JAMA editor discusses misinformation and different perspectives


What in your career and personal life attracted you to the editor-in-chief position?

I’m a general internist, and I’ve been a professor at the University of California, San Francisco in the department of medicine and the department of epidemiology and biostatistics. I’ve been doing that most of my professional life.

I have long sought to be published in JAMA, but really hadn’t had any experience working on the other side as an editor. But I have come to appreciate the importance of how we communicate about our science, and how doing that well can have an influence on how we practice medicine, how we design health policy and how we influence public health. It’s an extraordinary time to think about communication, and I feel really honored to have this role.

You replace Dr. Howard Bauchner, who stepped down in 2021 after JAMA aired a podcast and posted a tweet questioning the existence of structural racism in medicine. How do you plan to address what many say is structural racism embedded within scientific journals?

Every institution in our society, and certainly all our institutions in science and medicine, have started to reckon with the fact that these deeply ingrained biases affect the conduct of science, affect the care we provide to our patients, affect a lot of things.

The issues that JAMA faced are not specific to JAMA. These are true across scientific publishing. They are things we struggle with in academic institutions, and certainly in the conduct of healthcare.

The opportunity to think with real deliberation about how we structure our editorial boards, who works for us, who are part of our reviewers, who we ask for opinion pieces from, who sits on our editorial boards, is really critical. Who’s in the room matters. Who’s making a decision matters. What we want to be doing is making sure that we always attract the best science, always have the right voices, that reflect the breadth of views on important issues in science and medicine.

Are there any changes you’ve made that highlight new or different voices that you’re exceptionally proud of?

We host a big Peer Review Congress every four years, bringing together scientific journals from around the world. One of the most exciting talks there was how we collect data about the demographics of who makes up editorial boards and peer reviewers, so that we can ensure over time that we’re really reaching our goals to be an inclusive and equitable environment in scientific publishing. We look forward to continuing to work on that.

Across JAMA and the JAMA Network, we have hired deputy editors in all our journals who have a specific focus on and expertise in areas of equity, diversity and inclusion. It’s great to see them coming together to think about how to continue to shape our journal.

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How can journals work to build trust with their audience amid misinformation among patients and consumers?

We’re proud of what we publish in JAMA. Across the network, we publish explainer videos to try to reach lay audiences. But [targeting] the strains of sources of misinformation, and more targeted sources of deliberate disinformation, really is challenging.

We’re constantly being bombarded with information from places that we trust, but also from a lot of other places. It’s critical to sort through it to understand, “Well, how should I, as a patient, how should I, as a clinician, make a decision?” Especially because there are so many sources of misinformation, and then a few strains of very deliberate focuses of disinformation.

In the pandemic, these issues that have always been there became magnified, and oftentimes more highly polarized.

Our job as a journal is to make sure that we have high integrity in our process for deciding what science to publish, but then to also think about all the ways we can disseminate our findings and influence as broad an audience as possible.

One thing I’ve learned over the years is that you’re never just communicating to the group you think is your core audience. You’re always communicating to a much broader audience. Keeping that in mind is critical.

You’ll see us continuing to communicate to a broad audience, including patients, a lay audience, policymakers and the general public, but you’ll see us doing it in a way that recognizes there are other, oftentimes competing sources, and sometimes deliberate sources of disinformation. We’ll probably be amplifying our voice a little bit louder than we have in the past.



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