Why I'm a reluctant rapid responder

BMJ 2004; 328 doi: (Published 12 February 2004) Cite this as: BMJ 2004;328:413
  1. Mina Fazel (mina.fazel{at}, clinical lecturer in child and adolescent psychiatry
  1. University of Oxford

    Irritation, inadequacy, and resignation were among my first feelings when I read the rapid responses on to a paper I had published by the BMJ (2003;327: 134). And then the anger slowly crept in and stayed. I used to think rapid responses were a valuable and important way to maximise the learning opportunities inherent in publishing by enabling an exchange of ideas and knowledge. With two other doctors I had previously written a response to share our experiences of a rare medical disorder. I had also read the rapid responses to specific archived articles. But I felt completely different when reading the responses to my article.

    Like anyone who has published research I had gone through the long and difficult tasks of writing a proposal, obtaining funding, getting ethical approval, collecting and analysing results, and then writing numerous drafts before sending the work to be considered for publication. After peer review, which included the opinion of a statistical expert, I gave more consideration to the original work. This process of publishing a research article contrasts dramatically with that of writing and publishing a rapid response. Yet it felt to me that the two types of publication are given almost equal weight on the BMJ's website.

    I did not think the comments were worth replying to

    Anyone reading an article on the website is invited to read the rapid responses to the article, and the responses may highlight new and interesting points. But the rapid responses are an opportunity for anyone to enter into a “conversation” or “debate,” with little editing or review. In fact it is the BMJ's policy to publish any response as long as it is not libellous and to put it on the website unedited within 24 hours, spelling mistakes and all. This is in stark contrast to the published article, which has been edited, often to a surprising extent, by the BMJ's team.

    Rapid responses should be put on the website for a limited period only

    The three responses that appeared within days of publication of my article were in combination rude, poorly constructed, and, in my opinion, of little value. It surprised me that all three had been written by psychiatrists, as any doctor, let alone a psychiatrist, should know that discourteous approaches can hamper further discussion. A couple of the responders had written rapid responses on a wide number of topics in similar tones, and so it seemed that they were using the forum to grate on particular issues. In relation to my work I was disappointed that the BMJ thought this manner of exchange useful to the overall impact of the work.

    I considered my options. Should I reply on the website to the rapid responses? This would have the advantage of minimising the negative impact that the responders' comments might have on a naive reader. However, I did not think the comments were worth replying to. In strictly behavioural terms I did not want to reward bad behaviour with a response, as this would encourage the writers to think that they had made a point that was worth considering. I then thought I could just find a way to discredit the writers, and so I explored what other work they had contributed to the academic medical literature. Although this was satisfying to some extent, I did not think it would be a useful or mature way to respond. I fantasised about bumping into them at the forthcoming conference and asking them specific questions: what they thought of the Christmas number one, for instance. However, I also thought that it was the BMJ's decision to publish my work, and so I did not need to defend it.

    The experience has left me with a mixed view of the process and its results. I think that rapid responses should be put on the website for a limited period only, as the facil this, either the comments are worthy of publication or they should be sent on to or to the endless waste bin of cyberspace. Alternatively the BMJ could consider publishing the comments of the reviewers of a paper. This would add an interesting perspective to the overall discussion, as the reviewers are often experts inthe field.

    The BMJ is an impressive and important voice in medicine, and yet it is now giving any opinion—no matter how personal, badly constructed, or poorly written—an almost equal voice to the high quality articles it rightly prides itself in publishing.

    We welcome submissions for the personal view section. These should be no more than 850 words and should be sent electronically via our website. For information on how to submit a personal view online, see

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