From the (new) editor's desk

This issue marks the beginning of the journal's 25th year of publication. It is also the first under the guidance of a new editor. Such occasions give good reason for reflection. Volume 1, which included a modest two issues, debuted in August of 1995. The journal would quickly grow to publish four and then, within a decade, six issues each year. While the focus was on health services research, the journal made an immediate impact with its thematic issue on evidence-based medicine (EBM). The thematic presented critical dialogue on EBM, in stark contrast to the enthusiasm that followed the shift to a “new paradigm” for clinical practice that occurred just a few years prior. The EBM thematic would become an annual event and would later prove to be one of the few spaces in the published literature where open debate and criticism of EBM could exist. As the contributions to this debate increased, the journal later introduced the annual Philosophy of Medicine thematic in 2010 as a means to open more space for critical examination of both the evidence needs of practicing clinicians and healthcare stakeholders, and how that evidence is generated. The Philosophy thematic now tackles a diversity of themes related to our notions of evidence, health, healthcare provision, and clinical practice in the rapidly growing Philosophy of Medicine discipline. In the meantime, the journal would continue to publish health services studies from scholars around the world and in doing so, distinguishing itself as one of the few truly international repositories of research on that topic. The editorial decisions supporting the journal's development over the past quarter century were guided by the founding (and until now, its only) Editor-in-Chief, Professor Andrew Miles. In that time, Professor Miles gathered a diverse group of highly respected academic minds to serve as members of the Editorial Board. That group included representation from several disciplines in clinical medicine, health sciences social sciences, and the humanities - an acknowledgment that issues of health and healthcare services are not the unique domain of a single discipline and that our approach to many problems in healthcare can benefit from (or may even require) a diversity of methods or lines of inquiry. Under Professor Miles' leadership, the journal became widely recognized as a forum for scholars outside clinical medicine to engage with clinical audiences, testament to both the editor's willingness to publish works using methods or styles of academic discourse not normally seen in clinical journals and his proclivity to nurture debate. That such a modest Health Services oriented journal was able to attract contributions from top scholars in “non-clinical medicine” fields speaks to a recognition by the wider academic community of the importance of the journal's mission. I would like to extend my gratitude to Professor Miles for his contribution to building the journal over the past 25 years and his recognition for the value of debate in moving the science of clinical care forward. When it was announced that I would be taking on the role as the new Editor-in-Chief, several people expressed how important Professor Miles and the journal were in helping them advance their (what was considered at the time) more controversial works and ideas, something to which I can relate. In the previous paragraph, I made mention of the journal's mission. What exactly was that mission? According to the journal's “Aims and Scope” the stated mission is to “promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions.” A review of the journal's history (and what has been published) would suggest there was more to that mission. Given the breadth of topics and geographic representation of past publications, one might surmise that the mission was to highlight what can be learned about the organization and provision of health services from studies around the world and across disciplines. A close reading of the debates on models of practice (eg, EBM and person-centred care) or the thematic issues on Philosophy of Medicine might lead one to believe that the mission was to challenge accepted or proposed models for clinical practice—or to be blunt, reveal through science and critical examination of the literature what works in clinical practice and patient care and expose nonsense for what it is. With the history behind us (as it often is), it is time that we look to the future of the journal. This year, we will follow the tradition of presenting both the EBM and Philosophy of Medicine Thematic Issues. It is a goal of mine to not restrict such content only to the thematic issues but to make Philosophy of Medicine papers and critical examinations of EBM (and other models of practice) a regular part of the journal, perhaps through a special section in each issue. The journal has a tradition of success in such a model, as evidenced by the popular Complexity Forum. This does not mean doing away with these thematic issues, as such are popular with the community. On the topic of thematic issues, the journal has two new ones on the horizon. The first is focused on competency-based education (CBE)—an issue currently of great importance to the design and delivery of medical education in several jurisdictions around the world. Still in development, the second thematic will highlight the role of the humanities in clinical practice—issues of health and healthcare permeate several academic disciplines, and, as I suggested earlier, are not the unique domain of the biomedical sciences. A good scientist uses all the evidence available when generating a belief or making a decision and to ignore a body of evidence because of disciplinary lines is counterproductive to meeting patient care goals. Finally, the editorial team will work with the wider academic healthcare community in identifying how the journal can meet their needs. It is with great humility that I take on the role of Editor-in-Chief for the Journal of Evaluation in Clinical Practice. In that role, I will work to ensure that well-substantiated arguments and good scientific research always have a fair opportunity for inclusion in the journal, irrespective of the perceived popularity of their position. The journal, and by that I mean its leadership, will continue to foster debate on important issues and seek contributions (through a variety of means, including editorials and commentaries) from those who can provide insight into issues pertinent to how we define healthcare goals and meet them. It is my intention to continue the tradition of promoting thoughtful dialogue, critical examination, and rigorous science.

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