EDITORIAL

Follow the money trailDavid L. Turpin, Editor-in-Chief

Seattle, Wash

The primary goal of most dental publications isto link the results of new research with theclinicians who deliver patient care. The more

efficient this transfer of information, the more quicklytreatment will be altered, resulting in better outcomesfor the patient. Recent advances in information andcommunication technologies mean research results canbe disseminated with ever-increasing efficiency. Butour expanding ability to share information and theincreasing need of researchers to access informationquickly is driving a major change in how journalsoperate.

Currently, most journals, including the AJO-DO,require readers to pay a subscription fee to readpublished articles, either in print or online, but theconcept of open access is growing more popular withthe public.1 The cost of preparing scientific material forpublication has traditionally been borne by subscrib-ers—including institutions like the AAO—perhapswith some help from advertisers. In an open-accessworld, where everyone has free access to all researchthat has been approved for publication, subscribernumbers will plummet. Why pay to subscribe when youcan read the issue online for free? But if no onesubscribes, who will foot the bill?

Let the government pay for it, advocate some whosee no end to deficit spending. Yes, the NationalInstitutes of Health (NIH) funds $28 billion in researchthrough grants every year, but most clinical orthodonticstudies are not funded by large government grants.Some suggest that authors could pay to have theirfindings published, but I know many researchers wouldbalk at paying the total cost of publishing their re-search. Another option is to ask for voluntary contri-butions to support the publication of scientific findings.This sounds appealing on the surface, but those of youwho volunteer with charitable organizations know howdifficult it is to obtain adequate long-term funding,especially for operational costs. Based on my fundrais-ing history, this is not the answer.

A third option, and one with great appeal in somequarters, is to seek private or commercial funding. Yes,

Am J Orthod Dentofacial Orthop 2005;127:3990889-5406/$30.00Copyright © 2005 by the American Association of Orthodontists.

doi:10.1016/j.ajodo.2005.02.004

there is money in orthodontics, so why not go tocorporations that benefit financially from our businesssuccess—the manufacturers and suppliers of orthodon-tic goods and services? We can look to a model of thisapproach in medicine, especially some of the morepopular specialties whose members dispense prescrip-tion drugs. Their meetings and speaker expenses areoften paid for by drug companies. But is this the end ofthe perks handed out? According to a column in theTacoma News Tribune (reprinted from the Los AngelesTimes) last December, at least 530 government scien-tists at the NIH have taken fees or stock options frombiomedical companies in the past 5 years.2 Informationgathered by a congressional committee also shows thatNIH researchers have repeatedly crossed the line byaccepting outside consulting fees from private compa-nies without declaring their affiliations with thosecompanies. Reports the Times, “Dr. P. Trey Sunder-land, a senior psychiatiric researcher, took $508,050 infees and related income from Pfizer Inc. at the sametime he collaborated with Pfizer—in his governmentcapacity—in studying patients with Alzheimer’s dis-ease.” Many of these fees are not disclosed to Congress,the public, or the nation’s doctors, who, in turn, rely onrecommendations from the NIH and its scientists, suchas Dr Sunderland.

I am wary of commercial influence and the conflictsof interest that can develop when big money comes tothe people who have the most influence on the successor failure of a particular service or product.

I still favor keeping the user involved in paying partof the cost of publishing research. Having taken thisstand, I am not in favor of putting my head in the sandand doing nothing. Publishing more of our researchfindings only in an electronic format is one way toreduce costs. But for my money, the sustainability of anew economic model for open access remains to beseen. We need more answers to the questions aboutopen-access publishing.

REFERENCES

1. Llona E. Making access to scholarship open. University ofWashington Library Directions 2004;14(2): 1-3.

2. Willman D. At least 530 scientists got fees, stock in conflicts ofinterest, records show. Tacoma News Tribune 2004 Dec 22

Business sect.

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