Letters to the editor: the new order

Please respond to articles using website, email, or disk—but not paper

Letters are important to us. They often provide more penetrating critiques of articles than any form of prepublication peer review.1 If the publication of a scientific article resembles an appearance in court then the letters columns is where the jury of peers records its verdict. Imagine our regret therefore that we have the space to publish only a third of the letters we receive—and those five to six months after the articles to which they refer. Put another way, many of the carefully crafted responses we receive, and the insights they contain, end up in the bin.

The world wide web has rescued us, just as the whole letter publishing enterprise seemed about to collapse under its own weight. Since last week correspondents have been able to respond to articles directly via our website (www.bmj.com) using a response form that is linked to each article. These responses are screened by the editorial department, and our intention is to post all but the libellous, gratuitously rude, trivial, irrelevant, or incomprehensible on the website within 72 hours. Such a commitment might represent the most democratic step this journal ever takes: now everybody in the world with internet access (100 million and rising fast) can read whatever the journal publishes, on the day of publication, and see their response recorded within hours.

Interestingly, some of our first responses have come from patients. The very first gave a patient's perspective on early discharge after surgery for breast cancer. 2 3 If this trend continues we may finally begin to capture the dimension that has been missing from medical discourse for millennia: the experience of patients.

In time we hope to add to the website all comments that we have received on a particular article—however the responses have been submitted. Processing them is easier if they have been submitted in electronic form, which is why we would like authors to turn to paper only as a last resort. Some years ago we started requiring articles in electronic form; we are now doing the same with letters. Though many people lack internet access, most letters we currently receive have been “word processed”—so, even if an email is not possible, providing a disk should present no problem.

Those who worry about the accolade of publication in the paper journal can rest assured that all responses, regardless of medium, will be equally eligible for selection for the paper journal. But they should ponder which contribution is likely to be of more value to the scientific process—entering the hurlyburly of discussion while a topic is “hot” or getting their words into print months after most people's attention has moved on. Equally, those at home with email and the internet should not be too seduced by the speed of the medium: for our readers' sake we hope their responses will be as finely crafted, as well considered, and as well referenced as if they had been written with a fountain pen.