ST. LOUIS — It’s been eight months since Kirsten Bibbins-Domingo, a general internist, cardiovascular researcher and epidemiologist, became the 17th editor-in-chief of the Journal of the American Medical Association and its network of journals. Bibbins-Domingo, who previously worked at UC San Francisco, was named this week as a member of the 2023 STATUS list of People Who Matter in Health and Life Sciences.
She recently spoke at the Association of Healthcare Journalists’ annual conference in St. Louis, where STAT’s Usha Lee McFarling sat down with her to learn more about the changes she’s implemented at the journal, including a new open access policy. Under this policy, most JAMA articles remain available to subscribers only, but authors can publish their manuscripts publicly the day they are published and are not charged open access fees, as many journals do. Bibbins-Domingo also talks about what’s next for JAMA.
This interview has been edited and condensed for clarity.
I’ll start by asking how things are going at JAMA and what your biggest challenges have been other than adjusting to the Chicago winter.
This is a very big change. I knew this would be a great learning experience. What I started with is figuring out the logistics and also thinking about how an organization that has been doing things in a very strong way for a very long time – we’re turning 140 this year – can change in an environment , which is rapidly changing.
What was the most important focus for you?
We ask what are the issues at the forefront of medicine, and how does JAMA stay not only current on those issues, but bring those issues to light for our readers? How do we ensure that many different voices and perspectives can be found in our pages? We ask how does this network of journals keep up with the times and truly shed light on the most important questions in medicine?
You were chosen to lead JAMA after controversy over how the journal dealt with the problem of structural racism in medicine, something that many journals face. Since then, you’ve announced a number of new staff and diversity editors at each magazine. What do these editors bring to the publishing process?
All our magazines have an editor focused on equality, diversity and inclusion issues and work in different ways. These editors are part of the editorial team that reviews the articles, but they have a particular lens or perspective that they can bring to those papers. When we have a manuscript, we want to put the science in context with an editorial, and they can play a role in the important choice of who writes those editorials. We also launch programs to attract more people to be part of our editorial teams through scholarships, and these editors have an important role in shaping these programs.
The issue of fairness to me is not that one person should hold this for the organization, but that this should be the approach that the whole organization takes. What these editors do is help to think about it. Over time, you will see these editors thinking in the journals and writing about what we in medical journals can do better in this area. You’ll see us build on the strength of 13 or 14 people who think about it.
Open access is a huge issue in scholarly publishing right now. You have called wide access a “cornerstone of transparency” that is critical to trust in science. Can you explain The new JAMA policy and how was it developed?
Scientific discoveries must be made available to the widest possible audience so that scientists can do better experiments and translate science into improvements in health. This is what the open science movement is about. As it turns out, with most things, this involves people paying for what makes that information great—magazines that vet the content and deliver it in different formats to reach readers, for example. I don’t mean to oppose open science.
So what we decided as a journal was that authors, on the day we publish their work, can make their work available to any public repository and publish it. So if you want to find the results of an article and you’re in a country or institution that doesn’t subscribe to our journals, you can still find that science because it’s available in a public repository. This decision is rooted in the principles of what is good for science and it is rooted in justice, frankly, because not all institutions and not all people have a subscription to JAMA.
This public access approach is also rooted in the principles of equality of who can publish. Open access focuses mostly on ensuring equity in what is available to read, but this is due to the sometimes very high fees authors pay to publish in open access journals. What we’re saying is that we believe in open access — and we also believe in the value of what we do. We still think people will pay to subscribe to JAMA because there is value in the final version of the record, the graphics editors who do the numbers, the podcasts, the corrections that get published, because things change over time, that is, what this subscription buys you, all these pieces.
But we cannot have open access fees that put publication out of reach for authors who may be early in their careers, or in disciplines or institutions that are not as well funded. We are really pleased that the National Institutes of Health has just announced and published for public comment that this is the approach they are considering for all funded researchers at NIH.
I’d also like to ask you about another topic that has some editors quaking in their boots: ChatGPT and other AI tools in publishing.
I have to say that there are a lot of technologies that come along and we see them as a fundamental change and an existential threat, but I see a lot of them as tools. In much of what we do as scientists, as publishers, as clinicians, we need to be able to find ways to better access information, and these are tools that seem useful. I don’t think it’s helpful to ban a tool that will fill a need, but I think we need to ask ourselves what that means for us.
Apparently ChatGPT is already author indexed in PubMed because people are already using it just weeks after it was announced. So we had to be very clear: No, ChatGPT cannot be an author. Only humans can be authors. If authors use these tools, they should tell us. That’s what we say about any tools, like statistical programs — you have to tell us if you use them. And you are responsible for them. ChatGPT may fill a niche, but it’s clearly not the domain expert we expect the authors who post with us to be. The author takes responsibility for what is posted on the page, so if this tool is used, the author ultimately takes responsibility for it.
My last question is if you can give us any idea what might be upcoming or new for JAMA. What’s new that your subscribers might see soon?
There are many problems associated with conducting science. We feel it is our responsibility to be a place where some of the controversies and great dilemmas in how science is currently conducted can be discussed. We want to have these conversations in our diary and we want to have them in person. You’ll see us holding more meetings, you’ll see us provide a forum for multiple viewpoints. Covid has shown us how great our scientific discoveries can be in terms of translating them into health, but also how they are not keeping pace. They don’t happen fast enough, they don’t happen to help me understand a problem for the patient in front of me. Now you’re seeing a lot of introspection about how science is funded, how it’s regulated, how it’s conducted, and we as a journal want to be a home for convening and having those discussions.