Editorials

BMJ USA: A British contribution to American medicine

This article originally appeared in BMJ USA

Throughout its history the United States has benefited from British contributions.¹ In the early days of the republic, Americans used James Watt's steam engine in locomotives and steamboats. The works of British authors from Shakespeare to Kipling have featured in the curriculum of American schools. Recently British journalismled by Nature and The Economisthas become popular and influential, while the success of the film American Beauty has shown how much can be achieved by a combination of British and American talent.

We hope to emulate some of these successes in BMJ USA. The BMJ (British Medical Journal) Publishing Group, in partnership with the Clinicians Group, will be sending BMJ USA each month to about 100,000 primary care physicians in the US.

BMJ USA will feature articles from the weekly BMJ that are particularly relevant to primary care medicine in the US. Although the BMJ began in Britain, it publishes material from all over the world, and it is the international first choice for many primary care researchers. On occasion BMJ USA will also contain material from other journals published by the BMJ Publishing Groupsuch as Heart, Gut, and Thoraxand from our new semi-annual publication Clinical Evidence. Between those items we will sprinkle content especially commissioned from the US.

American physicians receive many journalsmany more than they have time to read. Why, then, are we adding to your pile? Because we believe that none of the other journals are like the BMJ. Five special characteristics of the BMJ stand out and are captured in this inaugural issue of BMJ USA.

First, the BMJ is a leader in evidence-based medicine, meaning the systematic and critical review of all available evidence on important clinical topics. The BMJ Publishing Group has launched three journals on the subject (Evidence-based Medicine, Evidence-based Mental Health, and Evidence-based Nursing), as well as Clinical Evidence (CE), which the United Healthcare Foundation is distributing to 400,000 American physicians for the next three years. CE reviews the evidence to answer key clinical questions faced by physicians. This issue of BMJ USA contains two papers reporting the findings of randomized controlled trials (BMJ USA pp 25 and 48), a meta-analysis on long-term aspirin use and gastrointestinal hemorrhage (BMJ USA p 37), and a chapter from CE on the treatment of menopausal symptoms (BMJ USA p 60).

Second, we publish papers using a wider range of research methods than the typical US journals. Besides traditional quantitative research, we publish qualitative research (see BMJ USA pp 18 and 42), systematic reviews, economic evaluations, and quality improvement reports. British primary care physicians find that qualitative research is often very relevant to their practice.

Third, we focus on primary care. We aim to be relevant to the day-to-day practice of primary care physicians. You will see very little etiologic or basic science research in the BMJ and BMJ USA. You will, instead, find papers on the common diseases of primary care such as asthma (BMJ USA p 18), depression (BMJ USA p 25), and hypertension and diabetes (BMJ USA p 48). You will also find papers here on the processes of care, such as doctor-patient communication (BMJ USA p 42).

Fourth, like a character from Dickens, the BMJ has a strong and distinct personality. We believe that a medical journal should not only educate, but entertain. Besides the standard fare of scientific papers and clinical reviews, you will find on our pages a potpourri of news articles, commentaries, personal soundings, and poignant fillers. You will see snippets from the medical literature in one of the BMJ 's best-read columnsMinerva (BMJ USA p 70). You may be surprised to read here a paper comparing the utility of heparin, alteplase, and streptokinase in removing blood stains (BMJ USA p 56). It comes from the annual Christmas issue of the BMJ, which is, by tradition, full of unusual research, humor, and parody. We will bring you other items from that issue in future issues of BMJ USA. But if you can't wait, you'll find the entire Christmas issue online (www.bmj.com/content/vol321/issue7276/).

Fifth, we are a leader in electronic publication. The BMJ has been online in full text since April 1998,² and bmj.com now ranks #2 among health web sites.³ We are the only major general medical journal whose full-text content is available online freely accessible to all. Our web site offers much more than the digital version of our paper journal, including "collected resources" of citations on specific topics, results of online surveys and debates, and extra material for many of the articles published in the BMJ. One of most vibrant features of bmj.com are the "rapid responses" (e-letters), which allow readers to respond to papers as they read them on the web. Around 100 rapid responses are posted each week and they let us see quickly which articles touch a nerve and produce a flood of responses.² Several rapid responses are reproduced in this issue of BMJ USA (BMJ USA pp 22 and 58), demonstrating our unique opportunity to publish articles and letters to the editor about them within the same issue.

BMJ USA was not launched early enough to find a place in the 150-year history of the BMJ (1840-1990) chronicled in the Mirror of Medicine.⁴ However, we expect that BMJ USA will figure prominently in its sequel. Medicine is now a global enterprise; people, pathogens, and progress in medical practice move easily across national borders. BMJ USA should be seen as part of the international sharing of information that will benefit our patients and our profession. We hope that you might help BMJ USA develop a character as unique as those of Charlie Chaplin or Bob Hopeboth Americans born in Britain.

Ronald M Davis, editor. 

BMJ USA, North American editor, BMJ

Richard Smith, editor. 

BMJ