Permission fees for reproducing tables in journal articles are exorbitant

Publishers’ charging for reproducing scoring systems is indeed a growing problem in medical publishing that is anti-scientific and not in the best interests of patients.1 Medical students, physicians, and other health professionals should not have to pay a licensing fee to obtain a simple question and answer screening test such as the mini-mental state examination, or pay for each test administered using a mobile application.2 Many patients will risk going unscreened and unidentified, and perhaps not receive the interventions that they should.

But the problem is worse, because it extends beyond scoring systems. I am editor of American Family Physician, which publishes clinical review articles. Such articles often incorporate tables and figures from other journal articles. Permission fees have become exorbitant. One table had 40 words, and the permission fee requested was $4400 (£2893; €3913)—more than $100 per word. One journal wanted almost $5000 for a table of drug treatment that largely consisted of product labelling information (public domain information).

This practice seems to be driven totally by profit motives and goes against the dissemination of medical knowledge designed to help patients.