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Variations on Open Access
A study of the financial and non -financial effects of
 alternative business models for scholarly journals




        Preliminary results presented 8 November 2004
                 by Kaufman-Wills Group, LLC
Research Objectives
1. What impact is open access having on
   scholarly journals’ financial factors?
2. What impact is open access having on
   scholarly journals’ non-financial factors?




ALPSP/HW/AAAS study          Kaufman-
                             Kaufman-Wills Group   2
Methods
l Written               questionnaire
      l 38 questions
      l emailed to population
      l Pre-tested
l Two             populations
      l HW            open archive journals
             l N=184
      l Directory          of Open Access Journals
             l N=1,151

ALPSP/HW/AAAS study               Kaufman-
                                  Kaufman-Wills Group   3
Response
l    HW open archive                      l    Preliminary results:
      l   184 mailed                                l   155 DOAJ (13%)
      l   68 completed                              l   37 HW (20%)
      l   37% response rate


l    DOAJ
      l   1,151 mailed
      l   245 completed
                                            90%à95% confidence,
      l   22% response rate
                                                + or – 5% points
ALPSP/HW/AAAS study           Kaufman-
                              Kaufman-Wills Group                        4
Findings
            Financial                             Non-financial
l    Current and future access         l    Print format
l    Sources of financial              l    Copyediting
     support for journal               l    Peer review
l    % of total each revenue           l    Author services
     type represents                   l    Copyright
l    Revenue trends and                l    Pre/post -publishing rights
     expectations
                                       l    Permissions policies
l    Surplus or deficit


ALPSP/HW/AAAS study        Kaufman-
                           Kaufman-Wills Group                        5
Journal Profile
         HW open archive                                       DOAJ
l    97% soc, 3% u press                       l    46% comml, 17% dept, 16%
l    60% Euro, 40% NA                               soc, 7% indiv
l    97% STM                                   l    58% Euro, 28% NA, 14%
l    95% orig, 5% review                            ROW
l    97% print + online                        l    72% STM, 12% SS, 9%
                                                    humanities
      l   Half <1960 print
      l   Half <2000 online
                                               l    100% original content
      l   78% online posted w/print;           l    74% online only
          13% asap                                       l   Half <1990 print
      l   11% addl online material                       l   Half <2000 online
l    >50% at least monthly                               l   69% post articles asap
l    Avg # mss sub/yr: 973                     l    10% Q, 90% other, N/A
l    Avg # arts pub/yr: 329                    l    Avg # mss sub/yr: 108
                                               l    Avg # arts pub/yr: 46

ALPSP/HW/AAAS study                Kaufman-
                                   Kaufman-Wills Group                                6
Online Hosting
      HW open archive                             DOAJ
l    Current content                  l    Current content
      l   100% HW                               l   71% own service
l    Archival content                           l   45% PMC
      l   60% PMC                               l   39% JSTOR
                                      l    Archival content
                                                l   56% other (SciELO)
                                                l   45% PMC
                                                l   39% INIST

ALPSP/HW/AAAS study       Kaufman-
                          Kaufman-Wills Group                            7
Peer Review
      HW open archive                              DOAJ
l    70% int + ext rev                  l    49% int + ext rev
      l   24% ext rev only                        l   45% ext rev only
      l   2.5% edit staff only                    l   2% edit staff only
      l   2.5% no peer review           l    70% 2 reviewers
l    76% 2 reviewers                    l    21% 3 reviewers
l    16% 3 reviewers



ALPSP/HW/AAAS study         Kaufman-
                            Kaufman-Wills Group                            8
Editing and Copyediting
      HW open archive                             DOAJ
l    42% content edited                l    44% content edited
l    95% copyedited                    l    55% copyedited




ALPSP/HW/AAAS study        Kaufman-
                           Kaufman-Wills Group                   9
Author Services
                                            Author Services                                              Author Services - DOAJ Journals

       40                                                                   140



       35
                                                              PDF or120 electronic format proofs
                                                                     other                                                                 PDF or other electronic format proofs

                                                              Online article submission                                                    Online article submission
       30
                                                              Online100 of paper through peer-review
                                                                     tracking                                                              Online tracking of paper through peer-review
                                                              process                                                                      process
       25                                                     Online digital art submission                                                Online digital art submission
                                                                      80
                                                                Responses
Responses




                                                              PDF for posting on Author's web site                                         PDF for posting on Author's web site
       20
                                                              Limited/Unlimited e-prints or downloads                                      Limited/Unlimited e-prints or downloads
                                                                     60
                                                              Post publication peer review                                                 Post publication peer review
       15
                                                              Online tracking of paper from submission                                     Online tracking of paper from submission
                                                              through 40
                                                                       publication                                                         through publication
       10                                                     None of the above                                                            None of the above

                                                              Other                                                                        Other
                                                                             20
            5



            0                                                                 0
                                      1                                                                     1
                                 Services                                                                Services
                ALPSP/HW/AAAS study                                               Kaufman-
                                                                                  Kaufman-Wills Group                                                                      10
Copyright
       HW open archive                           DOAJ
l    64% request author             l    50% request author
     to grant license to                 to grant license to
     publish                             publish
l    30% make copyright             l    23% do not require
     transfer condition of               any formal agreement
     publication                    l    16% make copyright
l    6% will grant license               transfer condition of
     if requested by author              publication

ALPSP/HW/AAAS study     Kaufman-
                        Kaufman-Wills Group                  11
Permissions Policies
         HW open archive                                       DOAJ
l   89% only with written permission          l    10% only with written permission
l   11% any academic use but no               l    18% any academic use but no
    commercial use w/o permission                  commercial use w/o permission
                                              l    68% all uses if source cited
l   70% use in author’s institution           l    10% all uses, no permission
l   86% use in author’s                            necessary
    presentations or publications
                                              l    12% use in author’s institution
l   70% posting post-print to                 l    13% use in author’s
    author’s web site                              presentations or publications
l   54% posting pre-print to author’s
    web site                                  l    8% posting post-print to author’s
                                                   web site
    ALPSP/HW/AAAS study           Kaufman-
                                  Kaufman-Wills Group                            12
Access to Content
        HW open archive                                    DOAJ
l    95% restrict current                    l    95% free on publication
     content; open archive                   l    OA “influentials”
l    OA “influentials”                                 l   56% authors
      l   68% publisher/                               l   49% publisher (BMC)
          publishing oversight                         l   16% publications staff
      l   43% librarians                               l   15% members
      l   43% OA proponents                            l   19% OA proponents
      l   35% members                                  l   11% institutions
      l   30% authors                                  l   8% librarians
      l   8% other similar journals                    l   8% other similar journals

ALPSP/HW/AAAS study              Kaufman-
                                 Kaufman-Wills Group                                   13
Business Model
      HW open archive                                  DOAJ
l    95% require subs for                 l    95% free content on
     current content                           publication
l    81% plan to test or                  l    49% plan to test or
     adopt different model                     adopt different model
      l   New funding sources
      l   New financial model
      l   Original articles free
      l   Open access, author
          pays
ALPSP/HW/AAAS study           Kaufman-
                              Kaufman-Wills Group                  14
Funding Sources
        HW open archive                                            DOAJ
l    End user                                 l    End user
      l   87% subscriptions                             l   13% subscriptions
      l   62% member dues                               l   8% member dues
      l   57% content licensing               l    Grants
l    Industry                                           l   39% gifts or fundraising
      l   92% comml reprints                            l   23% institutional
      l   78% display ads                               l   13% private foundation
      l   30% classified ads                  l    In-kind
l    In-kind                                            l   20% volunteer
      l   35% volunteer                                 l   20% in-kind contributions

ALPSP/HW/AAAS study               Kaufman-
                                  Kaufman-Wills Group                                   15
Revenue Sources as %                                                            Revenue Sources - 2004
                                                                                    DOAJ Journals

of Total (preliminary!)
                                                                                                6%
                  Revenue Sources - 2004                                       14%
                    Highwire Journals
                                                                                                               16%
                           2%
           12%                                                          6%

                                                                                                                     0%
                                                                     11%
13%




                                                          60%
9%                                                                                                      47%

                                                                                     Subscriptions/Licenses
      3%                                                                             Grants
       1%                                                                            Third-Party Licenses
                                                                                     Author Fees and Charges
Based on mean, which is arithmetic average (add percentages,
divide by N.) Journalsstudy
       ALPSP/HW/AAAS in each population, when asked to allocate -Wills Group
                                                         Kaufman-
                                                         Kaufman
                                                                                     Industry                  16
percentages to various revenue sources, reported receiving on                        Member Dues
average X% of their revenue from Y.                                                  Other
Author Fees
          HW open archive                                      DOAJ
l    Author fees 9% of total                   l    Author fees 47% of total
     revenues                                       revenues (BMC)
      l   91% article reprints                           l   88% page charges
      l   83% color charges                              l   37% submission charges
      l   17% page charges                               l   8% publication charges
      l   11% excess page charges                        l   5% color charges
      l   9% ms submission charges                       l   4% article reprints
l    Sources of author funds                   l    Sources of author funds
      l   60% don’t know                                 l   3% don’t know
      l   34% research grant                             l   51% research grant
      l   31% foundation grant                           l   6% foundation grant
      l   3% library budget                              l   41% library budget
      l   29% departmental support                       l   10% departmental support
      l   25% author’s personal funds                    l   7% author’s personal funds
      l   9% do not charge authors                       l   33% do not charge authors
ALPSP/HW/AAAS study                Kaufman-
                                   Kaufman-Wills Group                                    17
Financial Outlook
          HW open archive                                  DOAJ
l    75% surplus                            l    5% surplus
l    11% breakeven                          l    32% breakeven
l    14% shortfall                          l    63% shortfall

l    61% trended upward                     l    64% trended upward
l    22% stayed flat                        l    19% stayed flat
l    11% trended downward                   l    3% trended downward
l    6% don’t know                          l    14% don’t know

l    25% exceeded revenue                   l    3% exceeded revenue
     expectations                                expectations
l    39% met revenue expectations           l    87% met revenue expectations
l    36% below revenue expectations         l    10% below revenue
                                                 expectations
    ALPSP/HW/AAAS study         Kaufman-
                                Kaufman-Wills Group                        18
Current Business Model Challenges
        HW open archive                                  DOAJ
l    “Loss of individual                 l    “This is not a business,
     subscribers”                             it’s an effort”
l    “Acceptance of online               l    “No business model”
     journals by subscribers”            l    “Seeking additional
l    “Increasing institutional                funding and donations
     subscriptions”                           when initial funding runs
                                              out”
                                         l    “Increasing usage”
                                         l    “Acquiring good papers
                                              and reviewers”
ALPSP/HW/AAAS study          Kaufman-
                             Kaufman-Wills Group                          19
Current business model opportunities
        HW open archive                                  DOAJ
l   “Reach of journal via search         l    “Not sure what this
    engines”                                  means…we are a nonprofit
                                              enterprise”
l   “International subscribers,
                                         l    “Hope to continue to
    reduce rates to residents”                provide free access …to
                                              benefit society”
                                         l    “Full text free of charge
                                              available to all”
                                         l    “Hope to win more
                                              readership and listing in
                                              libraries and databases”
                                         l    “Help mankind acquire
                                              knowledge”
    ALPSP/HW/AAAS study      Kaufman-
                             Kaufman-Wills Group                     20
Impact of OA Movement
         HW open archive                               DOAJ
l    “Creates whole new                 l    “Validates what we have
     dilemma for financing                   been trying to do…”
     journals”                          l    “Put pressure on others
l    “Very little NIH research               to make important
     published”                              information on scientific
                                             progress available to
                                             everyone”
                                        l    “Raises acceptability,
                                             helps hold down prices”
                                        l    “None. References will be
                                             easier to check.”
ALPSP/HW/AAAS study         Kaufman-
                            Kaufman-Wills Group                      21
Will OA Journals Prevail?
             HW open archive                                      DOAJ
l    “Open access journals will only be        l    “Prevalent in some fields and may
     prevalent and/or succeed if the                be mandated by nature of the
     financing issue is addressed and               funding of the research published”
     solved”                                   l    “I believe that it MAY become
l    “No, doubt successful due to                   prevalent. So, I don’t want to miss
     financial issues”                              the boat. Its success will depend
                                                    on institutional and governmental
l    “Prevalent perhaps, but I don’t                policy”
     know if small association
     publishers can be successful              l    “Yes, eventually”
     without adding higher charges to          l    “Yes, yes, the model works”
     authors”                                  l    “Success will not be
                                                    complete…most of the famous,
                                                    high ranking journals will give
                                                    restricted access…”
                                               l    Paid subscriptions are an
                                                    “offensive contravention of the
                                                    opportunities for freedom in
                                                    knowledge exchange that the
                                                    Internet should provide”
ALPSP/HW/AAAS study                Kaufman-
                                   Kaufman-Wills Group                               22
Next Steps
l    Quantitative
      l   Survey AAMC society members with journals (N=111)
      l   Finish data entry, analyze frequency tables, prepare
          report
l    Qualitative
      l   30 personal interviews à case reports
             l   HW open archive publishers
             l   PLoS and other DOAJ publishers
             l   Elsevier and other commercial publishers
             l   University Press, other non-HW self -published society
                 journals
l    Timeframe
      l   Draft report to sponsors for review by end of year
ALPSP/HW/AAAS study                  Kaufman-
                                     Kaufman-Wills Group                  23
Kaufman-Wills Group, LLC
                                                                  Selected clients
                                                            •AAAS/Science
           Cara S. Kaufman, Partner                         •Am Academy Pediatrics
           Alma J. Wills, Partner                           •Am Assoc Immunologists
           Fred Fusting, Associate                          •Am Coll Cardiology
           Kaufman-Wills Group, LLC                         •Am Coll Radiology
           24 Aintree Road                                  •American Psychiatric Assoc
           Baltimore, MD 21286                              •Am Soc Clin Oncology
           410 821 8035 (office)                            •ASPET
           410 821 5460 (mobile)                            •College Am Pathologists
           443 269 0283 (e-fax)                             •Rockefeller University Press
           ckaufman@verizon.net                             •Intl Anesthesia Res Soc
           www.kaufmanwills.com                             •NEJM
                                                            •Project Hope/Health Affairs
                                                            •Am Acad Othopaedic Surg
                                                            •Am Urological Association
                                                            •Am Speech Lang Hear Assoc
ALPSP/HW/AAAS study                   Kaufman-
                                      Kaufman-Wills Group                                   24

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65 kaufman

  • 1. Variations on Open Access A study of the financial and non -financial effects of alternative business models for scholarly journals Preliminary results presented 8 November 2004 by Kaufman-Wills Group, LLC
  • 2. Research Objectives 1. What impact is open access having on scholarly journals’ financial factors? 2. What impact is open access having on scholarly journals’ non-financial factors? ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 2
  • 3. Methods l Written questionnaire l 38 questions l emailed to population l Pre-tested l Two populations l HW open archive journals l N=184 l Directory of Open Access Journals l N=1,151 ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 3
  • 4. Response l HW open archive l Preliminary results: l 184 mailed l 155 DOAJ (13%) l 68 completed l 37 HW (20%) l 37% response rate l DOAJ l 1,151 mailed l 245 completed 90%à95% confidence, l 22% response rate + or – 5% points ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 4
  • 5. Findings Financial Non-financial l Current and future access l Print format l Sources of financial l Copyediting support for journal l Peer review l % of total each revenue l Author services type represents l Copyright l Revenue trends and l Pre/post -publishing rights expectations l Permissions policies l Surplus or deficit ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 5
  • 6. Journal Profile HW open archive DOAJ l 97% soc, 3% u press l 46% comml, 17% dept, 16% l 60% Euro, 40% NA soc, 7% indiv l 97% STM l 58% Euro, 28% NA, 14% l 95% orig, 5% review ROW l 97% print + online l 72% STM, 12% SS, 9% humanities l Half <1960 print l Half <2000 online l 100% original content l 78% online posted w/print; l 74% online only 13% asap l Half <1990 print l 11% addl online material l Half <2000 online l >50% at least monthly l 69% post articles asap l Avg # mss sub/yr: 973 l 10% Q, 90% other, N/A l Avg # arts pub/yr: 329 l Avg # mss sub/yr: 108 l Avg # arts pub/yr: 46 ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 6
  • 7. Online Hosting HW open archive DOAJ l Current content l Current content l 100% HW l 71% own service l Archival content l 45% PMC l 60% PMC l 39% JSTOR l Archival content l 56% other (SciELO) l 45% PMC l 39% INIST ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 7
  • 8. Peer Review HW open archive DOAJ l 70% int + ext rev l 49% int + ext rev l 24% ext rev only l 45% ext rev only l 2.5% edit staff only l 2% edit staff only l 2.5% no peer review l 70% 2 reviewers l 76% 2 reviewers l 21% 3 reviewers l 16% 3 reviewers ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 8
  • 9. Editing and Copyediting HW open archive DOAJ l 42% content edited l 44% content edited l 95% copyedited l 55% copyedited ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 9
  • 10. Author Services Author Services Author Services - DOAJ Journals 40 140 35 PDF or120 electronic format proofs other PDF or other electronic format proofs Online article submission Online article submission 30 Online100 of paper through peer-review tracking Online tracking of paper through peer-review process process 25 Online digital art submission Online digital art submission 80 Responses Responses PDF for posting on Author's web site PDF for posting on Author's web site 20 Limited/Unlimited e-prints or downloads Limited/Unlimited e-prints or downloads 60 Post publication peer review Post publication peer review 15 Online tracking of paper from submission Online tracking of paper from submission through 40 publication through publication 10 None of the above None of the above Other Other 20 5 0 0 1 1 Services Services ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 10
  • 11. Copyright HW open archive DOAJ l 64% request author l 50% request author to grant license to to grant license to publish publish l 30% make copyright l 23% do not require transfer condition of any formal agreement publication l 16% make copyright l 6% will grant license transfer condition of if requested by author publication ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 11
  • 12. Permissions Policies HW open archive DOAJ l 89% only with written permission l 10% only with written permission l 11% any academic use but no l 18% any academic use but no commercial use w/o permission commercial use w/o permission l 68% all uses if source cited l 70% use in author’s institution l 10% all uses, no permission l 86% use in author’s necessary presentations or publications l 12% use in author’s institution l 70% posting post-print to l 13% use in author’s author’s web site presentations or publications l 54% posting pre-print to author’s web site l 8% posting post-print to author’s web site ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 12
  • 13. Access to Content HW open archive DOAJ l 95% restrict current l 95% free on publication content; open archive l OA “influentials” l OA “influentials” l 56% authors l 68% publisher/ l 49% publisher (BMC) publishing oversight l 16% publications staff l 43% librarians l 15% members l 43% OA proponents l 19% OA proponents l 35% members l 11% institutions l 30% authors l 8% librarians l 8% other similar journals l 8% other similar journals ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 13
  • 14. Business Model HW open archive DOAJ l 95% require subs for l 95% free content on current content publication l 81% plan to test or l 49% plan to test or adopt different model adopt different model l New funding sources l New financial model l Original articles free l Open access, author pays ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 14
  • 15. Funding Sources HW open archive DOAJ l End user l End user l 87% subscriptions l 13% subscriptions l 62% member dues l 8% member dues l 57% content licensing l Grants l Industry l 39% gifts or fundraising l 92% comml reprints l 23% institutional l 78% display ads l 13% private foundation l 30% classified ads l In-kind l In-kind l 20% volunteer l 35% volunteer l 20% in-kind contributions ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 15
  • 16. Revenue Sources as % Revenue Sources - 2004 DOAJ Journals of Total (preliminary!) 6% Revenue Sources - 2004 14% Highwire Journals 16% 2% 12% 6% 0% 11% 13% 60% 9% 47% Subscriptions/Licenses 3% Grants 1% Third-Party Licenses Author Fees and Charges Based on mean, which is arithmetic average (add percentages, divide by N.) Journalsstudy ALPSP/HW/AAAS in each population, when asked to allocate -Wills Group Kaufman- Kaufman Industry 16 percentages to various revenue sources, reported receiving on Member Dues average X% of their revenue from Y. Other
  • 17. Author Fees HW open archive DOAJ l Author fees 9% of total l Author fees 47% of total revenues revenues (BMC) l 91% article reprints l 88% page charges l 83% color charges l 37% submission charges l 17% page charges l 8% publication charges l 11% excess page charges l 5% color charges l 9% ms submission charges l 4% article reprints l Sources of author funds l Sources of author funds l 60% don’t know l 3% don’t know l 34% research grant l 51% research grant l 31% foundation grant l 6% foundation grant l 3% library budget l 41% library budget l 29% departmental support l 10% departmental support l 25% author’s personal funds l 7% author’s personal funds l 9% do not charge authors l 33% do not charge authors ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 17
  • 18. Financial Outlook HW open archive DOAJ l 75% surplus l 5% surplus l 11% breakeven l 32% breakeven l 14% shortfall l 63% shortfall l 61% trended upward l 64% trended upward l 22% stayed flat l 19% stayed flat l 11% trended downward l 3% trended downward l 6% don’t know l 14% don’t know l 25% exceeded revenue l 3% exceeded revenue expectations expectations l 39% met revenue expectations l 87% met revenue expectations l 36% below revenue expectations l 10% below revenue expectations ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 18
  • 19. Current Business Model Challenges HW open archive DOAJ l “Loss of individual l “This is not a business, subscribers” it’s an effort” l “Acceptance of online l “No business model” journals by subscribers” l “Seeking additional l “Increasing institutional funding and donations subscriptions” when initial funding runs out” l “Increasing usage” l “Acquiring good papers and reviewers” ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 19
  • 20. Current business model opportunities HW open archive DOAJ l “Reach of journal via search l “Not sure what this engines” means…we are a nonprofit enterprise” l “International subscribers, l “Hope to continue to reduce rates to residents” provide free access …to benefit society” l “Full text free of charge available to all” l “Hope to win more readership and listing in libraries and databases” l “Help mankind acquire knowledge” ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 20
  • 21. Impact of OA Movement HW open archive DOAJ l “Creates whole new l “Validates what we have dilemma for financing been trying to do…” journals” l “Put pressure on others l “Very little NIH research to make important published” information on scientific progress available to everyone” l “Raises acceptability, helps hold down prices” l “None. References will be easier to check.” ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 21
  • 22. Will OA Journals Prevail? HW open archive DOAJ l “Open access journals will only be l “Prevalent in some fields and may prevalent and/or succeed if the be mandated by nature of the financing issue is addressed and funding of the research published” solved” l “I believe that it MAY become l “No, doubt successful due to prevalent. So, I don’t want to miss financial issues” the boat. Its success will depend on institutional and governmental l “Prevalent perhaps, but I don’t policy” know if small association publishers can be successful l “Yes, eventually” without adding higher charges to l “Yes, yes, the model works” authors” l “Success will not be complete…most of the famous, high ranking journals will give restricted access…” l Paid subscriptions are an “offensive contravention of the opportunities for freedom in knowledge exchange that the Internet should provide” ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 22
  • 23. Next Steps l Quantitative l Survey AAMC society members with journals (N=111) l Finish data entry, analyze frequency tables, prepare report l Qualitative l 30 personal interviews à case reports l HW open archive publishers l PLoS and other DOAJ publishers l Elsevier and other commercial publishers l University Press, other non-HW self -published society journals l Timeframe l Draft report to sponsors for review by end of year ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 23
  • 24. Kaufman-Wills Group, LLC Selected clients •AAAS/Science Cara S. Kaufman, Partner •Am Academy Pediatrics Alma J. Wills, Partner •Am Assoc Immunologists Fred Fusting, Associate •Am Coll Cardiology Kaufman-Wills Group, LLC •Am Coll Radiology 24 Aintree Road •American Psychiatric Assoc Baltimore, MD 21286 •Am Soc Clin Oncology 410 821 8035 (office) •ASPET 410 821 5460 (mobile) •College Am Pathologists 443 269 0283 (e-fax) •Rockefeller University Press ckaufman@verizon.net •Intl Anesthesia Res Soc www.kaufmanwills.com •NEJM •Project Hope/Health Affairs •Am Acad Othopaedic Surg •Am Urological Association •Am Speech Lang Hear Assoc ALPSP/HW/AAAS study Kaufman- Kaufman-Wills Group 24