• Publication Ethics

    American Family Physician (AFP) endorses the principles of good publication ethics and standards as outlined by the Committee of Publication Ethics (COPE), the International Committee of Medical Journal Editors (ICMJE), and the World Association of Medical Editors (WAME). In addition, AFP’s medical editors have developed guidelines specific to publishing in AFP.

    Here, we summarize key principles and provide links to supplemental resources. We cover roles, responsibilities, and issues relating to authors, reviewers, editors, and the publisher. When dealing with questions of publication ethics, AFP’s editor-in-chief, in consultation with AFP’s executive committee of medical editors, uses these principles but ultimately decides on a case-by-case basis whether any form of editorial misconduct has occurred and how to manage it.


    As stated in our Authors’ Guide and Author Credentialing form, we prefer that our authors be experienced clinicians familiar with critically reviewing and analyzing the medical literature, knowledgeable about the principles of evidence-based medicine, and experienced with the medical publishing process. Authors must be able to demonstrate expertise in their area of interest or manuscript topic. We expect the experienced author to take the lead in evaluating the available evidence and writing the manuscript. In most cases, student authors will not be approved but can be acknowledged if they assisted with any aspect of article preparation. 

    Authorship. All authors should meet criteria for authorship promulgated by ICMJE: 

    • Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND

    • Drafting the work or revising it critically for important intellectual content; AND

    • Final approval of the version to be published; AND

    • Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    Acknowledgments. There should be no unnamed authors (also known as ghost authors) and no one listed as an author who does not meet the above criteria (also known as gift authors). Anyone not meeting criteria for authorship who has contributed to the manuscript should be named in an Acknowledgment. If there is no Acknowledgment, that means that authors have not received aid from non-authors, such as professional writers or medical information companies.

    First and corresponding author. Authors who agree to serve as first and corresponding author are expected to fulfill that role unless they obtain permission otherwise from AFP’s medical editors. Authors are expected to appropriately respond to comments from editors and peer reviewers and, when needed, to reply to Letters to the Editor about their published work, especially when questions of science or publication ethics arise.

    Changes in authors. Any changes in authors (adding, deleting, or changing the order of authors) should be done with the knowledge and informed consent of the AFP medical editors. Any disputes among authors will need to be resolved to the satisfaction of all authors and AFP medical editors before a manuscript can be published. 

    Number of authors. We expect articles to be written by one to (at most) three authors. Having more than three authors makes it more difficult to comply with the ethical standards of scholarship, which include the requirement that each author makes substantive contributions to the literature search, evidence analysis, and writing of the manuscript. 

    Originality of work. Submitted work should be original, not previously published, and not under consideration at another publication. 

    Plagiarism. To avoid plagiarism, authors should not use the language, content, or concepts of another source without an appropriate reference. And even with appropriate citation, they should not use extensive verbatim or near-verbatim portions of text from another source (a practice known as “copy-paste plagiarism”). However, we do allow authors to cite and re-use specific content from previous AFP articles, under editorial direction.

    Copyright. Except for federal employees, authors will transfer copyright of all material published by AFP.

    Conflict of interest. Authors should disclose all financial relationships within the past 36 months and foreseeable future that they may have with any commercial entity that may have a direct interest in the subject matter of their manuscript. 

    Editorial misconduct. Authors who violate standards of publication ethics (such as plagiarism) or AFP’s publication policies (such as those on authorship and conflict of interest) may be subject to various disciplinary actions, including rejection of their manuscript, publication of an Expression of Concern or Retraction (https://www.nlm.nih.gov/bsd/policy/errata.html), notification of any other publisher involved in the infraction, notification of the author’s department chair or institution, or prohibition from writing for AFP or a given number of years or indefinitely.


    Conflict of interest. Reviewers should disclose potential conflicts of interest before accepting an invitation to review a manuscript. We are particularly interested in whether reviewers have a financial relationship with a drug or device maker relevant to the topic of the manuscript (e.g., on the speakers’ bureau for a company that makes a product for the condition being discussed). 

    Confidentiality. Manuscripts being reviewed should be treated confidentially. For example, the work should not be shared with others or used in any way without the permission of AFP.

    Timeliness. To avoid disadvantaging authors, reviewers should promptly review any manuscript they have agreed to review. AFP normally asks reviewers to complete their review within two weeks of receipt. 

    Civility. Reviewers should avoid inflammatory language or personal, disparaging remarks. Authors should be accorded the same respect reviewers would want for themselves.


    Conflict of interest. AFP’s medical editors and members of their immediate family are prohibited from having any financial relationships with makers of drugs or medical devices or similar commercial entity. Commercial entities include pharmaceutical companies, medical education companies, or other entities producing, marketing, re-selling, or distributing health care goods or services to patients or health care professionals. AFP’s medical editors complete a conflict of interest disclosure form annually, which is reviewed by AFP’s editor-in-chief and director of Journal Media (publisher).

    Editorial independence. AFP’s medical editors have editorial independence from the American Academy of Family Physicians and have complete editorial authority to accept or reject manuscripts and set editorial policy and procedures.

    Editorial oversight. AFP’s medical editors are responsible for implementing the journal’s editorial policies, especially those related to editorial misconduct. Potential infractions should be dealt with in a timely, fair, and transparent manner (i.e., adhering to AFP’s written policies and procedures on editorial misconduct).

    Advertising. In general, AFP’s medical editors are not involved in the review, oversight, or approval of FDA-approved drugs, tests, or medical devices. However, to ensure that advertising for non-FDA-approved products are not egregiously misleading, AFP’s medical editors will review and approve ads for nutritional supplements and other substances and devices with health claims: AFP Advertising Policy for Nutritional Supplements, Foods, Food Additives, and Other Substances and Devices with Health Claims

    They will also review and approve so-called advertorials (i.e., an ad that presents content in an editorial-like manner) to avoid misleading readers and to clearly distinguish between ads and journal content: AFP Editors' Advertorial Principles, Policies, and Procedures.

    PUBLISHER (Director of Journal Media)

    AFP’s publisher will help ensure the editorial independence of AFP from its supporting organization, the American Academy of Family Physicians. 

    AFP’s publisher will assist the editor-in-chief (EIC) in dealing with cases of editorial misconduct that involve other publishers (e.g., cases of plagiarism involving unauthorized publication of an AFP article in another journal under a different author’s name). 

    AFP’s publisher will help ensure the absence of financial conflict of interest on the part of the EIC. (The EIC will oversee conflict of interest disclosures by other medical editors.)

    AFP’s publisher will assist the EIC in their oversight role involving advertorials and advertising for supplements and other non-FDA-approved substances and devices with health claims.