A Curtain Call for JFP

The Journal of Family Practice (JFP) is no more. Its publisher ended publication in November 2023, 6 months before it would have celebrated 50 years as an academic publication. At the time of its first issue, JFP was the only indexed family medicine journal publishing original research in the United States. Its initial goal was to become the journal of record—capturing the history, philosophy and research of the newborn discipline of family medicine. ^{1, 2}

Journals have origins and histories often unknown to readers, but which have major implications for their longevity. In 2021, the National Library of Medicine reviewed over 600 journals for PubMed Central each year, of which 25% pass scientific evaluation and over 350 for MEDLINE, of which only 14% pass scientific review. At this point in history, most new journals are online only and use open access, pay-to-publish financial models rather than subscriptions. New journals that are sponsored and published by legitimate academic organizations are generally higher quality and have a greater likelihood of surviving in a competitive environment.

Fifty years ago, academic family medicine was too new and its institutions too small to realistically consider sponsorship of a journal. A well-intentioned commercial publisher provided JFP free to family physicians nationally but also tied the journal’s fate to the financial success of advertising. That JFP assembled high quality work from energetic researchers was a tribute to the vision, energy, and dedication of Dr John Geyman, who was the founding editor of JFP. A superior group of editorial board members guided publication of research on topics that still are the source of much of the literature in the discipline and philosophical and intellectual articles by some of the most important writers and researchers in the first 20 years of family medicine’s existence. That the journal continued to publish after shifting from a primary research journal to a quality review journal, and managed to survive as long as it did is a tribute to the integrity and hard work of the many distinguished academic editors over its history. JFP remained successful almost despite the constraints placed on it. ³

JFP was one of the principal reasons that family physicians, who were unused to reading primary sources of clinical research, began to change both by reading and contributing to the scholarship of a new field. The editors believed that research about what family doctors did as well as why and how they did it was critical to education as well as clinical practice. McWhinney had written in Lancet about four criteria for family medicine to be considered an academic discipline. Two of those criteria—a defined body of knowledge and an active area of research ⁴—were immature in the United States. JFP helped change that.

At the outset of the discipline in 1969, there were no large studies of what family physicians actually did upon which to base an educational curriculum. Without that information, family medicine educators let specialties decide what should be taught to residents. That began to change when, in 1976, Marsland, Wood, and Mayo published a statewide study in JFP of over 525,000 patient encounters that established the first parameters for a residency curriculum based on what family physicians did and communities and patients needed.⁵ The research questions their study stimulated continue to be explored today. ⁶

For journals to make their history and their published work accessible to researchers and authors, they have to use National Library of Medicine resources. JFP never formatted its published work so that it could be searched for full text articles in PubMed Central. However, the vision of Green and Puffer secured resources from the American Board of Family Medicine Foundation to work with the publisher to create an archive of the articles from JFP. ^{7, 8}

While the number of published journals worldwide continues to grow, those focusing on primary care and family medicine remain comparatively limited. The wide variety of interests by researchers in family medicine assures that authors will find many venues for their work.⁹ But specialty-focused primary care journals are still necessary to have a starting place for ideas and a forum for conversations and controversies that mark a mature academic discipline.

For those who were present in the early days of family medicine, when generalists were dismissed as uninvited intruders into academia, JFP represented the triumph of hope over discouragement. The founding editorial board of JFP supported the belief by the group of young practicing generalists that they could create a new discipline, unintimidated by older and “wiser” academic advisers who counseled that it could not be done. They did it, nevertheless. JFP was one of the first assurances that family medicine would have a place in the debate about how education and the practice of medicine needed to change. For 49^1/2 years, the beneficiaries of that commitment were patients, learners, colleagues and communities.

Thank you, JFP. You will be missed.