Abstract
The Journal of Medical Internet Research (JMIR) was an early pioneer of open access online publishing, and two decades later, some readers and authors may have forgotten the challenges of previous scientific publishing models. This commentary summarizes the many advantages of open access publishing for each of the main stakeholders in scientific publishing and reminds us that, like every innovation, there are disadvantages that we need to guard against, such as the problem of fraudulent journals. This paper then reviews the potential impact of some current initiatives, such as Plan S and JMIRx, concluding with some suggestions to help new open-access publishers ensure that the advantages of open access publishing outweigh the challenges.