Rethinking where and how we publish in health sciences

Over the past few decades, scientific publishing has undergone significant transformations evolving from a print-based system to a digitised and globally accessible ecosystem.While this shift has facilitated faster dissemination and broader access to knowledge, it has also exposed systemic weaknesses, including the profiteering by major commercial publishers and persistent inequities in the publishing landscape.This opinion article aims to educate researchers in rehabilitation sciences and the broader health sciences who are unfamiliar with scholarly publishing models and practices, with the goal of fostering more accessible, equitable, and sustainable knowledge production and dissemination.We critically examine the limitations of traditional subscription models, as well as pay-to-publish open access (gold with article processing fees) and hybrid models, highlighting their financial and systemic barriers.In contrast, we advocate for more equitable alternatives: the free-to-readers and free-to-authors model (diamond open access), which typically involves publishing costs covered by academic institutions or public funders, and self-archiving (green open access).We also discuss the increasing importance of preprints and peer-reviewed preprints (peer-print articles) in decoupling knowledge dissemination from conventional journal publication.We argue for greater recognition of these latter models in academic evaluation and for institutional support of open infrastructures.We recommend broader reforms, including replacing authorship with contributorship, shifting the focus from novelty to reproducibility and transparency, and eliminating the journal impact factor as a criterion for evaluation.Collectively, these recommendations aim to reinforce a scholarly publishing ecosystem that prioritises equity, rigour, and the collective advancement of science.