Open Access and the Health Sciences

Access to high quality information is critical in any field, but in the health sciences it can, quite literally, be a matter of life or death. Early in my career I worked as a library assistant in a hospital library and one of my primary roles was filling interlibrary loan requests. On a regular basis we would field requests for articles from scholarly health sciences journals that were marked “URGENT PATIENT CARE.” That meant a clinician needed information from that article in order to make an informed, evidence based decision about how to treat their patient. We would rush to fill the request and send the PDF off through the online interlibrary loan system just as quickly as possible. But regardless of how fast we were, the interlibrary loan process always took longer than it would have taken the clinician to download the article from the internet on their own.

Image by Judith E. Bell:

This begs the question– why didn’t the clinician have access to the information they needed, given that the vast majority of scholarly research articles are available online? Simple: The full text of almost all of those articles we rushed to send off were out of the clinician’s reach because they were behind a publisher’s paywall. Research that is published in a traditional, subscription based journal is not freely available. The clinician or patient who vitally needs that information can access it only if they are affiliated with an institution that can afford the skyrocketing subscription rates for scholarly journals. This is particularly vexing when you take into account how scholarly research is produced– an overview of the general process:

  • An author writes a manuscript and submits it to a scholarly journal
  • Manuscript is handled by a volunteer or nominally paid scholar, acting as editor.
  • An editor facilitates peer review. Peer reviewers are experts in the field, volunteering their time to review the article.
  • Manuscript is accepted.
  • Author signs away copyright and donates their work, at no cost at all, to the publisher.
  • Publisher then charges institutions high fees to access the manuscript, now in article form.

The traditional publishing model is creating an access crisis. Happily, the open access publishing model offers a solution. Open Access (OA) research is research that is freely available in a digital environment, without price barriers and without most usage restrictions. OA publications are disseminated in a way that takes full advantage of the internet, without imposing unnecessary artificial restrictions on access, such as paywalls. OA doesn’t mean there is a reduction in quality, and it doesn’t restrict where researchers can publish. For years now, researchers funded by the National Institutes of Health have complied with a mandate that requires them to put a version of their manuscript in the PubMed Central Archive, thereby making the full text freely available on the open web, and at the same time publishing that same research in high impact, subscription based journals.

Support for open access in the health sciences is support for equal access to evidence for all patients and clinicians. What can you do to support open access in the health sciences? Seek out open access journals—raise the profile and quality of OA publications by submitting your high quality work and making OA publishing part of your professional narrative. If that’s not a viable option, submit your publications to the Scholarship Repository at USF. Including your work in the institutional Repository improves visibility and impact, and it allows clinicians and patients to access it when they need it, without having to wait for a library assistant to fill an interlibrary loan request. At the University of San Francisco, our nursing publications are downloaded around the world. You can see our work at