A theme issue for medics and an increasingly health informed public

What might it be like to practise medicine in 10 years' time—and how best should a medical journal reflect that? We have been wondering what the BMJ might look like by 2013—not just whether it will still appear in print or only on the web, but whether it should still be aimed primarily at doctors. Perhaps it should appeal to the new and growing audience of well informed patients—and, indeed, an increasingly health-savvy general public as well? We are planning an experiment in our issue of the journal next June which will aim for the first time to appeal to a wider audience than just the medical profession.

This is not a gimmick: it is born out of a conviction that the interaction between the public and the medical profession will change markedly in the next decade. Three years ago, the BMJ devoted an entire issue (18 September 1999) to the development of a partnership between doctors and patients, guest edited by social scientist Angela Coulter. This emphasised the need to move away from “doctor knows best” paternalism but suggested that “out and out consumerism” was not an ideal way forward either.¹

In a recent publication Coulter argued for a middle way: a coalition between doctor and patient.² If this model is to work, patients need to be as well informed as those providing their health care, she said.

Many patients are already well informed about healthcare options—through articles in magazines, radio and television programmes, and the internet. Ten years from now, many more doctors are likely to find themselves in a new role: as “Sherpas” guiding people through the maze of health care, rather than merely as healthcare providers.

Of course some members of the public may not want to be partners. They may, with justification, argue that doctors are trained and paid to make these professional decisions, so let them get on with it. Some people may be too sick or too worried about the person they are caring for to go searching the internet for the latest medical research. But for those who do want to read authoritative health reports, why shouldn't they be reading the same health publication as their doctor—and indeed, taking part in the debates which currently go on within the pages of the BMJ or on bmj.com? Some of them already read the BMJ, but we would like to make this theme issue something anyone interested in health might turn to.

We also want the theme issue to reflect how patients feel about their health, to look beyond the medical model, and to invite patients rather than just doctors or academics to comment on the research papers we publish. All this will mean some hard thinking about how we present the information we publish both in print and on the web. But we don't intend to dumb down the BMJ. We will apply the same rigour to the research and papers we publish.

If you have a research paper you would like considered specifically for this issue, please submit it by 15 December 2002 (see bmj.com for general guidance on submitting articles). In view of the wider audience, we will be interested in research papers into common problems such as dealing with pain and coping with depression. Although we intend to include some qualitative research, we don't want that alone as we plan to use the issue as an opportunity to show different types of research to a wider audience.

In addition to research papers, we also welcome ideas—from doctors and non-medics—for topics, controversies, or issues to raise in the theme issue. Your ideas will help inform our decisions on commissioning editorials and other non-research based articles. They may even help us decide the format we use—for example, whether we use a first hand report of a patient's experience, a multiple choice quiz, or maybe even a celebrity interview, rather than our current approach. Again, ideas should be submitted by 15 December, as a rapid response to this editorial.