A new era: the continuing evolution of the MJA

With this issue, Dr Martin Van Der Weyden retires after 16 years as Editor of the Journal. A tribute to Martin and his many achievements will appear in the next issue. Martin has been a generous and wise teacher, and his columns have set the benchmark in editorial writing. Under his guidance, the Medical Journal of Australia has become the leading publisher of general medical research in Australia. It makes a vital contribution to the debate on local and global medical issues including Indigenous health, patient safety, the honesty and integrity of scientific publishing and peer review, and Australian health policy. The Journal he bequeaths is robust and central to medical communication in this country.

As the Journal of the Australian Medical Association, the MJA has a freedom that is unavailable to most other general medical publications in the country: to publish and report free of commercial interests. You can be confident that studies published in the MJA are subject to strict rules requiring disclosure of conflicts of interest, and that they have been expertly peer reviewed. The MJA is uniquely placed to inform and facilitate discussion and education across our profession, and to anchor it within the context of the broader Australian health system.

To keep abreast of changes in clinical medicine and professional issues, and to meet the challenge of maintaining the Journal’s relevance for all doctors in the face of these changes, there are plans for the continued evolution of our print publication and an enhanced presence on the web.

The MJA will continue to publish major Australian research studies and remain the natural place for publication of data that are important to all Australian clinicians. I want to foster this role for the Journal. My dilemma, however, is that of the editor of any general medical journal: it is difficult to produce an article that meets the needs of both researchers who are interested in the minutiae of their topic and readers who may prefer a brief overview.1

While many Australian studies are appropriately published in specialty and international journals, general medical journals such as the MJA have a crucial role in building and disseminating a strong, usable base of medical knowledge. All doctors have specialised educational requirements and have to be selective in their reading — 75 trials and 11 systematic reviews are published daily2 — thus there is a greater need than ever for relevant interpretation and commentary. I will be inviting the authors of these “specialty” or “international” papers to write editorials for the MJA, which interpret their data. This will feed into an increased emphasis on articles, written by leaders in their field, that synthesise new information for our readership.

I want to develop the MJA ’ s natural role as a forum for the presentation of news relevant to doctors and for debate that develops around these issues. Currently, too many medical issues play out in the public media before the profession has a chance to consider or respond. A prime example has been the coverage of prescribing rights for non-doctors.3 Other important issues include the delivery of effective and efficient health care, the planning for, and training of, our medical workforce, and the improvement of Indigenous health outcomes. Our engagement in this process will determine the degree to which we remain an independent and vital profession and will also help to improve health outcomes for the community.

One crucial issue is health funding. Currently, Australia spends over 9% of its gross domestic product on health,4 increasing at up to 0.5% per annum.5 The population is ageing and demands on the health system are increasing, necessitating hard choices with respect to the way a limited health budget is spent. As doctors, we need to understand the opportunity costs of ordering a test or admitting an elderly patient to intensive care. In this way, we can participate in decisions involving the allocation of funds within the health budget. The MJA is the appropriate forum for this informed conversation.

Discussion about the practice of medicine needs to continue. Good medical practice: a code of conduct for doctors in Australia, adopted by the new Medical Board of Australia, was developed with little discussion within the profession.6 How this code is implemented is yet to be defined, and we should take this opportunity to explore and, perhaps, refine the way we practise. This debate should include doctors’ contributions to the public health care system, the organisation of medical practices, billing practices and time spent with patients, and the complexities of patient education and obtaining informed consent. Our future doctors also need to be included.

I plan to engage more with our readers via electronic media. Inevitably our website, planned to be relaunched, will become increasingly important in the life of the Journal. It will embrace new technologies and media, allow for the publication of more research and medical content and facilitate timely discussion around issues. Soon, I hope you will enjoy easy access to the Journal from mobile electronic devices and that you will use this resource to have your say in these conversations. The MJA is your forum.

Already, our recently launched email newsletter, MJA InSight, boasts the highest audited email circulation of any medical newsletter in the country.7

My background is as a general practitioner and medical editor, and I will be seeking to both broaden and strengthen the MJA community so that many voices (not just the loudest or best-positioned) are heard. I will be expanding our base of peer reviewers and plan to introduce a rotating position of “Guest Medical Editor”. This person will commission work in his or her field of expertise and refresh and inform our editorial team about advances in his or her area of interest.

Already, I have been overwhelmed by the passion and generosity of the MJA community, who, without favour, payment or (much) recognition, contribute to this publication. Peer reviewers are indeed our “unsung heroes”.1 Thank you to all who already contribute to the MJA and to those who will help in the future.

I envisage that an enhanced MJA will play an even more important role in the discussion of issues that affect medicine in Australia. With an expanded range of content and new technologies, we have the potential to engage the entire profession.

As the new Editor of the MJA, I look forward to guiding its evolution and to working with you.