What does a journal do for whom?

Rohrich has recently published a summary of a meeting of plastic surgery journal editors. His account of the meeting included summaries of a great number of topics, ranging from definition of the primary mission of specialty journals to disaster planning. As I start my term as editor of this journal, I have been sorting out a great number of questions. Most of the immediate questions are operational: what are the deadlines, where are the files, how do I open them, where are the new submissions, how do I call for help? Looming behind such issues, however, are some much bigger questions, many of which were debated by the editors, and many of which demand at least working answers from a new editor. What should a plastic surgery journal contain, and what readership should it serve? Rohrich points out that some surveys of plastic surgeons indicate a strong demand for varieties of aesthetic surgery articles, with a core of respondents persisting in declaring an interest in “reconstructive surgery.” Other trends influencing journal development include proliferation of subspecialty and regional journals, all of which compete for manuscripts. Online publication is also an influential factor. While any individual reader can now overwhelm himself with online information on any subject with the touch of a mouse, the author can decide to obtain access to millions of potential readers through online publishing, including open access sites that do not subject articles to peer review and that allow an author to publish as much as he can afford to pay. Journals face the temptation of linking to the huge online audience not only by archiving journal contents online, but by expanding the journal content with online articles, video attachments, Websites, translations and other features that can transform each journal issue into menus for multidimensional study. Within this rapidly changing scenario of medical information, a journal, I believe, still has a very distinct and important role. Consider, for example, a medical specialty as a group attending a large meeting. At any such meeting, there will be poster sessions, video rooms, and coffee breaks in the exhibit area, where a flood and babble of information, including gossip, rumor, and sales pitches, can be found. The focus of the meeting, however, is the program, where single topics are presented in announced order. This core of information and format allows the audience to concentrate on specific presentations that are endorsed as valuable by the program committee that reviewed submissions and selected their best choices for the program. What the program does for a meeting, a journal may do for an entire specialty. A journal can provide a finite amount of information at regular intervals and allow a reader to concentrate on articles and reviews judged to be valuable by peer review, which not only selects articles for publication but guides many manuscripts through revisions that improve the presentation and scholarship of many articles. A journal such as Annals should attempt to serve a readership that identifies itself as interested in the clinical and experimental development of plastic surgery. As such, the journal will be responding to the spectrum of articles actually submitted to it, but also establish standards by which these articles can be understood by the whole readership. Therefore, to serve its readership, the journal should strive to make articles on cosmetic surgery present evidence and argument credibly and in a comprehensive manner to a plastic surgeon specializing in hand surgery or a reconstructive microsurgeon engaged in peripheral nerve research. Similarly, a laboratory study of growth factors in nerve