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The American Journal of Medicine: The next 50 years
EDITORIALS
The American Journal of Medicine: The Next 50 Years
th
anniversary 1946-1996
his m a r k s the 50th y e a r of publication of The A m e r i c a n J o u r n a l o f M e d i c i n e ®. As I look at Alexander G u t m a n ' s inaugural editorial (Volume 1, No. 1, July 1946, and reprinted here), it is clear that the principles and objectives of the J o u r n a l have b e e n p e r p e t u a t e d through the years. It always has b e e n viewed as an i n s t r u m e n t to advance the education of medical students, residents and physicians c o m m i t e d to life-long learning. Stong e m p h a s i s has b e e n placed on the publication of reviews and critical essays covering the wide variety inherent in internal medicine. The goal of the J o u r n a l has b e e n to maintain the highest quality of p e e r review and to publish articles with its readership in mind. We have striven to publish w h a t is m o s t likely to assist the practicing physician and provide the greatest insight into medical p r o g r e s s for those in a c a d e m i c positions. More recently with our series on the "Science of Medical Care," we have e m p h a s i z e d basic r e s e a r c h as the s o u r c e of the n e w e s t and m o s t innovative ideas and c o n c e p t s for a d v a n c e d therapeutics and the increased well-being of patients. The objectives outline by Dr. G u t m a n to p r e s e n t a journal with a strong c o m m i t m e n t to the total educational p r o c e s s and the life-long p r o c e s s of learning for the physician continue to this day. Through readership surveys, focus groups, editorial discussions, meetings b e t w e e n the editors and representatives from the publisher, and other means, we have a t t e m p t e d to nmintain balance and to e n h a n c e the p r e s e n t a t i o n of not only clinical studies and reviews, but of in-depth educational nmterials, correspondence, CPC's and brief clinical observations. We believe that this balance has given a distinctive flavor to the J o u r n a l that will define it for the n e x t 50 years. In his editorial, Dr. G u t m a n highlighted the therapeutic use of antibiotics as one of the general topics selected for "exhaustive" discusssion and treatm e n t in the 1946 inaugural issue. Fifty years later the topic still is not exhausted. Indeed, in light of their re-emphasized inlportance, it is fitting that the focus of this January, 1996 issue is on infectious diseases, their importance, the d e v e l o p m e n t of antibiotic resistance, and the e m e r g e n c e of n e w (or changed) organisms. William D i s m u k e s ' editorial (pages 12-14) adds clear definition to the w a y in which these p r o c e s s e s have o c c u r r e d and will continue to unfold in the years to come. Certainly the search for n e w a p p r o a c h e s to antimicrobial therapies will o c c u p y the tinle of m a n y investigators and
T
~
clinicians in a c a d e m i a and in the p h a r m a c e u t i c a l industry t h r o u g h o u t the coming decades. What Dr. G u t m a n could not forsee and w h a t is particularly exciting as we enter the Journal's n e x t 50 years is h o w i m p o r t a n t basic science has b e e n to our understanding of h u m a n biology and clinical medicine. In the p a s t half-century we have witnessed the unraveling of the genetic code, n e w knowledge of cellular behavior, a clearer understanding of the i m m u n e system, and of h o w the imm u n e r e s p o n s e is initiated. It is r e a s o n a b l e to anticipate that within the n e x t 5 or 6 years, the entire DNA sequence for the h u m a n g e n o m e will be defined. This will enable us to u n d e r s t a n d c o m p l e x diseases at the the level of interacting genes and gene regulation. Malignancy, a u t o i m m u n i t y and developmental disorders will be c o m p r e h e n d e d through this n e w knowledge. Certainly in the n e x t 50 years gene t h e r a p y will b e c o m e a m a j o r part of our clinical a r m a m e n t a r i u m and to a degree of specificity that n e v e r before w a s d r e a m e d possible. The affiliation (1994) of The A m e r i c a n Journal o f Medicine ® with the Association of Professors of Medicine (APM) has allowed us to e x p a n d the editorial b o a r d of the Journal and create a f r a m e w o r k for continued critical review and analysis of the Journal, including its policies, editorial content, and the future directions that it will take for the enh a n c e m e n t of internal medicine. The pages of the Journal n o w dedicated to academic internal medicine bring to a wide audience reports, opinions, position papers, and debates emanating f r o m the APM. This gives the Journal and all of internal medicine a new range of opportunities for influence beyond its immediate borders. The i m p o r t a n c e of the Journal's objectives and the strength of its p u r p o s e s have also b e e n appreciated and s u p p o r t e d by its m a n y publishers and owners. During these 50 years a n u m b e r of changes of publisher, through p u r c h a s e s or m e r g e r s of companies that have b e e n responsible of The A m e r i c a n Journal o f Medicine ®, have t a k e n place: York Publisihng Company, Dunn and Bradstreet Company, Cahners, Reed, Reed-Elsevier, and n o w Elsevier Science. A change of publishers has always b e e n a s s o c i a t e d with s o m e degree of realignment, rethinking, and redirection, but always in a positive direction for the Journal. The s u p p o r t that has b e e n given in the last t w o years has b e e n e x t r a o r d i n a r y and has assured the continued growth and imp r o v e m e n t of the Journal's editorial content. The
January 1996 The American Journal of Medicine* Volume 100
9
AJM: THE NEXT 50 YEARS/BENNETt
relationship b e t w e e n the APM and the publishers has b e e n of mutual benefit to both organizations; and certainly has b e e n a driving force in the editorial direction of the Jou~nal. There you have the ingredients for the Journal's success for the next 50 years. • The opportunity and challenge of b~.nging the best of medicial science to the newest as well as the m o s t senior m e m b e r s of our profession for them to use in improving the health and well-being of their patients. • The involvement ~)f the Association of Professors of Medicine, which is commited to its mission of leadership for academic internal medicine where w e all
10
b e g a n to u n d e r s t a n d the intellectual and h u m a n dimensions of our profession. • Publishers and owners w h o appreciate and accept their role and contribution to the a d v a n c m e n t of patient care through physician education. On behalf of the Editors, the Association of Professors of Medicine, and Excerpta Medica, I pledge The A m e r i c a n Journal o f Medicine ® as a bridge bn_nging the best of medical science to the best of our profession as they carry out their responsibility to learn everyday h o w to care for their patients in the very best way.
January 1996 The American Journal of Medicine • Volume 100
J. CLAUDEBENNETT,MD, EDITORHN-CHIEF
The American Journal of Medicine: The Next 50 Years
th
anniversary 1946-1996
his m a r k s the 50th y e a r of publication of The A m e r i c a n J o u r n a l o f M e d i c i n e ®. As I look at Alexander G u t m a n ' s inaugural editorial (Volume 1, No. 1, July 1946, and reprinted here), it is clear that the principles and objectives of the J o u r n a l have b e e n p e r p e t u a t e d through the years. It always has b e e n viewed as an i n s t r u m e n t to advance the education of medical students, residents and physicians c o m m i t e d to life-long learning. Stong e m p h a s i s has b e e n placed on the publication of reviews and critical essays covering the wide variety inherent in internal medicine. The goal of the J o u r n a l has b e e n to maintain the highest quality of p e e r review and to publish articles with its readership in mind. We have striven to publish w h a t is m o s t likely to assist the practicing physician and provide the greatest insight into medical p r o g r e s s for those in a c a d e m i c positions. More recently with our series on the "Science of Medical Care," we have e m p h a s i z e d basic r e s e a r c h as the s o u r c e of the n e w e s t and m o s t innovative ideas and c o n c e p t s for a d v a n c e d therapeutics and the increased well-being of patients. The objectives outline by Dr. G u t m a n to p r e s e n t a journal with a strong c o m m i t m e n t to the total educational p r o c e s s and the life-long p r o c e s s of learning for the physician continue to this day. Through readership surveys, focus groups, editorial discussions, meetings b e t w e e n the editors and representatives from the publisher, and other means, we have a t t e m p t e d to nmintain balance and to e n h a n c e the p r e s e n t a t i o n of not only clinical studies and reviews, but of in-depth educational nmterials, correspondence, CPC's and brief clinical observations. We believe that this balance has given a distinctive flavor to the J o u r n a l that will define it for the n e x t 50 years. In his editorial, Dr. G u t m a n highlighted the therapeutic use of antibiotics as one of the general topics selected for "exhaustive" discusssion and treatm e n t in the 1946 inaugural issue. Fifty years later the topic still is not exhausted. Indeed, in light of their re-emphasized inlportance, it is fitting that the focus of this January, 1996 issue is on infectious diseases, their importance, the d e v e l o p m e n t of antibiotic resistance, and the e m e r g e n c e of n e w (or changed) organisms. William D i s m u k e s ' editorial (pages 12-14) adds clear definition to the w a y in which these p r o c e s s e s have o c c u r r e d and will continue to unfold in the years to come. Certainly the search for n e w a p p r o a c h e s to antimicrobial therapies will o c c u p y the tinle of m a n y investigators and
T
~
clinicians in a c a d e m i a and in the p h a r m a c e u t i c a l industry t h r o u g h o u t the coming decades. What Dr. G u t m a n could not forsee and w h a t is particularly exciting as we enter the Journal's n e x t 50 years is h o w i m p o r t a n t basic science has b e e n to our understanding of h u m a n biology and clinical medicine. In the p a s t half-century we have witnessed the unraveling of the genetic code, n e w knowledge of cellular behavior, a clearer understanding of the i m m u n e system, and of h o w the imm u n e r e s p o n s e is initiated. It is r e a s o n a b l e to anticipate that within the n e x t 5 or 6 years, the entire DNA sequence for the h u m a n g e n o m e will be defined. This will enable us to u n d e r s t a n d c o m p l e x diseases at the the level of interacting genes and gene regulation. Malignancy, a u t o i m m u n i t y and developmental disorders will be c o m p r e h e n d e d through this n e w knowledge. Certainly in the n e x t 50 years gene t h e r a p y will b e c o m e a m a j o r part of our clinical a r m a m e n t a r i u m and to a degree of specificity that n e v e r before w a s d r e a m e d possible. The affiliation (1994) of The A m e r i c a n Journal o f Medicine ® with the Association of Professors of Medicine (APM) has allowed us to e x p a n d the editorial b o a r d of the Journal and create a f r a m e w o r k for continued critical review and analysis of the Journal, including its policies, editorial content, and the future directions that it will take for the enh a n c e m e n t of internal medicine. The pages of the Journal n o w dedicated to academic internal medicine bring to a wide audience reports, opinions, position papers, and debates emanating f r o m the APM. This gives the Journal and all of internal medicine a new range of opportunities for influence beyond its immediate borders. The i m p o r t a n c e of the Journal's objectives and the strength of its p u r p o s e s have also b e e n appreciated and s u p p o r t e d by its m a n y publishers and owners. During these 50 years a n u m b e r of changes of publisher, through p u r c h a s e s or m e r g e r s of companies that have b e e n responsible of The A m e r i c a n Journal o f Medicine ®, have t a k e n place: York Publisihng Company, Dunn and Bradstreet Company, Cahners, Reed, Reed-Elsevier, and n o w Elsevier Science. A change of publishers has always b e e n a s s o c i a t e d with s o m e degree of realignment, rethinking, and redirection, but always in a positive direction for the Journal. The s u p p o r t that has b e e n given in the last t w o years has b e e n e x t r a o r d i n a r y and has assured the continued growth and imp r o v e m e n t of the Journal's editorial content. The
January 1996 The American Journal of Medicine* Volume 100
9
AJM: THE NEXT 50 YEARS/BENNETt
relationship b e t w e e n the APM and the publishers has b e e n of mutual benefit to both organizations; and certainly has b e e n a driving force in the editorial direction of the Jou~nal. There you have the ingredients for the Journal's success for the next 50 years. • The opportunity and challenge of b~.nging the best of medicial science to the newest as well as the m o s t senior m e m b e r s of our profession for them to use in improving the health and well-being of their patients. • The involvement ~)f the Association of Professors of Medicine, which is commited to its mission of leadership for academic internal medicine where w e all
10
b e g a n to u n d e r s t a n d the intellectual and h u m a n dimensions of our profession. • Publishers and owners w h o appreciate and accept their role and contribution to the a d v a n c m e n t of patient care through physician education. On behalf of the Editors, the Association of Professors of Medicine, and Excerpta Medica, I pledge The A m e r i c a n Journal o f Medicine ® as a bridge bn_nging the best of medical science to the best of our profession as they carry out their responsibility to learn everyday h o w to care for their patients in the very best way.
January 1996 The American Journal of Medicine • Volume 100
J. CLAUDEBENNETT,MD, EDITORHN-CHIEF