When Sumi Makkar Sexton, M.D., takes the reins as editor-in-chief of American Family Physician (AFP) on Feb. 1, she will be stepping into a role she has been preparing for since she took a rotation editing for the journal in medical school.
Sumi Makkar Sexton, M.D.
Family physician Jay Siwek, M.D., was editor when Sexton began that rotation in 1995. When Siwek steps down after 29 years of leading AFP, he will pass the mantle to a family physician who rose to the position of associate deputy editor at the journal while she was founding partner and president of an Arlington, Va., family practice. Sexton will continue to work at her practice, Premier Primary Care Physicians, and to teach as an associate professor of family medicine at the Georgetown University School of Medicine.
Sexton recently spoke with AAFP News about her career and her plans for AFP.
Q: How did you come to choose family medicine, and how did that decision lead to a career with an emphasis on education and editing?
A: I actually wanted to be a doctor since I was in third grade. I originally wanted to be a psychiatrist because I liked working with people and I liked to learn how people thought about things. In third grade, I actually did an analysis of all the teachers at my school, which didn't go over so well. But at the time I thought it was cool, and luckily I didn't get into too much trouble with the principal.
By the time I was in my third year of medical school, I realized that I loved every single rotation, and I didn't want to just do psychiatry. I knew there would be plenty of psychiatry in family medicine, and family medicine is everything I like to do, which is talking to people, understanding them, figuring out how they think and what works best for them. I get to practice that every day.
In my fourth year, at the University of Miami, my goal was to find a good family medicine program closer to my family in Ohio. I came to D.C. to check out the program at Georgetown and the rotation that was available was editing with Dr. Siwek. I fell in love with editing.
I was always interested in writing and I wanted to do something academic and teaching-related. The rotation was really an eye-opening experience, and from then on I've been with the journal.
Q: What is it about editing that was the right fit for you in family medicine?
A: It wasn't just editing, it was editing American Family Physician because I loved the articles, and frankly I was studying and learning and working at the same time. It was such an awesome fit. That's how I've approached my entire career since then. Even though I've been pretty much full-time family practice, I've always carved out time for AFP for two reasons. One, I'm staying up to date; I'm learning things constantly. And then I'm taking that information back to my patients, and what I'm learning from my patients takes me back to the journal. The two scenarios just work so perfectly, it's like puzzle pieces that fit nicely. And I don't get burnout from editing, and I don't get burnout from seeing patients.
Q: What do you want to bring into the role of editor-in-chief?
A: I really love teamwork. Jay over the years has already built a team of amazing, talented, awesome thinkers, so he's already done the hard work. Now all I have to do is work with these people, pick their brains, and keep making AFP great. And the editing team in Kansas, they take all the science and make it look great. I like to work with people, and I can't wait to work with both teams and have one team brainstorming and moving things forward.
Things I'd personally like to do? Since I'm very much entrenched in practice I want to keep that focus of the doctor in practice, how we can make things even more practical for our readers. I want readers to experience what I experienced, which is reading and learning at the same time, but while you're seeing patients. Of course, AFP is great when you're sitting on the airplane, when you want to just catch up on CME, when you have downtime. That's great, but I'd love to see AFP be part of daily practice. I use AFP pretty much daily when I see patients, and I'd like to have readers have the same enthusiasm about it as I do because it's really helped me and my patients.
Q: You've said your goal is to have a journal that meets the needs of the busy family doctor who only has time to read one journal. How will you manifest that goal in AFP?
A: Again, I am lucky that I am starting with an awesome product. Jay has done a fantastic job of bringing in various evidence-based departments, bringing in features like POEMs (patient-oriented evidence that matters), Cochrane for Clinicians, Putting Prevention into Practice, and of course we have our articles on key clinical topics. What I'd like to do is keep that diversity so that readers who may not have time to look at all the individual journals can trust that the practice guideline they missed in Annals of Internal Medicine is in AFP. It's about picking the best topics and also having more online features.
And in terms of meeting their needs, if you are able to see consistent themes within the journal, that will help you remember that issue of the journal. The next time you see a patient with high blood pressure or diabetes you'll remember, "There were several different articles on this. I know I can go to AFP." I'd like for readers to be able to access it more on the fly, too.
Q: Have you started to focus on any areas of change as you begin to take on your new role?
A: There are several areas that I would like to focus on, and I realize these are not instantaneous changes, they're goals. I'd love to engage readers and authors in many ways. I am looking into bringing back the writing workshops at national meetings that we've done in the past. I am exploring options for editing fellowships to make it easier for docs in practice to participate. I'd also like to engage readers at a young age through AFP podcasts and by possibly having student and resident members of the board again. I want to speak to readers in person and online to see how we can better meet their needs. How can we make our articles better with easier readability at the point of care and after patient care? How can we make getting CME through AFP easier for them? We don't need to make things complicated for our doctors and readers, we need to make things as easy as possible.
Another goal I have is clinical decision support. AFP has a lot of important clinical information. It would be nice to see that available at the point of care, whether somebody's looking something up on their own online, or somehow married or easily accessible through EHR (electronic health records). For example, in our medical organization, we are looking at clinical decision support tools and integrating those in our EHR. I'd like to see AFP material be part of that. Family doctors should be educated by family doctors.