Stephen Leeder: MJA — 100 years young

THE MJA celebrates its 100th birthday on 4 July. It has served the medical profession and the community as a dependable, science-based journal that combines research papers with commentary and perspective articles that respond to prevailing health challenges, be they new diseases, new therapies, professional concerns or serious changes in health policy.

Although originally the Journal often conveyed news, more recently the media cycle, especially when electronically supported, has more ably fulfilled this role. But reflection on the news is still a part of the MJA.

The section of the Journal that has proved most resilient is that which reports research.

Frequently this has a distinctive local origin and application, often with a twist as when it deals with snakebites and bluebottle stings.

As a general medical journal, its coverage of research is broad and often conveys messages about new treatments of interest beyond one specialty. By publishing evidence-based guidelines it has served a useful purpose in bringing to practitioners the best summaries of medical wisdom and insight relevant to their practice.

The exponential changes in the world of publishing enabled by information technology have upturned established ways of communicating the results of research, with online publication providing previously undreamed-of opportunities for rapid and widespread dissemination.

Information now flows so freely from one country to another that national limits on knowledge have lost their meaning. A yearning to read the latest issue of a leading international journal can be satisfied instantly with the click of a mouse.

Besides making medical information and research results immediately available, online publication has challenged the traditional business model of journals sponsored by subscription.

Journals that are completely open access, have no subscribers and prosper by researchers paying to publish in them, threaten the survival of print-based subscription journals as surely as music available on the web causes consternation in the DVD business. The MJA can no longer survive on a subscription base alone and needs advertising to supplement its income, but that need brings ethical challenges — sometimes tough ones.

Alongside these large changes in style and the business of research dissemination is another —a new approach to the time-honoured notion of peer review of research before publication.

Open-access journals not only allow authors generous space to explain results and present their conclusions but a growing trend is to either not review the papers before publication and let readers be their critics, or to depart from anonymous review in favour of publishing critiques simultaneously with the basic paper. Opinions vary as to what the long-term effects of this change will be.

The MJA moved many years ago from the era of massive linotype machines and printing presses, and stupendous amounts of paper, to its current method of production in which computers are pivotal in managing text, generating illustrations and producing the Journal for mailing.

It is now confronting the next round of changes that are every bit as dramatic. It has developed online capacity and works with its dear cousin, MJA InSight, to bring electronic information, often different in form and style to that in the printed journal, to thousands of email subscribers.

It would be a brave soul who claimed to know what the future holds. Claims in the past that a new technology (television) would destroy the old (cinema) turned out to be much exaggerated. Yet the fulcrum of creativity in the visual arts has moved and so it will with medical publication.

We are not positing the need for a continuation of the MJA in a blind hope that somehow researchers operating in an intensely competitive environment will turn to the MJA rather than high-impact international journals as places of first choice in which to publish. But surely Australia is mature enough for a general medical journal, whatever its format, to address distinctive Australian health and medical matters.

The Asia and Pacific region is one where new partnerships for better health may be forged and the MJA could well be a leading agent for change in that endeavour.

As Professor Paul Glasziou pointed out recently, with the rising number of journals and the confusing morass of information, traditional journals will need to be more vigilant than ever about making sure the best research is published and made available to the greatest number of people in as timely a manner as possible.

The values that have underpinned the MJA for a century have not degraded because of the digital revolution and we look forward to the next century with confidence and a spring in our step. Bring it on, as we believe we will be equal to the challenge!
 

Professor Stephen Leeder is the editor-in-chief of the MJA and emeritus professor of public health and community medicine at the University of Sydney.

The MJA will celebrate its centenary with a symposium, historical exhibition, reception and celebratory dinner on 4 July. Full details at www.mja.com.au/centenary/eventinfo