription budgets might not stretch to including this additional new fee and thus lose the BMJ readers. Also brought into the equation was the fact that the BMJ is a general journal that is of great interest to specialists, who might not read it if they had to pay.

Paying for bmj.com is giving up a vision, wrote one of the later correspondents, and another declared that it was an own goal of greed. Free access helps to make medicine more democratic and accountable. And if access to information is the cornerstone of the health business then perhaps the BMJ Publishing Group should reconsider its position.