journals (along with daily news reports and endless forms of entertainment) on a daily basis. They will be able to carry the information and access it wherever they go and whenever they want. Print publications are not likely to be dead in 20 years, but they are going to be regarded as a vestige of an earlier time. And that's not a bad thing for publishers, advertisers, or physicians. Great cost savings will occur in manufacturing and distribution that can result in a better outcome for all. The third big trend of the past 20 years— consolidation of ownership—will almost certainly continue. Why? Call it the American way. People who build businesses usually want to monetize the effort at some point. And large corporations never tire of rearranging their portfolios, usually in pursuit of increased revenue and profit. In addition, there will be an exciting array of new electronic communications products, and that is a virtual guarantee of an active mergers and acquisitions market. ^ 20 years have been an interesting time for medical journals, the next 20 are apt to be more so. f the past
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