Medical Journals: Eye on the Scoop : Medicine: Critics of the scientific journals see a growing preoccupation with grabbing the attention of the mainstream media.

Old-fashioned newspaper warfare broke out last week in the sedate sanctums of biomedical research when one of the country’s top medical journals abruptly upped its publication date in hopes of upstaging its nemesis, the New England Journal of Medicine.

The decision of the Journal of the American Medical Assn. (JAMA) to switch its weekly release date to the day before that of the New England Journal reflects what critics believe is some journals’ growing preoccupation with grabbing the attention of the mainstream media.

After all, newspapers, magazines, television and radio offer the journals not only a pipeline to a public with a seemingly insatiable appetite for health news, but also a source of prestige for the journals and for scientists interested in fame as well as funding.

“It is part and parcel of the American interest in celebrity,” observed Daniel S. Greenberg, editor and publisher of Science & Government Report, an independent newsletter on science policy published in Washington.

“An editor of a journal thinks, ‘It’s great that I edit such an important publication that the New York Times stands up and salutes when we publish something,’ ” said Greenberg. “I think it’s part of the quest for glory.”

There are, some suggest, more significant pitfalls.

“The risk if one seeks publicity too competitively and too aggressively is that this consideration . . . overrides more sober scientific judgment,” said Dr. Arnold Relman, editor of the New England Journal.

“If that should happen, that would be a disservice to the public and profession.”

The New England Journal and JAMA are among the best known of hundreds of medical journals that serve as an international forum for new research findings. Each week, reporters comb them for breakthroughs and revelations that they might reweave into stories.

JAMA, published by the American Medical Assn., claims by far the largest circulation--660,000 worldwide. But the New England Journal, published by the Massachusetts Medical Society and claiming 230,000 circulation, has greater cachet among academic researchers.

Those journals and others, such as Cell and the Lancet, are so-called peer-reviewed publications. That is, all submissions must be reviewed by outside researchers familiar with the subject for scientific merit and method before they can appear.

Last week, in its nine-page weekly packet to the press, JAMA said it was switching its publication date for only the third time in its 107-year history. Beginning in April, the journal will come out Wednesday instead of Friday. The New England Journal comes out on Thursday.

Dr. George D. Lundberg, editor of JAMA, said the journal hopes the new release date will encourage reporters to prepare not one but several stories on new research. A Wednesday release leaves time for breaking news stories as well as analytical weekend spinoffs.

Furthermore, Lundberg said in an interview, he wants JAMA poised to be the first journal to publish new findings--in particular in situations in which JAMA and “the journal you named” plan to publish papers on similar subjects during the same week.

“We would like under those circumstances for the authors of our papers to have a temporal precedent by publication date,” said Lundberg, a former professor of pathology at UC Davis and USC.

Asked why, Lundberg replied, “We think it’s nicer to be first.”

Relman, of the New England Journal, was similarly terse.

“I don’t think it’s a service to the profession or the public,” he said of the JAMA decision. “It’s obviously done for purely competitive reasons. That’s his privilege. It’s a free country. If he thinks it would help his journal, that’s fine.”

JAMA’s move comes at a time when more and more journals are supplying reporters with free or advance copies, and mailing out press releases and “tip sheets” translating into English from “medical-ese” the hottest research of the upcoming issue.

Many journals hire clipping services to monitor coverage in newspapers, magazines and broadcast media nationwide. Relman, whose New England Journal shuns press releases, allowed as how “we have always had more coverage than anyone else.”

“I certainly think the journals are much more interested in the media for a number of reasons, good and bad,” said Dr. Robert H. Fletcher, a former editor of the Journal of General Internal Medicine and incoming co-editor of the Annals of Internal Medicine.

The good reasons include a recognition of the role the public plays in shaping medical care, Fletcher and others said. In addition, scientists have an interest in making known their work--and a duty to do so--when they rely heavily on public funds.

The more questionable reasons include what Fletcher called “a competition among journals for the best articles or the most attention,” stemming partly from a desire by journal editors and sponsoring medical societies “to have their journal considered prestigious.”

“If there’s an article or journal quoted over and over and over again, I think it certainly may help the number of (research papers) that are submitted,” said Nancy Collins, director of marketing for Williams & Wilkins, which publishes 80 journals.

“I think it may be very subtle,” Collins added. “If physicians are reading all these journals and seeing these journals quoted all the time, do they feel they’re missing out? Shouldn’t they be subscribing?”

But courting the media has risks, some suggested.

Relman suggested that the danger lies in the possibility that journal editors will give sexy topics precedence over important science. Some reporters said they thought newspaper headlines have already become an important consideration at journals, including Relman’s.

“I think there’s a danger of it,” said Lundberg of JAMA. “But it’s (up to) the ability and morality of the editor, and the knowledge and wisdom of the peer reviewers, to keep the journal on an even keel.”

Will JAMA’s ploy lead to more extensive coverage? Several marketing people called it a clever move. But reporters and some editors were skeptical and insisted that the decision to cover a story is based on its merits, not the day it surfaces.

“I don’t think it’s going to increase the coverage that they get,” said Susan Okie, a physician and medical reporter for the Washington Post. “I think usually the middle of the week is heavier for news. . . . So they may be shooting themselves in the foot.”

Greenberg, however, disagreed.

“I think the essence is that the editors of the journals have learned brilliantly how to manipulate the science press,” he said. “And the science press plays the game with them. That’s their raw material.”