Share this article on:

00005768-199907000-0000100005768_1999_31_923_raven_clinical_7editorial< 23_0_1_1 >Medicine & Science in Sports & Exercise© 1999 Lippincott Williams & Wilkins, Inc.Volume 31(7)July 1999pp 923-924Clinical issues of the journal[Editorial]Raven, Peter B.Editor-in-ChiefAs editor-in-chief of Medicine & Science in Sports & Medicine, it has always been my position that the journal should reflect the interests of the College members. Upon my appointment to the position of editor-in-chief of the journal, I initiated sectionalization of the journal's table of contents (TOC) to include broad categorization of our organization's fields of interest. Those categories are clinical sciences, basic sciences and regulatory physiology, applied sciences, and special communications. In 1995, I provided another category for "epidemiology" in response to the increasing number of submissions. In the following table, I provide a summary of the published manuscripts in each of the categories since 1989.As one can see from the overall breakdown, it identifies a relatively equal split among the three major areas of science published in the journal and is representative of the interest groups within the membership of the College. Remember that only 30-35% of the manuscripts we receive for review are received from members. Also, our submission from non-U.S. institutions has grown over the years and exceeds 45% of submissions.Despite this equal representation of the membership interests, there remained a strident voice for the need for separate clinical publications, including a clinical journal, to address the interest of our clinical members. The publisher of the journal used focus group marketing surveys to determine the true need for another clinical sports medicine journal and the result was and remains a resounding no. When one considers the costs of launching a new clinical journal, the individual cost to the member would far exceed the costs of the currently available sports medicine journals. The cost for MSSE, on the other hand, is only $21.00 per member, and the clinical content appears to adequately represent the interest of the College. But to address what appeared to be a recurring, specific need, I recruited Thomas M. Best, M.D., Ph.D., MSSE associate editor, and an established academic physician, with a specialty in family medicine and sports medicine, to become clinical editor of a biannual clinical supplement dedicated to relevant topics in clinical sports medicine.Dr. Best was responsible for recruiting each author and reviewer of every issue, a time-consuming task. The financial burden of the entire process was, for the most part, absorbed by the patience and support of his clinical department and institution. Anyone who has been in a similar position would surely understand the difficulties of trying to do this and still provide a "good product" to the consumer. However, MSSE has provided the Clinical Supplement to the members of the College for an annual cost of less than a quarter per member.Though the development began a year earlier, our first issue of the MSSE Clinical Supplement was produced in July 1997 and covered topics relative to "Head and Spine Trauma." Since that time, three additional supplements (The Shoulder, Cardiology, and Pulmonary) have been produced. This month we present "Foot and Ankle," and there are two other issues currently in various stages of preparation.In the broadest sense, the goal of the supplement was to meet the needs of our clinical members. In a large heterogeneous organization such as ACSM this can be a rather challenging task. Our clinical constituency spans the range from orthopaedic surgery to primary care as well as various subspecialty disciplines. Although receiving positive feedback regarding our efforts with the Clinical Supplement, there remain a number of clinical members who are not aware that the supplement even exists.At its November 1998 meeting, the Board of Trustees approved a resolution to make MSSE more clinically relevant. It also approved a resolution to create a new educational series, Intensive Clinical Learning, to "focus on specific clinical sports medicine topics." The consistent requests to make MSSE more clinically relevant are made at the highest levels within the College without recognition of our efforts to provide the clinical interest group adequate representation within MSSE, as identified by the numbers summarized in the table.TABLE 1. Published manuscripts 1989-1998. In my tenure as editor-in-chief, I have observed that it is sometimes those who vocally demand the most who do the least when it comes to correcting the perceived omission, or in supporting the efforts of MSSE and the MSSE Clinical Supplement. In contrast, our clinical associate editors, along with Clinical Supplement editor Tom Best, have been instrumental in expanding the number of clinical manuscripts published.As my tenure as editor-in-chief draws to an end in December 2000 and the actual support from the clinical membership and financial support from the College for the MSSE Clinical Supplement has not been forthcoming, I have decided that the July 2000 Clinical Supplement will be the last issue. I regret the need for this decision but I cannot continue to ask Dr. Best to provide his service without some budgetary support and developmental assistance. Nor can I provide 100 contract paid-for pages to produce the supplement with an increasing backlog of accepted manuscripts for publication and my perceived lack of interest by our clinical members. The field of sports medicine now recognizes over 20 peer-reviewed publications, not to mention various other avenues for communication and education. No doubt these publications have undergone "growing pains," but one might begin to question the necessity for this number of journals and other reference materials.I present this case not as an indictment of my clinical colleagues, as I know many of you are well aware of my support and interest in the clinical programs of the College, as I have served on many long-range planing committees in which we identified the need to address the clinical members. From these meetings have come the team physician course. During my time as program chair of the annual meeting came the introduction of clinical tutorials and the hands-on clinical workshops. The sectioning of the journal's table of contents was initiated to provide clinical identity to published manuscripts, and the Clinical Supplement was to provide our clinical members with current information on "hot" sports medicine topics. So as I leave this office, I remain convinced that despite the continuing new calls for "clinical relevance" of MSSE and new clinical publications, more specifically a clinical journal, the lack of consensus support and the lack of individual effort provided by the vocal few is evidence for the College not to pursue this course.Peter B. RavenEditor-in-ChiefClinical issues of the journalRaven, Peter B.Editorial731