Health News Digest

August 13, 2012

Going Beyond Gutenberg:  The E-Publishing Revolution And Its Relevance To Health Care

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By  Michael D. Shaw

The basic model of book publishing—whereby works are printed, and the distribution of the books is subject to some sort of exclusivity, with royalties being paid to the creators of the content—has only recently undergone much change. If Johannes Gutenberg were to be transported from 1450 to 1950, beyond enhancements in cosmetic appearance, books would look quite familiar to him.

While the first paperback edition appeared in 1935, the format did not really take off until the mid-1950s, with the earliest major success being the Penguin edition of the then-scandalous Lady Chatterley’s Lover. Likewise, stories read aloud by narrators were available almost at the outset of sound recording, but audiobooks would be deployed on a grander scale in the 1930s, mostly as “talking books” for the blind. Eventually, with the proliferation of the audio cassette format in the mid-1970s, and the popularity of automobile cassette players, recorded books became a significant format.

Although a variety of e-book formats would appear more than ten years earlier, Amazon’s Kindle (2007) and Barnes & Noble’s Nook (2009) accelerated this approach. Soon after, other readers—in the form of tablet computers and smart phones—would further advance the cause.

It is noted that even if there are now alternative means of book distribution, the basic proprietary model still dominates the proceedings. For the most part, the major e-reader formats are not cross-compatible. It is ironic that distribution of personally-accessible listenable music, which lagged more than 400 years behind the distribution of books, is now in a far more advanced state. Perhaps this is because the difficulty in “violating” copyright disintegrated with the explosion of the mp3 format, and few consumers have lamented the demise of the $20 audio CD.

A curious phenomenon in book publishing is the notion that technical works—especially college textbooks—should be vastly more expensive than “popular” works such as novels. Many arguments are proffered to justify this including the unassailable fact that the requisite color, charts, graphs, tables, and illustrations are more expensive to produce than simple words on paper. Sometimes, the smaller print runs are also mentioned.

However, as economist Ethan Trex has pointed out, the high price of textbooks is symptomatic of misaligned incentives, not exorbitant production costs.

Professors pick the course materials, and faculty members don’t have any strong incentive to be price sensitive when it comes to selecting textbooks. Their out-of-pocket expense is zero whether the required texts cost $100 or $300, so there’s no real barrier to heaping on more reading material. If a student needs Class X to graduate, they’ll likely need to procure the required texts.

Moreover, many students aren’t all that price sensitive themselves. While the broke college kid is a beloved caricature, many students’ parents may still be footing the bill for school materials like books. Unless their parents raise a stink over a semester’s book bill, it’s easy to see how the textbook market could be one where none of the players actually have any strong incentive to be sensitive to prices.

As to the argument that the sales of used textbooks cuts into publishers’ profits, and this factor must be built into the new book price, this premise has been attacked by economist Hal R. Varian and others. Interestingly, Varian has written a number of textbooks.

Even though medical students these days are not blindly buying all the recommended books anymore, the cost of medical textbooks and learned medical publications in general is still far too high. This nonsense might be covered by federally-guaranteed student loans, but some day the creditors will be calling in their chits—trying to collect from docs who aren’t exactly earning the impressive fees of the past. And amid all of this, physicians must keep up with a flow of information, increasing at a faster pace than ever before. This scenario may not end well.

Fortunately, there are companies striving to improve e-books and electronic publishing. A few weeks ago, I spoke with Richard Ku, CEO of eSoftBook, Inc.. The company offers a flexible platform, supporting a variety of standards (Windows, iOS, Android and Mac), allowing authors, publishers, and e-book retailers a means to deliver content with speed and affordability.

Richard elaborated on eSoftBook’s cloud-based products and services:

1.    NeoCloud Platform—Designed for the creation of e-books and electronic content. It supports both business-to-business and business-to-consumer applications.

2.    NeoBook Delivery Cloud Service—Enables e-book retailers and publishers to quickly reach millions of consumers.

3.    NeoLesson Cloud Services—Designed for schools, universities, and corporations, to facilitate the delivery of electronic textbooks and related content.

Considering the stakes involved in health care and many other information-rich fields of endeavor, it is high time that book publishers truly commit themselves to going beyond Gutenberg, or simply get left behind. Alternative means for creators of content to distribute their works are in place and are expanding.