Sep 9 2011
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Faces of Public Health: Howard Bauchner

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Faces of Public Health is a recurring editorial series on NewPublicHealth featuring individuals working on the front lines of public health and helping keep people healthy and safe.

Howard Bauchner, M.D., recently took on the editor-in-chief post at the Journal of the American Medical Association (JAMA), the highly regarded journal published by the American Medical Association. Previously, Dr. Bauchner has been the editor-in-chief of Archives of Disease in Childhood, the official publication of the Royal College of Paediatrics and Child Health in the United Kingdom. Dr. Bauchner is also a professor of pediatrics and community health sciences at Boston University Schools of Medicine and Public Health.

NewPublicHealth spoke with Dr. Bauchner recently about his new role and about how his background in community health and the emerging importance of social media in health issues will impact the future direction of JAMA.

NewPublicHealth: What is most exciting for you about becoming editor-in-chief of JAMA?

Dr. Bauchner: I’m enormously blessed because under [former editor-in-chief] Cathy DeAngelis’ leadership JAMA thrived. It’s clearly one of the preeminent publications in medicine and that was certainly true before I arrived. I think the hallmark for JAMA over the last decade has been the enormously high standards it has had around integrity.

Where I think JAMA has been challenged, as have many journals, is in adapting to more creative approaches in communicating their material. The world is changing so fundamentally and so quickly. Journals have really struggled with utilizing new communication techniques. Some are pretty straightforward--a podcast, for example. But if you look at some of the leading intellectual websites, they do video casts of very preeminent scholars, and in the last month we’ve been able to add video casts to our website, and if users like they can download just the audio. We’re going to move into other forms of communication in the coming months with likely launches of some new applications certainly by the first of the year.

NPH: What kinds of applications?

Dr. Bauchner: We’re expecting to have an application both for tablets as well as for smart phones, and those are important particularly for our younger readers. Someone here has coined the term that journals need to be agnostic communicators and I really like it. We don’t know how each of our readers wants the information so we need to make it available to them in many different formats and that’s something that we’re committed to doing.

We’re also aggressively pursuing translating our abstracts and electronic table of contents into a number of different languages. I appreciate that much of scientific communication has been done in English, but in my travels around the world it’s very clear that many scholars in other countries, although conduct much of their professional life in English, would find it much easier if they could look quickly at a journal like JAMA in their own language.

NPH: Do you think readers are able to take in information as well and effectively on different modalities, read in different situations, as they do reading a printed journal and sitting in one place?

Dr. Bauchner: It’s a very provocative question. Five or eight years ago I think people speculated that they didn’t really think print had much of a future. But now I think it’s possible that as people move along in their careers and change the way they distribute their time, then perhaps while earlier in their career they may have wanted the information on smart phones or tablets, it’s quite possible as they move further in their career they may want to do that reflective reading of JAMA on a weekend or at night or on an airplane. I think the future of print is far more robust than we had imagined. The one thing that I think may change that substantially, though, is clearly the emergence of tablets, which unlike smart phones really can mimic print. So I think the tablets may have created yet another new twist on the story about how we read and how we communicate in ways that I don’t quite yet appreciate.

NPH: Can you talk about early online publication of articles in journals, often referred to as “online first” ahead of the print edition? Does that undermine the significance of articles that aren’t posted early?

Dr. Bauchner: One feature of online firsts is that they have more immediacy in terms of impacting clinical practice. In JAMA, recently, we posted as an online first an enormously important commentary about a law that’s been passed in Florida about the way physicians can speak with patients. It goes to the sanctity of the patient doctor relationship. We wanted to utilize an online first opportunity to bring that to our very rich and extensive community of readers quickly, so that article was submitted and put online within two to three weeks. We could have waited for print, but that probably would have been another two or three weeks, so we were able to get a very important paper out to the scientific and policy community quickly.

We do get original research reports in which we do expedited review, the peer review process is completed within a week, The paper is edited within a week and it’s placed online within days and we do that a number of times each year when we believe that paper will likely impact on the clinical practice of medicine.

NPH: How else will you use the JAMA website?

Dr. Bauchner: We do a news update that users can subscribe to. I love it. And I think you can expect to see more and more of our website changing on a daily basis rather than on a weekly basis. I think the journal that’s explored this and that committed to this more than any other that I’m aware of is that the British Medical Journal. So, for that journal, it’s the website that’s the official journal, not the print issue. And I imagine more and more journals over the coming years will go to such a format.

NPH: Do you plan to comment regularly in the JAMA blog?

Dr. Bauchner: I think the way in which I can begin to influence the journal is through the content that we present as well as the way in which we present it. I do think over time each journal editor finds their voice for the issues that are critical to them, so I think Dr. DeAngelis was simply extraordinary in talking repeatedly about the issues of integrity, conflict of interests and concerns about the relationship between industry and academic health centers, and I think for Cathy that emerged over a number of years and it wasn’t instantaneous when she became editor in chief and I think that’s probably true of all of the editors. So I think over time you’ll see my voice emerge but it may not be through blogging.

NPH: How will the journal focus on community health issues any differently than it has in the past?

Dr. Bauchner: I think the one area where many American journals have had less of a robust commitment has been to the healthcare issues of low and middle resource countries, global health, and clearly with more American physicians interested in the issue, it’s important for JAMA to do a better job in its coverage of global health both from a narrative standpoint as well as from an evidence standpoint.

Clearly the landscape of what is healthcare has really broadened over the last decade or two, and so we recently had a theme issue on violence, for example. I think for us it has been a consistent and important contribution to give public health a voice in a prominent journal. The anniversary of 9/11 is coming up and I’ve just read a number of editorials and a number of commentaries that will focus on the consequences of mass trauma. JAMA has always had a very substantial and broad view under the former editors and that will certainly continue under my leadership.

There are two other ways we can influence public health issues. One is through commentaries. And I think we’re probably going to solicit a broader representation of leading scholars to write those. And in the “clinician’s corner” section, each of those articles should contain information about the larger environment in which health issues such as diabetes and obesity occur.

Tags: Community Health, Faces of Public Health, Public health, Public health law