This response rate is in keeping with increasing use of the site, which now conducts about 45 000 user sessions per month. Respondents to the year 2000 survey cut across a range of ages, nationalities and professional interests. Just over one-third (35%) were less than 35 years old and roughly half (53%) were between 35 and 54 years old. An increase in the proportion of female respondents (47% in 2000, compared with 43% in 1999) follows an overall trend in Internet usage.

Almost 40% of respondents identified themselves as physicians or physicians-in-training, and an additional 18% were in another health care occupation. Some of our visitors defied categorization. One is a "poet/medical transcriber/health care activist," and we also had visits from an "international civil servant" and a "research technician on mites and ticks."

Just over half of the people (54%) completing the survey were Canadians and 13% were Americans. The next most common place of origin was the United Kingdom (3.5%), followed by Italy (2.5%), Spain (2.1%), Australia (2.1%) and Germany (2.0%).

And what were these people looking at? Among repeat visitors, the most popular sections of eCMAJ were the table of contents (69%) and the scientific articles (62%). Visitors were also given a list of attributes unique to the print and electronic versions of the journal — for example, the electronic journal has daily updates on health news — and asked which ones, if any, they valued. The most popular attribute for repeat visitors was the ability to search back issues (80%). Among respondents with access to the paper version of the journal, the favourite attribute is its portability — the I-can-read-it-in-the-bathtub factor. Portability might not be unique to the paper journal for long, however: 38% of respondents indicated their support for an eCMAJ format compatible with handheld computers.

Journal editors and publishers are wrestling with questions of accessibility and revenue for online journals, and CMAJ is no exception. Respondents who are not CMA members were asked how they felt about user fees. They were more willing to pay to print portable document format (PDF) copies of articles if they could read the full text for free online (33% agreed or strongly agreed) than to pay to view the full text if only the abstracts were free online (27% agreed or strongly agreed). Only 18% were willing to pay a modest fee for online access to eCMAJ.

Our questions about access elicited pleas to keep the Web site free of charge. One came from a specialist in Yugoslavia, who commented that he is paid only $50 per month. An Argentinean specialist added that "people living in developing countries need some good journals for free." The 162 respondents (14%) who were CMA members appear to support the interests of nonmembers in this regard: 61% agreed or strongly agreed that online access should remain available without charge to nonmembers, whereas only 14% disagreed or strongly disagreed.

The online survey gave readers a chance to air their views and opinions about the journal. And air them they did. "Not a very good publication, unfortunately," snorted one Ontario physician. "It's out of touch with the realities of practising medicine in Canada."

"eCMAJ is useful in determining the speed of filing the paper edition in the round file," added another critic, a Canadian GP.

However, most of the comments were positive. An academic researcher from Australia liked "the inclusion of more philosophical material in the journal" and another reader wrote that the journal is "much improved since the acceptance of qualitative research articles." A Canadian health care practitioner uses it "to keep abreast of quickly changing information and for patient counselling." A physician from Manitoba commented that the journal provides "an opportunity for Canadian doctors to communicate with each other on a national scale." A Canadian research technician wanted "more reports on nutrition" and a medical student from British Columbia wanted "a section on medical students and issues related to them."