Publish or Perish

For physicians, what is the purpose of publishing journal articles? When totally new ideas are involved, the peer review process is clearly important for communicating and validating scientific understandings and breakthroughs. For physicians, however, publishing often provides a very important additional function. Specifically, the process of publishing a peer-reviewed article involving patient outcomes enables a physician to examine, reflect upon and learn from a specific clinical experience. The rigid discipline involved in honestly subjecting one’s own patient outcomes to peer review provides a unique environment for improving one’s clinical practice.

At the same time, the integrity manifested by going through this process communicates to colleagues one’s clinical interest and skills in a specific subject area, and in doing so, invites new patient referrals. This notion being true, it must then be acknowledged that publishing is often a form of marketing one’s clinical skills to the broader world.

To some scientific purists, the idea of peer-reviewed publishing being an extension of marketing is crass and unseemly. Nevertheless, most physician specialists who require large referral bases know the value of publishing outcome studies in support of their practices. Moreover, I would argue that rather than being crass and unseemly, honestly communicating one’s patient outcomes is more successful and manifests more integrity than any other means of marketing a clinical practice. Is this process not a lot better than anecdote or vague notions of reputation fostered through friendship, or for that matter a highway billboard?

One of the beauties of marketing one’s skills through the publication process is that once published, patients themselves, who clearly have the most at stake in finding good medical care, can ideally access critical information. For this later point to be true, however, an article in question must be available to interested patients, which is rarely the case with traditional journal articles that are locked up behind very expensive subscriptions and paywalls. No matter, the movement towards open access journals is finally breaking down such barriers. As a result, it’s reasonable to expect many more physicians to take advantage of—and focus their marketing efforts on—publishing within the peer-reviewed literature. To my way of thinking, this is real progress!

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