Some Ideas About the Future of Medical Textbooks

I had a recent discussion with an academic physician who also serves as the editor of a medical textbook which he told me accounts for some 10% of the yearly sales of the publisher. He remarked that many such textbooks are now expensive "boat anchors" and that the future belongs to some type of alternative electronic publication. However, neither he or his publisher fully understand exactly what will replace the current medical textbook or the underlying revenue model. For what it's worth, here are some of my ideas about what some possible next steps in the evolution of the medical textbook:

• I believe that the successor to the medical textbook of today will be what I will call here the e-text-blog. Stated briefly, it will consist of a web-based electronic text about a medical topic that is organized into chapters. For broad medical topics, it will be multi-author and accompanied by one or more "professional" blogs managed by the chapter authors. I have discussed professional blogs in previous notes (see: Professional Blogs as Meta Information Resources).
• These blogs will act as forums for the discussion of both emerging medical knowledge and also the review of new chapter drafts as they emerge. Such an e-textbook will never go out-of-date because of the frequent updates of individual chapters. The readers will have an active stake in keeping it current and accurate through their participation and comments in the accompanying blogs.
• Although limited access to such e-text-blogs may be offered at no cost to medical students, residents, and fellows, I am sure that full access to all of the resources will require a yearly subscription fee which will also allow participation in the blogs and the opportunity to download portions of the e-text.
• Because the cost of publishing and distributing an e-text-blog will be close to zero, some academic physicians may come to understand that they can disintermediate the current publishers of medical textbooks by developing such "learning devices" themselves. In so doing, they can exert more influence in a particular medical specialty, generate revenue, enhance their clinical referrals, and attract additional research funding.

I have previously discussed the notion of professional blogging as a suitable enterprise for academic faculty members on clinical tracks (see: Professional Blogs as Publication Vehicles for Physicians in Academic Clinical Tracks). The idea of medical e-textbook authors also serving as bloggers may be a challenge. It's clear to me that writing a medical textbook or journal articles calls upon a different set of skills than generating a daily blog, which is closer to being a newspaper columnist with daily deadlines and less time to think about new ideas. Nevertheless, I believe that blending an e-textbook with blogging will introduce a freshness to the e-textbook that may be currently lacking in some of these publications.

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I discovered an index of medical e-books (see: Auto-Medical-RSS) that you may want to visit but be warned that the site is not well organized. However, it does provides the opportunity to download PDF files of some useful medical texts. This downloading approach seems to be a far cry from the interactive e-text-blog "communities" that I describe above.

Comments

[drneelesh]

I think this is a very true account of the changing trends in medical education.
I expect we will soon have a new batch of Authors of medical "textbooks" via professional blogging.Though, I suspect we will need ONE authoritative and comprehensive printed Textbook on every subject for offline reference

[Ajit Alles]

I find that text books, while possibly not as current as an electronic text, are much more user friendly. It's so much easier to flip through a textbook than through an electronic "book". Additionally, I often stumble on useful information while thumbing through a book looking for something else. Serendipitious knowledge can stimulate sudden flashes of insight that often prove invaluable. I love the internet and I am not a technological Luddite, but I think the predicted demise of textbooks is a shame.

Ajit Alles