A Few Final Words


Stephen Tarnoff, MD

Perm J 2022;26:22.997 • E-pub: 04/05/2022 • https://doi.org/10.7812/TPP/22.997

Author Affiliations
Stephen Tarnoff, MD
Previous Editor-in-Chief
The Permanente Journal

Copyright Information
© 2022 The Permanente Federation. All rights reserved.

In early spring of 2020, I was asked to serve as the interim editor-in-chief for The Permanente Journal (TPJ) during a time of evaluation of its mission and future direction. My professional life has been devoted to caring for patients within an integrated, organized system of care. Having just stepped down from a series of leadership roles that focused on supporting continuous quality improvement, a better care experience for patients, and the efficient and appropriate use of medical resources, I welcomed the opportunity to continue my professional passion through the pages of this journal.

My charge was straightforward: maintain our valued Medline indexing status and the high reputation of the journal while the reimagining work unfolded. During my tenure, with the assistance of my editorial and managerial colleagues and staff, we worked to lay the groundwork for the forthcoming revitalization.

We reinforced the scientific integrity of TPJ through more discerning acceptance criteria; narrowed the concept scope of our manuscripts; reorganized and expanded our editorial board to be more diverse in terms of geography, clinical and scientific background, age, race, and ethnicity; and refined the editorial processes to better reflect best practices in scholarly publishing. Knowing I played a role in supporting the journal and, hopefully, making some incremental improvements during this challenging transitional period is a source of great satisfaction for me.

I had a lot of help. Because I had little background in running a scholarly journal and my transition time was short, my learning curve was extremely steep. I was fortunate to have many talented individuals assist and support me in the work. I give recognition and thanks to Monica Leigh, our former senior managing editor. Her team from KWF Editorial have been superb partners. Monica is a patient teacher, wise counselor, and first-class editor. My senior and associate editors, despite demanding clinical and administrative responsibilities, worked tirelessly to uphold the integrity and the intellectual rigor of TPJ. Manuscript submissions to the journal remain strong. In 2021, we published 122 articles and showcased an impressive 35 days’ average time to first editorial decision. I thank them wholeheartedly for their support and encouragement.

We all owe a collective debt of gratitude to our many peer reviewers. Reviewing requires deep expertise, a precious investment of time, and a commitment to the scientific process. Without our peer reviewers, trust in academic publishing would be undermined. The names of our devoted peer reviewers are published in this issue as a recognition and thanks for the important service they provide.

Behind the scenes, a capable and proficient Steering Committee met regularly to help shape TPJ’s path forward. Their work resulted in TPJ’s new aims and scope as well as other exciting new developments, including a new website that will launch later this year. The committee reaffirmed that TPJ will continue to publish open access, at no cost to authors or funding agencies, eliminating what many authors cite as the most challenging obstacle to participation in scholarly activities.

Finally, and most profoundly, during my tenure, 2 separate and wholly unanticipated events impacted the content and direction of this journal. Both served to underscore and further convince me of TPJ’s tremendous potential and why it will be an important and relevant journal in the years ahead.

The month I started, the COVID-19 pandemic fully broke with all its attendant trauma, pain, and disruption to our communities, our economy, and our personal and professional lives. Less than 3 months later, the murder of George Floyd generated an outpouring of grief, anger, and rage over the enduring harm and damage caused by hundreds of years of persistent, unexamined, and unacknowledged systemic racism. Both events will undoubtably continue to impact our national life for years to come.

For those of us involved with health care, the effects of these events will be especially profound. The global pandemic and the acknowledgment of the impact of systemic racism have rightly and necessarily ushered in a new era of reckoning for health care. They have stripped away so many illusions and clearly exposed the terrible inequities imposed upon people and communities by what we used to more benignly refer to as the “social determinants of health.”

The health care community is hungry for answers on how to address these issues and is looking for new ideas, new approaches, and new solutions. This is the “sweet spot” for TPJ. Grounded in the principles and values of Permanente Medicine and other like-minded integrated systems, its contributors have a longstanding commitment to high-quality, equitable, and affordable care for all. The Permanente Journal, moving forward, intends to be a premier publication for content related to health care delivery science; value-based and high-value care; clinical and applied research; and manuscripts on equity, inclusion, diversity, and health care disparities. It will be a journal that well-intentioned leaders, researchers, and clinicians turn to for the latest learnings in these critical areas.

After an extensive national search, Dr. G. Richard Holt has been selected as my successor. As I pass the torch and welcome him as TPJ’s next editor-in-chief, I am truly excited by what lies ahead for the journal. I welcome you to share your thoughts and feedback by writing to tpj@kp.org.


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