A major problem affecting academic and research libraries today is the serials crisis – the fact that journal prices continue to increase dramatically, far above the general inflation rate. Open access journals and archives of various types have been proposed as possible solutions to the problem, suggestions which have been met with both enthusiasm and deep distaste. Medical libraries are in the thick of the debate, a situation which this article (Open access: Implications for scholarly publishing and medical libraries) discusses at length. The authors talk about the phenomenon of open access journals (which do not charge consumers for use of the content) and of self-archiving/depositing in freely available websites (in which the author makes his or her work freely available). Both methods are already being used to a certain extent, and probably the best solution lies in some combination of these and other methods. The only certainty is that the current state of affairs cannot continue. It just remains to be seen what changes will actually happen.