The proliferation of available marketing channels—those targeting physicians as well as other audiences—has many in the medical publishing world convinced that the day of the dead tree is fading fast. Is the future of medical publishing online?

“I think we’re going to see a 10-15 year changeover,” says The New England Journal of Medicine‘s Art Wilschek. “We’re seeing a lot of readers still reading the print. They still haven’t gone totally to the Internet—they’re using it for different purposes—but the younger doctors are using it more.”

For The Journal‘s part, nejm.org is getting 14 million views per month, and the title is looking to leverage its leading brand more online. “Like everyone, we’re looking for opportunities,” says Wilschek. “We just don’t jump into everything.”

Of course, online ad rates are a fraction of what print rates are, and even as more advertisers migrate online, they aren’t likely to catch up. That could mean less-profitable pubs get squeezed out. “They’ll close or reinvent themselves,” says Wilschek, who notes that many publishers are making more from CME and custom publishing than from traditional ads.

Turmoil in medical publishing is nothing new–many of the biggest titles from years past, like Medical World News, Medical Tribune and Modern Medicine, are no more. But in the brave new world of medical information, the ease of entry that controlled circulation granted to the titles of yesteryear will be lost. Still, not everyone’s sanguine about the business. “It’s still the best possible and least expensive means of leveraging a sales call,” says CMI’s Bob Girondi. “People are going to say, ‘If I’m going to do this in a cost-effective manner, I’m going to have to include a broad array of customer-focused, fully-integrated media, beginning with journal advertising.’”