After nearly 30 years as editor of American Family Physician (AFP), Jay Siwek, M.D., has decided it's time for a change. He plans to step down in January 2018.
Jay Siwek, M.D.
And that means the search for a new editor-in-chief(316 KB PDF) is kicking into high gear.
In addition to his AFP duties, Siwek was family medicine department chair at Georgetown University in Washington, D.C., for many years and currently is the department's vice chair. He's also been a health columnist (Washington Post, Newsday, Woman's World) and tour physician for the National Symphony Orchestra. In recognition of his contributions, Siwek received the AAFP Award of Merit in 2000 (now the AAFP Award for Distinguished and Meritorious Service to Family Medicine) and the Lynn and Joan Carmichael Society of Teachers of Family Medicine Recognition Award in 2001.
In this Q&A with AAFP News, Siwek shares his thoughts on leaving AFP, recalls his accomplishments with the journal and reveals his hopes for the journal's future.
Q. You've been at the helm of AFP since November 1988 and were associate editor for seven years before that. What will stepping down look like?
A. In a sense, I've been stepping back for about a year or so already. I've been offloading some responsibilities onto my team of editors.
Once the new editor-in-chief is hired, I hope to help that person learn how things work, to make that person's life easier. I'd also like to get back to some projects that have been on the back burner, some for many years. There's plenty to do after I step down as editor.
Q. You were the first residency-trained, board-certified family physician to serve as AFP's editor, and you've had experience in medical education and in clinical practice. How have these informed your editorship?
A. I was actually the first family physician to be editor. When I came on board as associate editor, AFP had been around for about 30 years and had an editor and five associate editors -- none of whom were FPs. That seemed kind of ironic.
Taken two years after Siwek was named editor of American Family Physician, this photo from the AAFP staff directory shows him alongside two members of the journal's staff.
So part of my job on the front end was to assemble a team of family physician editors and increase the number of family physician authors.
Regarding my background, all parts of it help each other. The editing makes you pay attention to the science and what's new, and that, in turn, helps when you're practicing and teaching because you're up-to-date on things. They all work together so that each part is better than it would have been otherwise.
I know what it's like to be an FP, and I know what it's like to teach residents and medical students. When you engage with learners, you see different learning styles and see how a journal could be crafted to address those different styles.
Q. In your first editorial as editor, you wrote, "If it ain't broke, don't fix it." But then you proceeded to make changes in AFP. Why? What have been some of the key changes and accomplishments during your time as editor of AFP?
A. Yes, I wrote that editorial because I was told AFP didn't need fixing, but then I realized I had to make major changes. For example, articles didn't have reference citations back then. They were not peer-reviewed. There weren't many FP authors. That's all changed.
In terms of accomplishments, I pulled together a team of great family physician editors and have maintained it even with turnover. Altogether, the medical editor team has more than 300 combined years of editing experience. They're an amazing asset for AFP.
We've developed more than 20 new AFP departments over the years, some of them now gone, most others still in play. If we had more space in each issue, some of those now-gone departments might be with us still.
I collaborated with fellow family physician editors to create the evidence rating system called the Strength of Recommendation Taxonomy, or SORT, which is used by AFP and several other family medicine journals. It's designed to present the key clinical recommendations for practice in a reader-friendly way.
Over the years, we never had a catastrophe to climb out of. AFP's been good and continues to get better. There's always something new; it's never boring. I'm not kidding! Right now, I have three new departments in the wings that we'll be working on.
It's sort of like family medicine -- you never know what you're going to see when you open the door. The variety of creative things that you can do with the journal, the problem-solving -- it's all been fun. That's why I didn't bug out earlier.
Q. As you look forward, what do you hope for AFP -- and the family physicians it serves -- in the future?
A. AFP's mission is to provide readers with high-quality clinical information they can use in practice to take better care of their patients. It's important to keep finding different ways to do that and to take advantage of AFP Online, which is a whole other phenomenon.
About 3 million different people look at AFP Online each month -- about 30 million different people each year. They don't just read the current issue, either. They look for a piece of information they need, and they might find it published three, five or 10 years ago. The fact that they are using the information and that we don't have a way to continuously update that information has been a challenge and a conundrum I have tried to address.
We have some workarounds to help readers get to the most current information, but I would love to see AFP Online become something more than a static repository of information, to have a team around the country that would tweak the online content so that as the science changes, our online information changes.
Q. Will it be hard to let go?
A. No. I did a similar thing as family medicine department chair at Georgetown University. I was the chair for 15 years, but as my grandkids arrived and my wife suggested not working so much, I began cutting back until I felt I couldn't remain department chair because I had offloaded so many responsibilities. So I became vice chair and still am. I had to let go seeing patients and teaching and precepting residents. Now the main thing I do is teach medical students and work on special projects to help out. It's been totally fine; I've never looked back. I hope AFP will be similar.
This might sound clichéd, but it really has been a privilege to be able to create clinical information that so many people like and use, and to hopefully achieve AFP's mission – providing practical information you can use to take better care of patients. That's where I get my satisfaction. What I've been doing has a chance to make an impact. That's a good part of the reason why I've been doing this for so long.