The Scholarly Poor: Dentists

I shall post occasionally on the concept of the “Scholarly Poor” – people who need to read the scholarly literature and who can’t. “Can’t” == cannot afford the extortionate PayPerView (PPV) fees demanded by all publishers (all == all I have come across, and that includes a few on the side of the angels). Please let me have your experiences and views and I’ll try to blog them. Not all at once…

So my first category of scholarly poor is dentists.

Dentists? Don’t make me laugh. Dentists aren’t poor!

No, they aren’t. But they are scholarly poor. A scholarly poor person does not read the literature because it costs too much. Remember that reading a paper, even for a few minutes can cost 50 USD. And it’s higher in the medical sciences (so far the record is 61 USD, from Bentham publishers – can you beat that?). So here’s a conversation with my dentist – no names:

• PMR “Do you need to read the dental literature”
  
• “yes” (I would have been worried with any other answer)
  
• PMR “Do you ever find that you can’t get access?”
  
• “all the time. Most of the time I can only read the abstracts. When I was studying/training it was fine – I used to get these requests for copies of papers from practising dentists”. Note, of course, that these are requests to steal material.
  

So, next time you are sitting in the dentist’s chair think about whether s/he has read the latest relevant literature. Note, of course, that editorials are very often hidden behind paywalls. So the Ruritanian J. Dent might have an editorial “100 years of novocaine” (novocaine is a dental local anaesthetic ). It could give pointers to recent information. It might suggest benefits, counterindications, etc. Who knows, because you’ll have to pay 50 USD to read it. It might, of course, say nothing you didn’t already know. So probably not worth forking out 50 dollars for.

I’ve just learnt that cocaine used to be used as a local anaesthetic (http://en.wikipedia.org/wiki/Procaine ).

[That’s rubbish – you can’t believe anything in Wikipedia. Well you can’t believe anything in Rur. J. Dent either because you can’t read it!]

Dentists, next time you can’t read an article, ask your patient whether they are a scholarly publisher and what their PPV costs. I’ll leave the rest up to you. Or say that you’ve just seen this new treatment and can they pay 50 dollars to find out whether it’s any good.

Is it fair to say that dental treatment is unaffected as a result of not having access to the literature? That the information filters down by word of mouth? That enough papers are stolen and recirculated?

I don’t know. I’d be interested to know whether there has been a study. Dare we ask dentists questions like “how many teeth did you pull out unnecessarily because you hadn’t been able to read the literature? Did you use an anaesthetic that had reported side-effects?” I don’t see why not.

Because lack of access to the literature must ultimately lead to bad practice and patient mis-care.

Maybe Ben Goldacre already knows.