Four futures for scientific and medical publishing

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Abstract
Lisa (the smart, well informed daughter): a world of global conversations Information exchange occurs predominantly not through “published” information but through conversation (much of it over the telephone), email, list serves, bulletin boards, and informal websites. A paediatric surgeon, Lisa, with a specialist interest in liver surgery who also happens to be interested in cricket, romantic poetry, and camels will be connected to a series of electronic communities who will keep her up to date with her interests. She will keep electronic copies of some of the material. An advanced search engine will allow her to find whatever she wants within her own database. The research Lisa is conducting is part of a multicentre study. The data are kept centrally, and a constant electronic—and sometimes voice—conversation goes on between all those involved in the research. Once a week there is a conference call that many of the participants join. In some ways publication of the research is unimportant because everybody who needs to know is part of the research, but the research is archived on an academically sponsored website. Conversation about the research circulates around related communities, and sometimes—but rarely—clinicians and researchers from other parts of medicine will access the archive. Lisa's academic credit comes from the “buzz” in the community. Everybody knows who is thinking originally and doing highly innovative work. Sometimes Lisa needs information from beyond her special interests. She then either uses a search engine to direct her to the relevant electronic community or she asks somebody within her communities she thinks will know where to go. “I don't know, but I know a man who does” is the mantra; and, even though the world has six billion inhabitants, we are all only five links from each other. Lisa picks up general information from the mass media and from chat in her communities. The conversation is not all about the special interests. When something interesting happens in medicine or health care it spreads very quickly, like gossip, through the linked communities. Companies producing hardware are making money in Lisa's world, but there's little role for publishers. The communities are self generating and contain the information they need. Information is a side product of their professional and leisure activities. People keep their own databases. Although this world might sound far fetched, it exists already. Doctors, we know, get most of their information from each other, not from published material. The information from colleagues is directly relevant to them, is more credible than what is published, can be understood and internalised through conversation, and may be directly actionable in a way that is unusual with published material. Many doctors belong to groups, often international, related to their special interests. And most research that is published is already known to the “invisible college” of people interested in that area of research. BioMed Central is trying to create a business for this world by providing infrastructure (even electronic journals) for the communities. It is perhaps doubtful, however, whether communities need much more infrastructure than is easily and cheaply available through Yahoo and the like. It's the quality of the conversation that matters, not the technology or infrastructure.

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