PRS enters expanding open access arena with launch of spinoff journal

Mike Stokes
02/25/2013 at 11:00AM

Plastic and Reconstructive Surgery has developed a reputation for innovation among medical journals by constantly exploring new technology to deliver scientific content in dynamic ways. This spring, PRS will continue to push the digital envelope by entering the rapidly expanding open access (OA) movement with the launch of an online companion journal, PRS Global Open (PRS-GO), which is now accepting submissions through PRS's existing enkwell system at

The OA concept - publishing peer-reviewed research online for anyone in the world to access for free (institutions or authors commonly pay an article processing charge to cover costs related to production) - is as old as the Internet itself. From 2000 to 2009, however, the volume of scholarly articles available in open access journals grew tenfold; the number of OA journals during that period grew from 70 to more than 4,700, according to a 2011 study in PLoS One, an OA journal published by the Public Library of Science.

"Open access is a true innovation in surgical review journals," says PRS Editor-in-Chief Rod Rohrich, MD. "It is growing rapidly across all fields of study, particularly medicine. Entering the open access arena will allow PRS to remain at the leading edge of scientific publishing."

The growth of OA has been bolstered by the requirements of major funding agencies in the United States and Europe, including the National Institutes of Health, to provide public access to the published results of the research they sponsor.

"The NIH has the exemplary open access policy, in which its grantees are free to publish anywhere they want, but they have to make the peer-reviewed manuscript available [via] open access in PubMed Central, a repository hosted by NIH," says Peter Suber, director of the Harvard Open Access Project, which is dedicated to fostering the growth of open access. "Because the NIH is so big - it's the world's largest funder of scientific research - it gives us a huge advantage over other countries that are moving more slowly. On the other hand, it's only one funding agency, and a small part of our publicly funded research. In the United Kingdom, all of the public-funding agencies are moving toward open access policies."

"I get at least one or two emails per day from a new open access journal," says Dennis Orgill, MD, PRS Reconstructive section editor. "It's the future of publishing, and it shows the foresight of the journal to embrace the change rather than be reactive to it."

Benefits of OA
PRS joins a host of other major journals, such as Nature and Journal of the American Heart Association, to introduce open-access companion journals. Buoyed by the strong reputations of their parent journals, open-access offshoots typically have less-stringent criteria governing the acceptance of articles, yet they can surpass their parent journals in terms of reach and impact factor because of the accessibility of the articles. Lippincott, Williams & Wilkins, the publisher of PRS, will apply for indexing as soon as the journal has fulfilled the requisite threshold to do so.

Dr. Rohrich cites several benefits to authors in offering an OA alternative to PRS, including a much shorter interval from acceptance to publication, a wider audience with whom to share their research and, perhaps most notably, more flexibility to publish the sort of high-quality articles often fall among the 80-85 percent of manuscripts rejected each year by PRS.

"We receive many good papers that I have to reject," he says. "PRS-GO will allow us to publish these very good articles."

"The space constraints involved with print publishing severely limit the number of manuscripts we can accept," adds PRS Co-Editor James Stuzin, MD. "Because of this, many good articles are ultimately published in other plastic surgery journals."

With the introduction of PRS-GO, authors of articles that narrowly miss being selected for PRS will be given the option of having their work published in the open-access journal - without needing to resubmit the manuscript.

"The articles go through the same peer-review process, so they are still going to be very good," says Dr. Orgill. "But they aren't going to be rejected because someone else had a similar idea but submitted it two months earlier. Open access will allow more great articles to be published, even if they are duplicative because that will no longer be a concern."

Though many articles are initially expected to come from submissions originally intended for PRS, the editors say PRS-GO is envisioned as much more than a de facto "Plan B" publishing option.

"There are many articles that I expect will be submitted directly to PRS-GO," says Dr. Rohrich. "And we're going to see articles that we never would have received for PRS because the new journal will have a broader reach, and the content will be even more timely because we'll be able to publish it rapidly. PRS-GO will be a totally author-driven journal in which we'll see good-to-excellent articles."

"PRS-GO is going to take off quickly," adds Donald Lalonde, MD, PRS CME/MOC section editor. "For a lot of people, it may end up being the Plan A."

First to publish
In addition to accommodating researchers whose funding requires publication in an open access forum, PRS-GO will likely be a preferred option for those eager to be the first to publish their findings in a particularly active area of study.

"If you have something that is time sensitive, you may not want to wait as little as three months to get it published in PRS," says PRS  Associate Editor Charles Butler, MD. "If it's a hot topic that was discussed at a meeting or a public announcement - something that everybody is working on, but you were the one to get it done - PRS-GO will allow you to publish in weeks rather than months."

"Speed to publish is also important for promotions in an academic environment," adds Dr. Orgill. "But the real advantage of open access to private practitioners, especially those in the cosmetic end, is that it provides a way of documenting their work that is open to the entire public. They can have their work published under the PRS banner that's available to patients, other doctors and people throughout the world. Having that information available to everyone is important to researchers or anyone who is trying to popularize something they do in their practice."

The benefits of launching an open access journal, however, are not limited to authors and those who will be able to readily access their work. Dr. Rohrich believes that the exposure the format provides will ultimately further enhance the PRS brand.

"It will allow us to have a much more global reach, not only among our readers, but also among our authors," he says. "Open access will allow us to get information out much faster to a bigger audience."

Suber agrees with that assessment: "That's one of the big selling points [of open access] - if it enlarges the audience, it's probably good for the brand," he says. "Open access gives research a larger audience and, therefore, greater impact - and that's what researchers are after. They are not paid for their articles; they write for impact, not for money."

Price to publish
For many potential authors - especially those in North America - the greatest adjustment to the open-access model of medical journals is how these titles are funded. While access to the research in these journals is free, someone must cover the costs associated with making those articles available in an appropriate format, and that falls to the authors themselves.

Most traditional journals such as PRS are largely subsidized by a combination of advertising and subscription revenue, but it's common practice among open-access medical journals to charge the authors an article processing fee to have their work published.

"When journals charge fees, it's common for them to be misunderstood as vanity publishing, but it's not," says Suber. "No journal that conducts peer review should be mistaken for a vanity publisher."

PRS-GO will charge $1,995 to publish accepted articles and $500 for case studies and shorter articles, but in a forum where article processing charges can easily exceed $3,000 per article, Dr. Rohrich says it was important to keep the fees competitive as the new journal establishes its footing.

"In the world of open access, the author retains the rights to the images and the article, but for the privilege of doing so, there is a publication cost," says Dr. Rohrich. "It's really being done at a base cost to cover the processing and editing of the article for an online venue."

Suber notes that 88 percent of OA article processing charges are ultimately paid by institutions - not individual authors.

"Many open access journals - especially the prominent ones - charge a publication fee," he says. "In fields where the authors don't have the money to pay the fee, those business models don't work, but most funders of medical research - both public and private - are willing to pay those fees on behalf of their authors."

"The fee to publish in PRS-GO is less than those charged to publish in many of the other OA journals in medicine," Dr. Stuzin adds. "We've done our best to keep that fee low."
Though a number of print journals with small circulations also charge similar fees (not long ago, even PRS charged authors to include color photography), paying to publish can be a dubious notion to some.

"It is going to require some time to get my head around the whole concept, just as others will, but I understand that it's a reasonable thing to do," says Dr. Lalonde. "It's a different model that writers aren't necessarily used to. It's not good or bad - it's different.

"In the traditional model, people have concerns about advertising funding the publication of scientific research," he adds. "The money has to come from somewhere, but the scientific validity of the content will be up to the PRS editorial board, and an article in PRS-GO will have just as much scrutiny as an article in PRS. It still has to be accepted, and if it's not accepted, its not going to be published - even if you're willing to pay twice as much."

"I was initially very skeptical about the concept of authors paying to publish," admits Dr. Butler. "But after learning more about the global marketplace and the progression of open access throughout medical publications worldwide, it really changed my perspective. There is value in having research placed in the public domain, where access is virtually unlimited to anyone with an Internet connection. Fewer barriers means better medical information exchange and transparent communication channels."

International affairs
With roughly 60 percent of the manuscripts currently submitted to PRS originating overseas, PRS-GO is expected to continue to raise the journal's profile worldwide. In developing nations where a subscription to PRS is often a luxury many surgeons cannot afford, open access is expected to open many doors.

"This is a win-win in terms of reaching a lot more physicians through PRS, which will allow us to share more knowledge to improve patient care," says Dr. Stuzin. "In the long run, it's going to increase submissions to the journal because by branching into the countries that don't have subscription access, these physicians will become part of our PRS-GO community and will start submitting articles to the white journal on topics that we may not know anything about. It's a chance for PRS to become a global journal in the truest sense."

And with PRS-GO in its infancy, Dr. Stuzin says it could easily become geographically oriented with large subsections of articles from the Pacific Rim, the Middle East or the Asian subcontinent.

"I think we'll see a lot more articles based on regional interests in plastic surgery," he says. "Those articles may be very interesting to a wide range of readers that we're not necessarily reaching right now."

In anticipation of international interest in PRS-GO, the PRS editorial board and pool of reviewers is being expanded to include greater representation from the global community of plastic surgeons - as well as from the United States and Canada.

"It's a really exciting way to expand the educational outreach of the white journal to a global audience," says Dr. Stuzin. "In doing so, not only will we improve the interchange between plastic surgeons around the world and PRS, but ultimately we're going to improve patient care. PRS-GO is not simply going to be a U.S.-based publication providing information to the world, it's going to be plastic surgeons around the world using PRS-GO to educate each other."

"We are going to truly become a global journal with an international perspective," Dr. Rohrich adds. "And that is good for PRS and the entire specialty."

The article was originally published in the January/February issue of Plastic Surgery News. This version has been updated.