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It is now exactly 10 years since I took over editorship of the BJGP. The dominant emotion is one of profound gratitude; I am immensely fortunate to have been allowed to do this job. When Richard Smith left the BMJ he quoted a Woody Allen joke, about the man who swept the floors in the strip club. His friend asks ‘What's the pay?’ ‘Ten dollars a night.’ ‘That's not very much.’ ‘No, but it's all I could afford.’ Unlike Richard, I'm not sure I would have paid for the privilege of doing this wonderful job, but it's a close run thing.
Richard also pointed out perhaps the prime responsibility of editors, to be a good steward of their journals, and it's fair to claim I have succeeded in that. It's a source of great satisfaction to know that I am handing the BJGP on in good health, and into such capable hands. There has been more than just stewardship: in the last 10 years we have moved to electronic publishing, and having all the articles submitted and processed electronically. We have moved to open rather than blinded peer review, and that seems both to have been welcomed by authors and reviewers, and to have helped improve the quality of reviews (sorry, no evidence for that last statement); it also, perhaps surprisingly, puts us into a minority among biomedical journals. We have also tried to make the Journal more attractive to readers whose interest is in good clinical work (as opposed to other researchers). This last initiative is only in its infancy, but we have made a start. We should have liked to have got further with this project, but we've discovered that distinguishing between the versions of an article for hardcopy and for electronic publishing involves quite a lot of staff time. We were also encouraged to learn, at a recent conference of editors, that this is not an area where we are lagging behind the majority of specialist biomedical journals.
This piece is my way of paying tribute to everyone else who has supported the Journal, so I should start with the readers. The challenge for the BJGP is to produce something that is welcomed both by researchers who want their work published, and by readers who may not want all the fine detail required by a scientific article. We get occasional tributes from readers, and tiny amounts of praise go a very long way. One of the mysteries is our failure to foster a dialogue with the readers. We know that UK GPs are a diverse lot, and not ashamed to voice their own opinions, and yet we get many fewer letters than we would welcome. Some years ago, and I compared myself to my mother when I did so, I complained to the readership ‘But you never write’. The only noticeable response was two letters saying, more or less, ‘The Journal's rubbish’, so I haven't tried that again. We also get a lot of, mostly indirect, criticism, largely of irrelevance. A few years ago, during a review of publishing, there was much talk about what readers wanted, so the College commissioned a survey of readers, and it turned out surprisingly positive. The trouble was that it had a disappointingly low response rate (so low that we would never have considered it for publication), so it's not clear that we can rely on it any more than we should rely on the intermittent complaints of irrelevance from ‘disgusted of Tunbridge Wells’. Feeling that we are shouting into a vacuum is one of the frustrations of publishing.
Of course the people to whom I owe most are the real workers, those who are really responsible for the Journal appearing regularly every month. That's mostly the staff in the office, who have had to put up with my foibles as well as dealing with the egos of authors and readers. Special mention goes to Alec Logan, who has been producing the Back Pages for longer than I have been editor — a stunning achievement that merits a long service award, whatever individuals feel about the output. Hot on their heels are the reviewers, the unsung heroes of scientific publishing. As it says on our website, under instructions for appealing against rejection ‘The peer review process is widely acknowledged to be imperfect.’ With the aid of peer reviewers we produce something that is truly a reflection of general practice: diverse, messy, and flawed; but without them publishing would be a complete shambles. On the next level up are the various members of the Editorial Board, who have collectively given huge support over the years. Editing can be lonely, and they have between them been the ones to have kept the loneliness at bay.
Then there are the researchers and writers. There's something odd about the relationship between editor and writers. Certainly I have never before had a professional (or, for that matter, personal) relationship characterised by such mutual dependence, distrust and, on occasions, frank loathing. The oddest aspect is the way that they all think I have power over them; I know they have equal power over the Journal (although of course in their case it is exercised collectively not individually), since if they stop sending me their work, the Journal collapses. We have had two quite scary moments when it felt as if we were running out of material — more worrying the first time since the second time round we knew how to deal with it. Unfortunately, I still don't know how it happened. The way the volume of material awaiting publication comes and goes is reminiscent of the ornamental lake in front of Boot Magna Hall that Evelyn Waugh created in the opening chapters of Scoop, that has a life of its own:
‘The lake was moved by strange tides. Sometimes, as at the present moment, it sank to a single, opaque pool in a wilderness of mud and rushes; sometimes it rose and inundated five acres of pasture. There had once been an old man in one of the lodges who understood the workings of the water system; there were sluice gates hidden among the reeds, and manholes, dotted about in places known only to him, furnished with taps and cocks … But he had been in his grave fifteen years and the secret had died with him.’ (Scoop, Evelyn Waugh, 1938)
The mutual loathing between authors and editors provides a perfect context for the kind of deceptively polite letters that the English have perfected as an art form. ‘Dear Dr X, We found your paper absolutely fascinating. Unfortunately we simply don't have the space to accommodate it at present and must regretfully turn it down.’ Trouble is, despite my impeccable upbringing I never really learnt polite dissimulation. The combination of that and my pedantry (from which I have not been cured by 10 years as editor) turns out to be a somewhat toxic combination in an editor, resulting in letters either of brutal rejection, or of interminably nit-picking acceptance. It has even been said that it's more pleasant being rejected by the Lancet than accepted by the BJGP. And here there is an element of unavoidable discrimination: those who know me personally understand that it is all bluster, and that what I want most is for authors to be equally direct back. We did discuss adding a note to the ‘Information for Authors’ to explain what kind of an editor authors are dealing with, but I could never come up with a form of words that didn't make me wriggle with embarrassment. So all I can do is to take this opportunity to apologise to all the authors I have upset in the last 10 years. Please forgive me — I never meant any offence, although I well know that many of you had good reason to feel offended.
Nor does it stop with the researchers. I may be unique in having received two letters of incandescent rage from reviewers who felt slighted. There is at least one author who described an invitation to write an editorial as ‘the most off-hand request’ he had ever received. And then there is the College itself. I should like to think we have offended them, though I fear nothing like enough. The College, quite correctly, subscribes to the idea of editorial independence, but there were times when it felt that to those concerned it means the independence to publish what the College approves of, not the freedom to publish what it may find difficult, uncomfortable or embarrassing. The Journal does a better job if it encourages open debate and in that we have probably not succeeded enough. Beyond that, as Alec recently pointed out to a member of Council, we serve the College's interests, and retain international credibility only by being able to exercise independent judgement. It helps to be praised occasionally by senior figures in the College, but that is a bonus; on the whole the College has been a benign and supportive publisher, and deserves all our thanks for its own long-term stewardship of the Journal.
One does not take on a job as editor to make friends. Before I started a colleague warned me that editors make enemies, and I have a quote from Ernest Hart, a distinguished editor of the BMJ with which I finish any talk about editing:
‘Editors must have enemies. Woe to the journalist of whom only good is said.’
With which, to my few friends and numerous enemies I bid farewell, with the words of Schiller:
Auch das schöne muss sterben.