If you keep up with the latest news, then you routinely read or hear about recent studies by scientists who are trying to solve medical mysteries: What causes disease and problems in the human body? And what’s the best way to treat these conditions? This ever-growing body of research is compiled, along with other news and opinions from the world of medicine, in medical journals.
There are about 30,000 medical journals published around the world, but only a handful of titles, such as The New England Journal of Medicine and JAMA, are household names. The National Library of Medicine (which is part of the National Institutes of Health) maintains an online database called PubMed, which allows anyone to search for studies and other research on a given disease or treatment. Doctors, scientists, and medical students make up the primary audience for medical journals, though anyone with enough curiosity and ability to make sense of often-complex scientific terms and concepts can read one.
A Long History
The earliest medical journals were published in the 17th century. For the first 300 years or so of their existence, medical journals were printed on paper and eventually came to resemble magazines. Most were published weekly or monthly and mailed out to subscribers. But that all began to change in the late 20th century with the arrival of the digital era. Today, most users read medical journals on computers, tablets, or smartphones. For example, JAMA delivers about 293,000 copies of its print edition each week, but 1.8 million subscribers link to the journal online.
Who Owns and Publishes Medical Journals?
Some medical journals are owned by medical societies and other health-focused organizations. For example, the Massachusetts Medical Society owns TheNew England Journal of Medicine, while the American Medical Association publishes JAMA. The American Heart Association produces Circulation, a journal devoted to research on the cardiovascular system. But a handful of large commercial publishers produce most other medical journals.
The articles in medical journals that garner the most headlines are research studies in which scientists do experiments designed to answer questions about disease and treatments: “Does this new experimental drug lower cholesterol?” for example, or “Will walking 30 minutes a day reduce your risk for type 2 diabetes?” When an experiment is completed, the scientists compile their results and write a manuscript that describes the study -- what they set out to learn, how they investigated the question, and what they found. Then they select a medical journal that they believe will be interested in publishing the research and send the manuscript to its editors.
In traditional medical journals, the next steps look something like this: First, an editor will decide whether a submitted manuscript has merit and will be of interest to readers of the journal. If so, the editor will next ask a group of experts who specialize in the same field of medicine as the study’s authors to read and judge the quality and accuracy of the manuscript. This process, called peer review, can help identify flaws or errors in how the study was done or in its results, in which case the peer reviewers will suggest that the authors make certain changes to the manuscript. If the study is deeply flawed, peer reviewers will recommend against publishing it. But when a study gets a thumbs-up from peer reviewers, it is usually accepted and published in the journal.
Who Pays? Subscription vs. ‘Open Access’
The publishers of most traditional medical journals charge a subscription fee to cover production costs and generate profits, just like magazines you may subscribe to at home. (Nonsubscribers can read or download an article from a medical journal if they pay a fee.) But, unlike most popular consumer publications, medical journals do not pay authors who contribute studies and other articles for their time and effort. The payback for these doctors and scientists is the knowledge that their work will be recognized by their colleagues and others, and perhaps influence the practice of medicine.
Over the last generation, an alternative to this traditional approach has emerged, known as open-access (OA) publishing. Publishers of OA journals do not charge readers any fees, either for subscribing or for reading and downloading individual papers. Instead, OA journals make money other ways, notably by charging doctors and scientists fees to publish their manuscripts.
The arrival of OA journals has had benefits and downsides. Doctors, researchers, and patients who have been frustrated by high fees charged by traditional medical journals have welcomed the ability to read about new research for free. The presence of OA journals may also have contributed to a trend in which traditional journals are making more of their content free, too. For example, any study completed with funding from the National Institutes of Health must be made publicly accessible within 12 months of publication in any journal.
But the ability to publish journals inexpensively online has also given rise to so-called predatory journals, which are shady publications that exist mainly to make money, not advance medical science. Predatory journals aggressively solicit manuscripts from scientists who are eager to publish their work and are willing to pay for the privilege. In many cases, editors at predatory journals do not put manuscripts through peer review or otherwise check them for accuracy. It can be difficult for even a scientist to determine whether a medical journal is legitimate or predatory, though one that’s full of typos and grammatical errors is likely the latter.
If you or a loved one is coping with a challenging illness, it may be tempting to search for answers in a medical journal. Should you choose to take the plunge into the complex world of medical literature, proceed with a few words of caution. The results of a single study published in a medical journal don’t prove that a treatment is effective. And don’t make any medical decisions based on what you read, such as quitting a medication, without talking to your doctor.