Published 9 October 2008, doi:10.1136/bmj.a2033
Cite this as: BMJ 2008;337:a2033

Editor's Choice

A difficult balance

My predecessor but one, Stephen Lock, chose to call the book he wrote towards the end of his 16 years as editor "A difficult balance." It was a good choice. Getting the right balance in a general medical journal is an editor’s greatest challenge. The BMJ walks various tightropes—or, put more positively, attempts to bridge many divides: between primary and secondary care, clinical medicine and public health, health care and health policy, the UK and the rest of the world, online and print, magazine and journal. One good thing is that when the balance tips too far in any one direction, readers are quick to tell us. Another good thing is that we have more readers of the BMJ now than ever before.

One of the BMJ’s core functions is to help to get good research into practice—what’s now called knowledge translation—whether in clinical medicine, public health, or health policy. Our ultimate goal must be to improve outcomes for patients and the public. So we aim to publish original research that is relevant and actionable. A slight change in our acceptance criteria at the beginning of last year meant we accepted fewer research papers. The consternation of researchers was hard to ignore. Partly because of this but largely because good submissions are now pouring in, we’ve restored the number of research articles we publish to at least four a week. All of our research is open access, freely available on bmj.com.

This welcome strengthening of the research presence in the journal has an impact on other sections. Despite now being an online journal first and foremost, which means we have potentially unlimited space, we do have constraints. Editorial time is one; the number of pages in the print journal are another. More pages for research means fewer pages for something else. Over the past few months we’ve published slightly less clinical education content. Readers have again been quick to reprove us, a response that chimes with repeated reader surveys over the years: what doctors most want from the BMJ is balanced, evidence based, relevant, readable clinical education. So we’ve found more space in the print journal for clinical content, relevant we hope to both primary and secondary care (doi:10.1136/bmj.a1746, doi:10.1136/bmj.a260, doi:10.1136/bmj.39489.687894.DE, doi:10.1136/bmj.a1073).

What has been squeezed out of the print journal by this flush of clinical content? Not the obituaries (though we are redressing an imbalance there too: several readers have complained that we’ve been giving too little space to internationally renowned UK doctors and too much to doctors from elsewhere). What we have in this week’s issue is fewer letters and a little less magazine content. If there’s no outcry, perhaps—for once, for now—we’ve got the balance right. I doubt it, but am not downcast. Far from it. We look forward to your continued help in maintaining the difficult balance and bridging medicine’s divides.

Cite this as: BMJ 2008;337:a2033

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