One of the core messages of Open Access Week is that the inability to readily access the important research we help fund is an issue that affects us all—and is one with outrageous practical consequences. Limits on researchers' ability to read and share their works slow scientific progress and innovation. Escalating subscription prices for journals that publish cutting-edge research cripple university budgets, harming students, educators, and those of us who support and rely on their work.

But the problems don't stop there. In the digital age, it is absurd that ordinary members of the public, such as healthcare professional and their patients, cannot access and compare the latest research quickly and cheaply in order to take better care of themselves and others. 

Take the case of Cortney Grove, a speech-language pathologist based in Chicago, who posted this on Facebook:

In my field we are charged with using scientific evidence to make clinical decisions. Unfortunately, the most pertinent evidence is locked up in the world of academic publishing and I cannot access it without paying upwards of $40 an article. My current research project is not centered around one article, but rather a body of work on a given topic. Accessing all the articles I would like to read will cost me nearly a thousand dollars. So, the sad state of affairs is that I may have to wait 7-10 years for someone to read the information, integrate it with their clinical opinions (biases, agendas, and financial motivations) and publish it in a format I can buy on Amazon. By then, how will my clinical knowledge and skills have changed? How will my clients be served in the meantime? What would I do with the first-hand information that I will not be able to do with the processed, commercialized product that emerges from it in a decade?

Cortney's frustration is not uncommon. Much of the research that guides health-related progress is funded by taxpayer dollars through government grants, and yet those who need this information most—practitioners and their patients—cannot afford to access it. We asked Cortney to share her story in more detail.

What do you do for a living?

I'm a speech-language pathologist, and I specialize in autism, social cognition, and language-based learning disorders. Because of that, I tend to look at research from across a lot of disciplines. I need to know what cognitive scientists are finding, to learn about motor development, to get social linguists' perspectives.

On a daily basis, I provide therapy for kids with special needs. What I do in my spare time and continuing education is to try and figure out better, more efficient ways to hep these kids.

Can you describe the issue you recently ran into?

We do continuing education in order to keep our licensure, so I recently attended an online conference. Frequently what happens is that I'll hear about a bit of research in a lecture that I'll find interesting from another perspective, so I'll write it down to look for it later.

I went online to find the referenced articles when I started to realize I couldn't access any of the articles on my list for free. All of them are behind a gate and cost somewhere between $40 and $100 an article.

I got frustrated. I spent maybe three-and-a-half hours looking at subscriptions to these companies to see if that was a viable option, but they were too expensive. I then started going to the websites of individual researchers. Unfortunately, only one of the 17 or 18 papers I was looking for was available.

This is when I started to get really frustrated. It became clear to me that what was going to happen was what I heard during a number of lectures: "Don't worry, I'm publishing a book about all of this if you want to know more."

Why do I need to wait five, seven, ten years from when a research article comes out for someone to package and process it in order for me to consume this information? In that five to ten years, my clients are going to continue developing without the benefit of the latest research.

What sort of articles were you looking for?

When we're in school, they teach us about evidence-based practice, and a big part of that is based on using the latest research. The other part is using your own clinical expertise to determine whether the evidence available to you is good for your client. For example, something that may be a great method for me to employ would be terrible for another speech-language pathologist to employ if she doesn't have the same experience.

Now, I can access the publications of [the American Speech-Language-Hearing Association's] core journals. Unfortunately, the articles I need are rarely in those. Topics in Language Disorders, for example, has a $122 subscription for four issues. But there's no guarantee that the articles I'll get in the four issues next year will be useful for me—and that's just one journal!

I really need to collect information from different fields so I can do proper evidence-based practice, but the work I want is from a hundred different journals, not just three or four.

How much did you end up spending?

Nothing yet. I ended up emailing a professor of mine from school, and I'm waiting to hear back from her, while at the same time asking her, "Is there a more reasonable way for me to do this?"

Some people told me to go to the local medical school library and download the articles from there. I don't know if it's feasible for me to go to a library of a school I don't go to! And at the moment, I don't really know any students who I could ask.

When there's a PDF available somewhere in the world, it's really a shame to have to either pay or jump through so many hoops to get it.

When it comes to research articles, what do you think the future should look like?

Here's my concern: how many times the information gets paid for is really frustrating. A lot of these research experiments are conducted thanks to government grants. If it is already government funded, taxpayers are already paying for it. Institutions then pay for subscriptions, then authors turn it into a book and sell it to me. It's like the information has been paid for multiple times before it comes to me—and it comes to me five-to-ten years later in some sort of packaged form.

I think that ideally, if you're going to be in a healthcare profession—or really any profession—that research should be easily available. Even if I had to pay an acceptable yearly fee—if for $300 a year I could access everything—that would be better than how it is today.

I'm a speech-language pathologist in private practice. I know that if I was affiliated with a university, then through that I could have access to the information I need. And that highlights a bigger issue: there's always a gap between the research world and the clinical world. There's a gate that holds the normal profession out of the research process—or even from simply being able to consume the information. By the time it comes to most of us, it's prepackaged and late.

Even with my continuing professional education, there's a barrier. Researchers will let you read their research—once you pay $700 to come to their course. Either way, the regular working professional is being denied this information, or the information is very expensive. Had I wanted to read the articles I needed, I would have had to pay thousands and thousands of dollars. And that doesn't seem right, especially when I'm just working to help kids with special needs.

Cortney's experience highlights the misaligned incentives of large swathes of the scholarly publishing system. Thanks to an obstinate and powerful group of legacy publishers, research is slow to get to those who benefit most from it: practitioners, researchers, patients, students. It is becoming more and more obvious that the only players benefitting from the status quo are the middlemen, the publishers themselves. Open access to scholarly works bypasses an unnecessary point of friction, empowering healthcare professionals like Cortney to take advantage of the most innovative practices and provide the aid their patients and clients truly need.

The good news is that a fix is within our grasp. Please support access to taxpayer-funded research.

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