[Publishing models in medical journals].

Medical journals are published by scientific societies, universities, publishing agencies and other for-profit or non-profit organizations. The traditional way to cover the expenses in printed journals has been a "subscribers pay" model. The rise of electronic versions in the internet, either together with the printed version or replacing it entirely, plus a progressive adherence to an "open access" for electronic versions, has created financial difficulties. Therefore, the "authors pay" model has been added. Both models can be subsidized by commercial or institutional advertising, but still a main source for financing relies either in subscriptions or in authors' payments. A small source of income that helps to cover publishing costs is a "charge for manuscript reception", currently applied by several journals. Those authors whose work has institutional or external support can use their grants to cover any charges, but the situation is more difficult for those who do not have such support. Since 1872, Sociedad Médica de Santiago-Chilean Society of Internal Medicine, owner and publisher of Revista Médica de Chile, has employed the "subscribers pay" model, subsidized by commercial advertising and temporary sponsors (Chilean government and others). The printed journal is reproduced in an open access electronic version, in www.scielo.cl. The increasing cost of both publications systems demands a time for reflection.