The New England Journal of Medicine (NEJM), one of the most prestigious periodicals in the world, celebrated its 200th anniversary this past week. Medgadget was there for the proceedings, “Dialogues in Medicine,” which consisted of panels on HIV/AIDS, Maternal & Fetal Health, Breast Cancer, and Cardiology. The panelists included patients and clinicians, such as Drs. Paul Farmer and Eugene Braunwald (of global health and cardiology fame, respectively), who talked about progress in their fields and how NEJM facilitated enhanced communication that contributed to those advancements. After the event we were able to catch up with NEJM‘s Editor-in-Chief, Dr. Jeffrey Drazen, for an exclusive interview.
Shiv Gaglani, Medgadget: How did you become involved with NEJM specifically and medical publishing in general?
Dr. Jeffrey Drazen, NEJM: When I was in medical school, in the 1960s, Dr. William Strohl, one of my preceptors, advised me to subscribe to NEJM to stay up to date with the latest in medicine. When, nearly 40 years later, the position for editor in chief became open, I applied. Twelve years later, here we are.
Medgadget: Do you remember the first NEJM issue or paper you ever read?
Drazen: The September 4, 1969, Original Article, “Birth Control, Judicial Surgery, and the Wonderful One-Hoss Shay.” I was in my first year of medical school, and I was drawn to it because I had memorized the opening stanza of the “One Hoss Shay” in junior high and the article by Dr. Curran started with it.
Medgadget: What event, initiative, or issue are you most proud of while you have been the Editor-in-Chief of NEJM?
Drazen: SARS, the epidemic of rapidly fatal respiratory disease that had the world on edge in the spring of 2003 set, for us, a new way for a medical journal to play a proactive role, in real time, during a serious public health threat.
In mid-March 2003, the news media reported that a physician with a severe, acute respiratory illness had been removed from an airplane in Frankfurt. When I first heard the news on a Sunday morning, I called my contacts in the Far East and in Canada, where the first cases were identified. I asked doctors treating SARS patients to send us epidemiological descriptions of their outbreaks, including data from chest X-rays and blood counts — specific data that wouldn’t be in news reports, but that doctors would need.
Within days, NEJM.org published initial reports of SARS that were peer-reviewed and edited. There were over 700,000 downloads of our articles within weeks of our publication. By June, the outbreak was significantly curtailed. We will never know whether the Journal’s fast action may have helped to stem the epidemic. One thing we know for sure is that we changed the standard for the speed of medical communication with that event, gathering and disseminating crucial information as fast as possible to help physicians diagnose and quarantine cases to contain the disease. This changed the game.
Medgadget: Expanding upon the previous question, what are you most proud of in terms of NEJM‘s 200-year history?
Drazen: NEJM has innovated through its 200 year history, both in our pages and the way we deliver information. In 1812, editor John Warren started the journal because he recognized how important communication was to medical practice. Ether as a surgical anesthetic was adopted rapidly in the medical community after reports of its successful use in surgery were published in our pages in November 1846. An open heart surgical procedure was published in NEJM in the 1920s, leading the medical community to see that open-heart surgery was possible. And Sidney Farber’s article in 1948 showed progress against childhood leukemia, leading to many small steps ahead, with cures today for most. There are many, many examples of how information we have published have helped improve the ability of health professionals to care for their patients.
I’m also very proud of what we’ve done to enhance the utility of NEJM as a teaching tool. Our peer-reviewed Videos in Clinical Medicine instruct students, trainees, and younger physicians on specific common procedures. Along the same theme, our Interactive Medical Cases are very popular and allow both young and experienced clinicians to test themselves in a clear, engaging format. I’ve always been mindful of clinical relevance, and I want every issue of NEJM to offer something useful for practicing physicians who are taking care of patients.
And finally, we’re now available on multiple platforms, optimizing our properties for the mobile web, recently via a new iPad Edition, and several iPhone apps.
Medgadget: Medgadget covered the release of NEJM‘s iPad App. What changes are you most looking forward to in terms of the future of NEJM?
Drazen: We never know what the future will bring. But we are currently working on initiatives that, we hope, will better serve the practicing clinician. We are committed to offering content relevant to medical education from training through maintenance of certification. We envision a global network of clinical peers connected around practice and patient care.
Medgadget: Again, following up on the question above, what are you most looking forward to in terms of the future of medical technology?
Drazen: Medicine is driven by knowledge. In the future we will be able to assimilate and use large amounts of information in a seamless fashion. We will know our patient’s genomes and their medical histories so that we can appreciate how to prevent illness or, once it strikes, how to defeat it. Through search engines, this individual knowledge will be coupled with access to the best information from research so that we can make information based decisions. Our time as healers can be spent synthesizing the information and working with patients to find the best path forward. Much of what now do as guesswork will be replaced by true knowledge.
For more information, you may visit the NEJM Bicentennial Website and check out a video interview with Dr. Drazen below: