The Market for Physician-Researchers’ Labor: Unpaid Work, Paid Access

Academic publishing is foundational to advancing medical knowledge, shaping professional identity, and promoting academic advancement. Yet the contemporary publishing model increasingly relies on uncompensated labor by physician-researchers, while imposing financial and access barriers to the dissemination of that same work. This article examines the structural features of academic publishing that normalize unpaid authorship and peer review, shift costs to investigators through article processing charges, and restrict access to clinically relevant research. It also considers the growing role of artificial intelligence in peer review as a predictable response to systemic strain. Finally, the author proposes institutional, editorial, and professional actions to support ethical, sustainable, and mission-aligned approaches to scholarly publishing in medicine.