Musings of the editor in the last print issue of Paediatrics & Child Health

I am a proud member of the University of Alberta Medicine Class of 1983. My favourite parts of medicine have not changed in the 41 years since our graduation. Medicine provides ample opportunities for interesting conversations with a tremendous variety of people from all walks of life. I love getting to piece together the clues that lead to a diagnosis. Like when one reflects back on an Agatha Christie novel (or an episode featuring my favourite television detective Peter Falk as ‘Columbo’), I often could have derived the answer sooner had I attributed the correct weight to each potential clue.

Some things in medicine are far better than they were 41 years ago. All physicians have ready access to the fruits of medical research including high-quality systematic reviews, leading to evidence-based guidelines. As much as Artificial Intelligence will not replace me yet, I am impressed with the ability of ChatGPT to derive a differential diagnosis for some of my difficult cases. Electronic medical records prevent the need to search aimlessly on the ward to find a patient’s chart and their Search function saves me time trying to figure out where the results of the tuberculosis skin test actually got recorded in the chart. However, I long for the days of concise progress notes when ‘Copy and paste’ was not an option.

There have been losses along the way:

1. Social interaction with those who I work with is not quite like it was before the pandemic. People work from home more and it’s not as easy as it once was to round up colleagues for a quick lunch.

2. Interacting with children can be more challenging than in the past. They are generally displeased if one interrupts their video game to ask a question.

3. Journals (including Paediatrics & Child Health) are moving towards online publication only. In a somewhat obsessive-compulsive fashion, I have read my favourite journals on a treadmill, on airplanes, and on car trips. Sure, I could still print the online version of a journal, use a hole punch, and put the pages in a Duotang, but that’s not the same as receiving a glossy journal in the mail. Not many years ago, I had let a journal subscription lapse. I read the latest issue online and then renewed the subscription. I got the print version of the issue that I read online in the mail shortly thereafter. It was striking how many things of interest to me I had missed in the online version, having not opened all the abstracts and not been able to readily flip through the pages to look at the figures and tables.

Now it is time to cease grumbling about it and list the advantages of the upcoming online-only format for Paediatrics & Child Health:

1. Moving online will save us printing 3.5 million pages annually. We can pretend that the majority of those pages got read and recycled, but we all know that is not true.

2. The price of printing and mailing journals has outpaced inflation. Moving online means lower costs for subscriptions, including those that the Canadian Paediatric Society (CPS) purchases for its members.

3. Once manuscripts are accepted, they will be published online as soon as they are ready and are likely to appear in an online issue within 1 to 3 months. In recent times, it sometimes took up to 1 year for that to happen in print. That benefits both readers and authors.

4. Statistical analysis in medical publications has become increasingly sophisticated over the years. We will be able to incorporate more figures and larger tables, as well as multimedia like audio and video, into the main manuscript.

5. Our page limit will no longer be strict. The page limit in the print version meant that we had to sacrifice another manuscript to publish a long one. I am a firm believer that authors prefer concise manuscripts, hence our word limit of 2500 words. However, in the future, we will have some flexibility if an author convinces us that they could improve their manuscript if allowed more words. This especially applies to qualitative studies.

6. We will be able to publish colour photographs and figures at no charge to the authors.

Of note, over one-quarter of readers already receive only the online version by request.

All CPS members already have access to the journal online, using their CPS login details. Our Canadian and international readership can also continue to access the online journal through their institutional or personal subscriptions.

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Now I just need to figure out how to download the online version of Paediatrics & Child Health onto a tablet to read on my treadmill.