[How Scientific Publishing works].

Scientific, Technical and Medical Publishing (STM) is changing: the whole communication process (content production and delivery, distribution and dissemination) is involved in the change. The objective of this paper is to review some of the key issues currently faced by the publishing and scientific community; the review is also an attempt to provide a basic framework to clinical practitioners and researchers. The first section of the paper presents the main "facts and figures" of the STM landscape, following the mergers and acquisitions of the last 20 years. Then, the paper explains how the continual growth of catalogues, innovation and academic pressures generated new business models and publishing formats. Finally, the article considers the impact of the wider access to online information, on both publishers, authors and readers. In conclusion, the main concern expressed by the author is that the so-called "single-article economy" could probably be the next step of the STM publishing environment, in a perspective of a "just-in-time" usage of medical literature; this could represent a challenge for professional readers that will be less aware of brand and journal context, losing the opportunity to consider the single publishing items (papers, reviews, guidelines, etc.) in a deeper cultural framework.