Abstract
A reader recently complained that social issues are too prominent in JRSM. It is a difficult argument to refute if you accept, as I do, the findings of Michael Marmot’s report on the socioeconomic determinants of health, one of the most important analyses published in the last decade. 1 Social issues should have a place in medical journals, just as patients should. The criticism may be directed at the decline in case reports and some clinical studies published in JRSM. Again, any such criticism is fair as certain papers have been phased out of JRSM and now find a home in our open access companion journal, JRSM Open. 2
Our ambition with JRSM is to publish articles that interest a broad readership. Any research we publish should be as widely generalisable as possible, like this month’s study answering the question of whether female doctors provide longer patient consultations. 3 Case reports and narrower clinical studies tend not to meet these criteria, although each and every such paper will find adoring readers. Our editorial policies have helped to increase both citations and impact factor in recent years, at a faster rate than comparable journals.
The nature of JRSM papers also reflects the fashions of the day, as this month’s article from our archive shows. For soldiers returning to many countries from the Great War, medical baths were an important intervention for treatment and recuperation. 4 Our faith in the effectiveness of medical baths a hundred years ago seems surprising now, but R Fortescue Fox sensibly noted in 1915 that treatment of military cases should first be in hospital, second in town and only finally in the health resort. The full back archive of JRSM issues is available on the journal’s website and provides ample evidence that social issues are familiar themes in these pages.
To underline the point, Stephen McGann, actor and star of the BBC’s hit period medical drama, Call the Midwife, explains how he ‘loves to explore the relationship between medical science and the wider society it serves’. Considering I asked him to write about the challenges he faces in authenticating his role as Patrick Turner, an overworked doctor ‘on the front line of post-war urban health’, it was a pleasant surprise to learn of the research and attention to detail that goes into each episode. There is acute awareness among actors and programme makers of the health and social implications of the show. 5
Indeed, as William Osler said, ‘The good physician treats the disease; the great physician treats the patient who has the disease’. Perhaps the best physician treats the disease, the patient and the society the patient lives in?