PRS Global Open: A Dream Turning to Reality

Abstract

Supplemental Digital Content is available in the text.

A dream doesn't become reality through magic; it takes sweat, determination and hard work.—Colin Powell

Most great things begin as a dream. When I became editor-in-chief of Plastic and Reconstructive Surgery in 2005, I envisioned PRS becoming a global journal for all of plastic surgery—above and beyond its then-current station. PRS co-editor Jim Stuzin and I, along with our amazing ASPS editorial office team and stalwart editorial board, have worked diligently, relentlessly, and imaginatively for the past 15 years to accomplish this goal.

As I became more involved in global medicine through the World Association of Medical Editors, it became starkly obvious to me that PRS, despite being the best and most-read plastic surgery journal in the entire world, was not available to all plastic surgeons globally. As a subscription-based journal, it was neither accessible nor affordable for many plastic surgeons around the world; access to PRS is something we take for granted in North America. The more I got involved in World Association of Medical Editors (eventually serving as its president), the more obvious it became that the future of peer-reviewed, academic medical journals was in open-access publishing.

Most point to a December 2001 gathering in Budapest hosted by the “Open Society Institute” as the official birth of the open-access movement. The scholars, publishers, and other stakeholders gathered at that summit defined their mission and promise of this new vision for publishing, which still rings true today:

An old tradition and a new technology have converged to make possible an unprecedented public good. The old tradition is the willingness of scientists and scholars to publish the fruits of their research in scholarly journals without payment, for the sake of inquiry and knowledge. The new technology is the internet. The public good they make possible is the world-wide electronic distribution of the peer-reviewed journal literature and completely free and unrestricted access to it by all scientists, scholars, teachers, students, and other curious minds. Removing access barriers to this literature will accelerate research, enrich education, share the learning of the rich with the poor and the poor with the rich, make this literature as useful as it can be, and lay the foundation for uniting humanity in a common intellectual conversation and quest for knowledge.¹

That mission became my dream and vision for plastic surgery. In April 2013, we officially published our first compendium of Plastic and Reconstructive Surgery – Global Open (PRS Global Open), the first North American open-access, peer-reviewed global plastic surgery journal. However, while the journal itself was a publishing trailblazer and, in hindsight, is understood to be prestigious and groundbreaking in its own right, our overarching focus was—and continues to be—quite simple: focus on publishing clinical articles on patient safety, techniques, and new technology that would benefit all plastic surgeons and affiliated specialists worldwide. The mission of the journal has always been improving plastic surgery patient safety, outcomes, and care one open-access article at a time. It is these three standards, coupled with free access to anyone, anywhere, that enable PRS Global Open to elevate the science of plastic surgery worldwide.

Now, as I prepare to close my term as Editor-in-Chief of PRS Global Open and assume the role of Editor Emeritus, I would like to take this time to look back on how PRS Global Open was conceived and carefully built into a world-class journal available to all plastic surgeons around the globe.

When the journal was just a concept, we had the support of our publisher, Wolters Kluwer, led by then-President and CEO of WK Health Medical Research Karen Abramson. PRS Global Open was Wolters Kluwer’s first open-access medical journal. We had the support of PRS co-editor Jim Stuzin and several other like-minded individuals on the editorial board. We had support from physicians and staff leaders of the distinguished organization that owns the family of PRS journals, the American Society of Plastic Surgeons. And we had a world-class editorial office team ready for the challenge.

We all very much understood the need for open access to become a reality for North American surgery journals—and the opportunity for plastic surgery to take the lead. There was, here was, however, some reluctance and resistance to embrace the concept of launching a new journal that could potentially become a competitor to PRS. That short-term obstacle, while understandable, was the major challenge that had to be surmounted.

When this concept was initially presented to the ASPS Journal Business Operations Committee, many flatly rejected the concept as unfeasible and absurd. Plastic surgery colleagues even within the scientific publishing community derided the concept. But we did not give up. We observed and reported on what was happening in the world of medical publishing. For example, when PLOS ONE, the peer-reviewed open-access mega journal of the Public Library of Science, launched in 2006, it published 138 articles that year. In 2011, PLOS ONE published nearly 13,800 papers. At that point, 1 out of every 60 of all articles indexed by PubMed were published by PLOS ONE.² We reported the lessons I was learning through World Association of Medical Editors on global inequities in access to scientific literature, and we studied the effects of PRS’s own peer-review process. Due to page limits and the pressure to keep the PRS Impact Factor high, we were unable to accept and publish many good studies and were, in fact, delivering these papers to competing journals. We knew our vision for adding an open-access journal to the ASPS portfolio was the right thing to do evolutionarily, practically, and morally; so we persisted, and PRS Global Open got the unanimous go-ahead in May 2012³ (Fig. 1).

Fig. 1.

The initial logo for PRS Global Open, used from 2012 to 2016.

So, what does it take to start a new journal in uncharted territory? What components do you need for success? How do you overcome challenges and arduous beginnings?

• We had to educate plastic surgeons and North Americans about open access and overcome a lot of misinformation and skepticism about the intent, outcomes, and philosophy behind this type of publishing—in which the “reader-pays” (subscription) model is replaced with a not-insignificant “author-pays” article-processing charge. Dan Sullivan (our then-managing editor), our publishers, and I collaborated on several editorials and policy pieces to help spread clear, concise, and accurate information about the open-access movement.^2,4,5

• Following some unexpected changes in the editorial office as well as adjusting for some unforeseen deficiencies in workflows, the core editorial team was cemented. Aaron Weinstein was selected to manage the editorial office; I. Donnell Moore volunteered to step in as peer-review and editorial-process coordinator for PRS Global Open, and—though not initially part of how the journal was conceived—Ed Tyan saw the need for his copyediting services on the new journal and stepped forward to help. These stalwart staff members, along with the rest of our editorial office team, have grown with the journal just as the journal has been able to grow because of them.

• We worked diligently to build our reviewer base. We started by challenging our then-current PRS Editorial Board members and key reviewers to join this global movement, and then rely upon them and our ASPS colleagues to help us expand the borders of the journals’ reviewer base to all corners of the world.

• We gradually and deliberately developed a truly international editorial board for PRS Global Open. Our first editorial board (see Supplemental Digital Content 1, which details the inaugural editorial board of PRS Global Open, http://links.lww.com/PRSGO/B569) comprised people from around the world who supported the vision of the journal and are truly part of publishing history. Gradually, we were able to expand to include even more highly-qualified, highly-recommended plastic surgeons from around the world who were interested in selfless peer review. This involved multiple strategic planning meetings for both PRS and PRS Global Open, and we have vastly constructed and expanded our Editorial Board primarily of global plastic surgeons and established regional editors, which has truly helped raise the quality of the journal to a new level. Today, PRS Global Open is increasingly autonomous, increasingly global, and powered by an increasingly diverse network of plastic surgeons who truly embody and embrace the open-access journal’s philanthropic, pioneering spirit. (See Supplemental Digital Content 2, which details the 2020 editorial board of PRS Global Open, http://links.lww.com/PRSGO/B576.)

• We made every effort to market the journal heavily in person, print, and digitally to attract readers and writers. The initial “nickname” for the journal—“PRS GO”—provided us some fun opportunities to ask plastic surgeons “Where will ‘GO’ take you?” But the mission of the journal was always the true heart of the messaging in every call for papers and readers from Day 1: Improving safety, outcomes, and care—one open-access article at a time.

• We literally took this show on the road to market the journal to readers and writers, to grow our reviewer base and editorial board, to listen to and learn from plastic and reconstructive surgeons and medical editors around the world. We were fortunate to travel to places domestic (including San Diego, Chicago, Orlando, Los Angeles, and New York) and places abroad (including India, China, Russia, South Korea, Brazil, and Australia) to meet face-to-face with current and future editorial board members, readers, and authors. We were honored to “see the sights” with our hosts (Fig. 2) in our international travel, but the main focus of these trips was always to build lasting relationships with those who would become some of the catalysts for the journal’s continued growth.

• We built a new and separate identity for the journal that capitalized on everything people knew and respected about PRS, but allowed PRS Global Open to keep from being perceived as a secondary journal. We doubled down on what made PRS Global Open unique. First, we made the decision to publish all abstract and proceedings supplements in PRS Global Open, including the abstracts presented at the annual meetings of ASPS, Plastic Surgery Research Council, European PSRC, American Association of Plastic Surgeons, as well as those from local and regional meetings in Russia, Italy, Ireland, and more. This initiative has been expanded and continues today, as PRS Global Open is proud to be the home for plastic surgery abstracts, posters, and proceedings, as they are the seeds that will grow into future forests of research and advances in our field.

Fig. 2.

While PRS Global Open Editors and staff were honored to see the sights with our hosts, the main focus of our international trips was to make lasting relationships with those who would become catalysts for the Journal’s continued growth. Rod J. Rohrich, MD and Aaron Weinstein at the Taj Mahal in Agra, India in 2015 (A); Rohrich and James M. Stuzin, MD at Gyeongbokgung Palace in Seoul, South Korea in 2015 (B); Rohrich and Patricia Neves, MD at Cristo Redentor in Rio de Janeiro, Brazil in 2017 (C); Rohrich and Weinstein at the Sydney Opera House in Sydney, Australia in 2018 (D).

• We continued by heavily promoting two major features that make PRS Global Open stand out: Case Reports, which most plastic surgery journals (including PRS) do not publish, and the worldwide nature of our content. The homepage, digital collections and labels, marketing efforts, and even our annual Best Paper Awards focus heavily on case reports and the country (or countries) of origin of our articles. Additionally, the nickname “PRS GO,” which was perceived as relegating the journal as a “junior” or “to-go” version of the White Journal, had to go. PRS Global Open outgrew its nickname; so in 2016, we re-branded, and the old “PRS GO” logo was retired and replaced with the current logo (Fig. 3).

• We worked diligently and patiently with our staff and publisher to build new processes and adapt to the ever-changing flow of an open-access journal. This culminated in the establishment of a cascading peer-review model and a unique Editorial Manager portal to independently manage the peer-review process. We had to execute this vision for every article, every day and assure readers and authors that our peer-review process was rigid and that we were advancing patient safety and outcomes and elevating the science of plastic surgery globally with each issue.

• We taught and warned our readers about predatory publishing and how some unscrupulous individuals and companies were taking advantage of young, unsuspecting researchers from around the globe and sullying the good name and good work of true open-access publishers in the process. This resulted in our classic editorial on recognizing predatory open access journals.⁶

Fig. 3.

The current logo of PRS Global Open. Established 2016.

As mentioned previously, a big part of the challenge in launching PRS Global Open has not been simply in establishing a separate identity but growing it as well. Thinking outside the box, growing without boundaries and avoiding stepping on the toes of PRS was a tall task, but I’m proud to share our progress.

We introduced operative video technique articles and easy-to-understand infographics. With the guidance of Donald Lalonde, MD, and Jeffrey E. Janis, MD, we launched and grew a new series of articles called “Practical Plastic Surgery Reviews” (Fig. 4), pragmatic and clinically-useful review articles designed to emphasize information that readers can use to understand and improve care of plastic surgery patients worldwide, including locales where high-tech and expensive solutions may not be readily available. These review articles are a “must-read” for plastic surgery residents and young plastic surgeons from around the world.

Fig. 4.

Practical Plastic Surgery Reviews are a new series of very pragmatic and clinically-useful review articles that were designed to emphasize information that readers can use to understand and improve care of the plastic surgery patients worldwide, including locales where high-tech and expensive solutions may not be readily available. These review articles are a “must-read” for plastic surgery residents and young plastic surgeons from around the world. Read them: https://bit.ly/PracticalPSReviews.

Our most recent initiative, PRS Global Open Mini-Series, consists of single-issue deep dives on aspects of plastic surgery from world-renowned plastic surgery institutions, such as McMaster University, NYU Langone Health, and MD Anderson Cancer Center (Fig. 5).

Fig. 5.

PRS Global Open Mini-Series are collections of new plastic surgery research on a single thematic topic from world-renowned institutions. Read them: https://bit.ly/GlobalOpenMiniSeries.

The PRS Global Open Keynotes Podcast (Fig. 6), led by Dr. Damian Marucci from Australia, has seen amazing growth, with our 2020 unique downloads increasing nearly 300% over 2019. The series won the Folio: Eddie and Ozzie Awards Honorable Mention for “Best Podcast” (2019) in its first year! In these podcasts, Dr. Marucci interviews the plastic surgery giants of today and leaders of tomorrow about their research, techniques, PRS Global Open papers, and what the future may bring in this exciting field of medicine.

Fig. 6.

The Award-winning PRS Global Open Keynotes Podcast helps surgeon stay up to date with the latest breakthroughs in plastic and reconstructive surgery. Available on Apple Podcasts, Spotify, and PRSGlobalOpen.com. Listen: https://bit.ly/PRSGlobalOpenKeynotes.

Growing our Resident Advisory Board program internationally, culminating in the PRS Global Open Resident Ambassadorship, has been one of the initiatives of which we’re most proud. It has led to the creation and growth of one of the journal’s signature initiatives—“Face the Case” (Fig. 7), our interactive case report quiz, and video discussion series, spearheaded and grown by our amazing 2018–2020 PRS Global Open Resident Ambassadors Kate Boehm, MD; Or Friedman, MD; M. Rachadian Ramadan, MD; Anna Steve, MD; and Macarena Vizcay, MD. “Face the Case” has won several national publishing awards: APEX Awards for Publication Excellence—“Best Special Purpose Social Media” (2019, 2020); Folio: Eddie and Ozzie Awards Honorable Mention for “Best Social Media/Online Community” (2019); and the American Society of Healthcare Publication Editors Gold Award for “Best Use of Social Media” (2019). This has been a tremendous asset to expand the depth and breadth of the journal and its social media presence.

Fig. 7.

“Face the Case” is the award-winning interactive case report quiz and video discussion series. Follow PRS Global Open on Twitter, Instagram, and Facebook to participate in the next quiz and see how you would face the case.

Finally, underlying all this amazing hard work, we have gone through the methodical process of getting PRS Global Open and its content indexed far and wide from day one. The journal is listed in PubMed Central and the exclusive Directory of Open Access Journals. It is discoverable in PubMed and is fully indexed in the Web of Science’s Emerging Sources Citation Index (ESCI) and Elsevier’s abstract and citation database, Scopus. In addition, the publishing industry has taken notice of what we are doing: in 2020, PRS Global Open won the top award in the Folio: Eddie and Ozzie Publishing Competition for “Best Full Issue of a Medical Journal.” Of note, Plastic and Reconstructive Surgery was a proud runner-up. These benchmarks are a testament to the quality of the journal’s content and indicative of the hard work our authors, staff, reviewers, and Editorial Board members do for the journal every day!

Over a short period of time, we have transformed a dream into a reality. PRS Global Open has grown into a world-class, highly-cited, peer-reviewed global journal that is free to read for anyone, anywhere. We are beyond proud of this journal and all who have poured their heart into launching and growing it. We are advancing the art and science, clinical practice, and safety of plastic surgery every day, one open-access article at a time. We are confident in the team we’ve assembled, in the new leadership—and in you—that this vision will continue.

A dream you dream alone is only a dream. A dream you dream together is reality.

—John Lennon

ACKNOWLEDGMENTS

The authors acknowledge Mike Stokes, American Society of Plastic Surgeons Staff Vice President of Communications, for all of his support over the years and for providing American Society of Plastic Surgeons and copyediting services on this editorial; our steadfast team at Wolters Kluwer, including Liz Durzy, Tom Pacific, and Aidan Derrico; Angela Burch (who, as part of her role on the editorial staff, developed the graphic logos for many new journal initiatives over the years, including many seen in this editorial); and Christina Carson, Darienne Dickey, and Maddy Ramos for their pivotal roles in the Journals’ editorial processes, digital initiatives, and social media presence.