Some Final Thoughts

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On August 31, 1999, my term as Editor of the AJRCCM ends. As has been the custom, the departing editor is granted the opportunity for some final reflections, and this is a chance I would not miss. First, however, I have some reassurances about the transition, which this time should be seamless. Until August 31, 1999, I will serve as editor and our current associate editors as the arbiters of submitted papers. We will follow this process through until February 28, 2000. We will review papers until that date, and most new submissions will be reviewed completely by the same set of associate editors. The new editor, Martin Tobin, will assign papers submitted for the first time after August 31, 1999, for review. Because the peer review office remains in Chicago, the same staff will remain in place. Hence, the review process will not have to be reformulated as in the past when the Journal has changed editors or moved to another city. Under the able leadership of Patricia Luce and with special thanks to Rebecca Lutrell, our readers can continue to expect prompt and efficient processing and no "down time."

I have now served as either an editor or associate editor for 10 years, and much has happened in that time. The growth of the International Meeting and of the Journal has been remarkable. The number of Journal submissions has nearly doubled, and the quality of submission has increased. The challenge that we face in the next decade is the capacity to publish all worthy material in the Journal. We must move to adopt an absolute standard of excellence for acceptance of papers rather than imposing page limitations based on financial constraints. This is essential for the Journal to continue to maintain its eminence in the world and to serve our members and contributors fairly. Of course, this philosophical position is the luxury of someone who does not have to deal with the financial realities of the Society. I feel confident, however, that our newly liberated ATS will meet these challengesand relieved that they will not be faced on my watch.

When I wrote my introductory letter (A. R. Leff. 1994. Your kinda journal. Am. J. Respir. Crit. Care Med. 150:606- 607), I set forth some goals, which I hope have been realized. It was my particular desire to foster a spirit of internationalism among scientists whose interests extend beyond national boundaries and whose common enemy is lung disease. We welcomed contributions from colleagues across both oceans, and we have achieved remarkable success in so doing. Acceptance rates are comparable for papers submitted from Europe and Asia with those submitted from North America, and, accordingly, we are stronger and richer for having encouraged the American Journal as an international venue. Of course, we are American in name only, and the type size of the word American as it now appears on our cover testifies to the recognition that the small print (now barely within the optical resolution of this writer) might well one day disappear. This is not my decision to make, but if I could do so, I would. It is equally important that the Journal continue to recruit international scientists and clinicians as associate editors, so that decisions to accept or reject work in the Journal are made by a representative group of international colleagues. In this era of electronic transmission, it is no longer essential for the editor to be American, and we are on our way in this regard. Martin Tobin carries proudly his Irish passport, as well as credentials and credibility on both sides of the Atlantic.

Another goal was to establish high quality debates on important issues relating to respiratory and critical care science. This we have done as pro-con debates, which have sparked considerable interest among our readers. Our debate on tobacco industry sponsorship received warm support from the ALA and less overwhelming support from our members. Still, I think we stand in good stead as the only society that has officially recognized that the interests of tobacco companies in discovering the causes of respiratory disease may not entirely coincide with our own, by refusing to publish research sponsored by tobacco companies or their affiliates.

Another debate on whether the ALA and ATS should remain as a single unit received overwhelming support from members of the ATS and far less enthusiasm from the ALA. In fact, this debate inspired the first attempt by the ALA at a "gag order" on the editorial content of the Journal and ATS News that highlighted in many ways the differing interests of the two groups. These sorts of editorials define the dangers of wandering from science into politics, and in general, I believe that our readers are far better served debating issues related to science and clinical medicine (lung reduction surgery, chemotherapy of lung cancer, antileukotriene versus corticosteroids for treating asthma). Politics and science make poor bed-fellows, and the insulation of the editor from the political process of the ATS (as mandated by the by-laws) must be preserved. This is not the case for all societies, as marked by the recent summary dismissal of the editor of JAMA. Of course, medicine and politics were mixed (inappropriately in my opinion) in this case. However, I must say that the policy of having an amateur editor like me is certainly a good one. In five years, I have written only one editorial, although I had the opportunity to write many. While you might have been able to guess my biases, I think it is best to keep them out of print, particularly when there are so many excellent society members upon whom I could call. I also believe that editorials should be tied directly to material appearing in the Journal that month. Clinical Commentaries serve as the sounding board, but their length mandates factual support of the authors' views.

When I was interviewed for the position of editor, I was asked how I would find time to do the job. My response was that I did not have the time to do the job and that no candidate who did should be selected. The role of the editor is to respond to the needs of the Society, and the editor cannot become the Journal. Knowing that I had only five years required me to move quickly to develop consensus among my brilliant associate editors and the various assembly chairmen in working with the Publications Policy Committee to achieve our goals.

It is probably worth defining the nature of our relationship with industry, particularly the pharmaceutical industry. In addition to providing advertising revenues, which are vital to our financial underpinnings, many of the articles and supplements that we publish are industry-based. How do we foster this relationship without becoming incestuously linked with people who make the drugs we use? Oddly enough, by rejecting their papers according to the same criteria we use for any other rejection. Industry knows that if a paper is published in the AJRCCM, it is ranked as excellent science. This is the only route into the Journal, and publication thus provides the "endorsement" that a proprietary company may be seeking in the marketing of its wares. I think that this is how it should be. I would note that we have rejected a substantial number of supplements to the Journal, even though they would have been clearly identified as non-peer-reviewed works and bound and numbered separately from the accompanying volume. This was done where I regarded that material to be too proprietary in nature to justify publication. I must say that industry has without exception accepted this in good faith. I would also like to note some particularly selfless contributions made by industry that have seemingly no promotional value. For 13 years now, Boehringer-Ingelheim has funded the Transatlantic Conference, which has become a nidus for the international development of our Journal and, to some extent, our Society. This support has been completely unrestricted and totally unrelated to BI products. Two years ago, I chaired the TAC and had a scientist from a competing company as a speaker. In a supplement that will follow shortly, a superb conference will be sponsored by Merck, which was held at the Karolinska Instituit in Stockholm. This conference was entirely one of basic science; the low profile and total lack of restriction of content is another admirable example of how we can work together to advance mutual scientific goals.

Finally, some words of thanks. I would like especially to thank many of the people who most of our contributors never meet. Bridget Donahue developed our initial Chicago operation, and Patricia Luce and Rebecca Lutrell have carried this forward into a highly professional operation. Time from receipt to decision has been reduced by more than one month. The credit for this goes to them. On the publications side, Chris Shepherd and her publications group in New York have helped us cut publication lag from acceptance from more than 7 months to 4 months. These people have assumed broader roles than defined in their job descriptions, and losing the opportunity to work with them on a daily basis leaves me empty. The ATS administration, Marilyn Hansen, Carl Booberg, Don Temple and others have always been there for me when I ran over pages and budget, and their dedication to the excellence of the Journal is unshakable. Most remarkable are our associate editors. I am extremely proud that these extraordinarily talented people accepted the difficult job of Associate Editorship, and entirely amazed that they were willing to take some direction from me. All are qualified in their own right to be editor, and one, in fact, has agreed to do so. Martin Tobin is a brilliant choice, and I am personally gratified that after seven years as an associate editor, Martin found the inspiration and ambition to seek the editor's job. He does not have the time to do this job, he writes far too many papers and textbooks, and works far too much on affairs of the societymy definition for the perfect "amateur" editor. Another of our AE's, Jeff Glassroth, has become President of the ATS. His help and advice during the difficult transition in the reorganization of our Society was invaluable. Citing the contribution of these two associate editors is intended to be illustrative. Each associate editor has made a unique contribution in their field of expertise that has shaped the quality and nature of the Journal, and I am enormously indebted to all of them. The associate editors were my most valued advisors both in their particular fields of expertise and in the more general goals and policies that we set together for the Journal.

No one will be surprised that I conclude by thanking my family, for this is the source from which the time that I did not have to be editor was extracted. I thank my children for wearing their name tags at dinner so I could keep them straight, and I thank my wife, Donna, for picking up what I dropped and for her invaluable advice on the practice of professional journalism. Without her advice, you might have read some interesting material that belonged on the cutting room floor.

ALAN R. LEFF, EDITOR

Department of Medicine

University of Chicago

Chicago, Illinois