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To consider whether the world would be different if your institution disappeared is a sharper exercise than to compose its mission statement. Would the world miss the BMJ? The day that the BMJ is redesigned seems a good time for us to try to answer that question.
Nobody would start a new general medical journal today, and many that exist are
beginning to disappear. Information scientists argue that there are too many journals, that much
of what they publish is of poor quality, and that important material may be lost in a welter of the
unimportant: the "signal to noise" ratio is horribly low.1 Meanwhile, enthusiasts for the Internet curse the slowness and
exclusivity of paper journals and predict their imminent demise.2 They want a world where authors go directly to readers unimpeded
by editors. The BMJ's environment may not thus
seem inviting, but that is nothing newof
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