It is no coincidence that Elsevier, the publisher of The Lancet, distributed a press release to announce that the number of registered users of The Lancet's website has surpassed 1 million on the same day that the Public Library of Science (PLoS) launched its new medical journal, PLoS Medicine. PLoS is headed by some of the leading proponents of the Open Access movement, and in its own words is "committed to making the world's scientific and medical literature a freely available public resource". The primary target of the Open Access movement in its drive to change the current model for pricing and distributing scientific and medical information is none other than Elsevier, the world's largest publisher of STM journals.

As a consumer of health and healthcare information, I find the goals and determination of the Open Access community admirable. As a long-time publishing industry analyst, not a research scientist, I don't feel qualified to assess whether the proposed solution of an author-pays model for covering peer-review and publishing costs will in fact improve the state of scientific research or improve decisions made by healthcare consumers. However, I do feel qualified to comment on issues related to evolving publishing models and the economic incentives for authors and publishers to create appropriate content and value-added tools for various audiences.

In the current environment where consumers increasingly use the Web to find information about goods and services they buy, and where health-related information is sought by between 71 and 80% of online users (according to Harris Interactive), Open Access proponents are right to suggest that there is a demand from average consumers for trustworthy and authoritative healthcare and medical information. If federally-funded research reports become freely available on the Web by mandate, then commercial STM publishers will have to find a way to add value to differentiate their offerings from the "raw" content that is produced under grant. Enterprising publishing companies will embrace new technologies (some more quickly than others) and will find new means of adding value to core content to target the information needs of a variety of user populations with differentiated products in order to create commercially-viable products. This is the essence of the publishing business.

To end on an ironic note, it is quite likely that "open" access to basic scientific and technical research information will occur with or without external intervention as an expected consequence of technological advances in digital publishing and the economics of Web distribution. Commercial STM publishing companies will invest resources in improved methods for accessing relevant content and in developing value-added content for specific audiences. Basic content will become commoditized. The spotlight that the Open Access movement has directed on STM journal publishers will likely accelerate the process of change that is occurring in this segment. However, many changes would have occurred as a natural evolution that is affecting the entire publishing industry.