Episode Transcript
[00:00:03] Speaker A: Welcome to the Ortho Joe Podcast, a joint production of the Journal of Bone and Joint Surgery and Ortho Evidence.
Join hosts Mohit Bhandari and Mark Swankowski as they discuss current topics and publications in the world of orthopedics and beyond.
Well, hello, Mo. Hello. Where are you?
[00:00:22] Speaker B: I am in Canada and enjoying a little bit of the sun. I understood that Boston has had a little more snow than us, so I feel a little privileged right now. Now and with little afternoon, little afternoon cafe.
[00:00:37] Speaker A: Well, I'm, I'm coming to you from the Trio Orthopedic center, having just finished a fat, rather robust morning clinic and just ran in here, so I have no coffee and desperately need some.
[00:00:51] Speaker C: So.
[00:00:53] Speaker A: But it's a beautiful sunny day here and we're headed towards above 20 degrees, which is, uh, which is good news. Very good.
You and I discussed some time ago that we'd really like to get our two predecessors on the line and talk about their times of reign. And today we're privileged to have Dr. Vern Tolo, who held the reigns for four to five years. And I, I believe that the starting date was roughly 2010 to 2014, thereabouts, something like that. But Vern is a renowned pediatric orthopedic surgeon, past president of the American Academy of Orthopedic Surgery, was, I would say, a major influence on the field of orthopedics in terms of diversifying our field, particularly in leadership and in program development. And Vern deserves a lot of credit for being ahead of the curve and challenging us to change as a profession.
So I had the privilege of working for Vern as a deputy editor, and he is just the most wise and thoughtful gentleman that one can ever work for. And it's my pleasure, and I know yours as well, Mo, and soon to be our listeners. Just chat with Vernon.
So Vern is in la. He actually doesn't talk much about it, but he's from the Dakotas and got really smart. He was on the faculty at Hopkins and then moved out to LA Children's many decades ago and continues to serve at LA Children's and Vern. So let's just start with what were the discussions like when the board decided to not have an orthopedic surgeon do both the editorial role and the CEO role. How did this, all this change come about?
[00:03:00] Speaker C: Well, I think it was some of the pressures from the business aspect of the journal. I happened to be a deputy editor for Pediatrics, but I also was on the board at that time of jbjs. And so I did have some intimate knowledge of the discussions that were going on. And I think it was. Felt that it was time to have a person who is really the big role as it would be as a CEO, who was trained to run a business and to work in the area of the journal, to develop it into a little larger element than simply having this, the one flagship journal.
[00:03:41] Speaker A: Yeah, so. So I think the. The trustees split the job in two as the editor in chief and. And then was this simultaneous, these two searches that went on?
[00:03:51] Speaker C: It was simultaneous.
Wow. We both can't. Anderson, who became the CEO and myself began pretty much within weeks of each other. The search for the editor in chief had actually dragged on for quite a bit of time. I was. I was not the first choice, and it didn't bother me too much because I've told my wife I wasn't even the first choice for her, probably, but it subsequently worked out really well.
[00:04:18] Speaker A: Yeah, that must have been quite difficult because all the editors before you had moved to Boston or the Boston area, and with the new structure, the decision was made that that wasn't going to be practical or possible. So you were in LA and the job was all the way across the country. How did you manage that?
[00:04:41] Speaker C: Vern would be flying to Boston about 15 times a year. And it actually worked out fine because you hop on a plane at LAX and take five, six hours, whatever it is, pull out your computer and do editing the whole way. It's like being in your office. So I didn't mind the flights at all, and I was not about to move to Boston, I have to say. My wife didn't want to move to Boston, so it actually worked out well. And. And, you know, with the electronics now and the technology, it's. From my standpoint, it worked well. I thought it was necessary to spend at least some time at the office. So I usually would spend about two days every. Every month there, and then sometimes a little bit more, just so I got to know the people who work there. There's a great group of employees who are very dedicated, and just to get to know them better was very important for me in Face to Face Matter.
[00:05:42] Speaker B: Do you remember Vern, like, sort of like in that first month that, you know, the first 90 days, and, you know, what were you thinking? Because, you know, it sounds like there was a complete structural change in the way JBGs, you know, ran.
There's getting to know. Getting to know a new CEO, getting to know your role within that, and probably, I'm guessing, some changes that you may have wanted to make or things you wanted to really highlight. How did those first early days look for you?
[00:06:09] Speaker C: Well, I guess the first early days was just for me to educate myself in the world of publishing. Even though I had been deputy editor, I was far away from the nuts and bolts of publishing a journal. And so I spent the first few months educating myself more than trying to make any changes right away, just to see what the area was about and to see what opportunities we had. I became actually really intrigued with the whole different process of publishing and sort of amazed when I first got to the JBJS office and realized that there were probably about 40 employees. So it was a large operation and many of these were sort of behind the scenes. As a deputy editor, you didn't really realize exactly how. How much good work that they did. So the first part was more for me, education.
[00:06:59] Speaker A: Right. And you know that. And I think the reason why the trustees split the job in two is because of the rapid changes in scholarly publication with the questions about open access, new platforms to manage the editorial process, etc. Etc. And they identified Kent, who I believe came from the New England Journal of Medicine and had worked there for many years and in a sort of a senior level. But you know that that whole thing is. It's a. It's a different world than we. We in orthopedic surgery live in. And tell us a little bit more about how the education process went about that world that you had to not manage exactly, but you had to understand it. How. How did the education go?
[00:07:48] Speaker C: Well, I think the education for me was just to talk to all the different employees at jbjs. I met with everybody there and tried to figure out what their roles were and how they were doing them, which helped me a huge amount.
One of the things that early on that we were looking for, as you know, the journal expanded into a variety of different publications, which at one point we just had the one journal. But Kent felt strongly that we needed to amplify that to the other journals in order to.
To be competitive.
So we actually met with some of the editors of other journals. I remember one in particular, the editor of Circulation, who had a whole family of journals that they published, didn't. To help educate us, to see about how we could go about splitting it up into a variety of different journals to have a broader impacts.
So that took a period of time to figure out what they are. And there were some false starts. Like, Mark, you know, you were involved with one of the trauma newsletters type of things, and there were Some things that didn't go the way we exactly hoped that they would go. But in general it worked out okay to have the numerous publications available for our membership or our readership.
[00:09:11] Speaker A: What were the sister journals that you started during your term, Vern?
[00:09:15] Speaker C: Well, it was the. We'd always had reviews as part of the main journal, but JBJS reviews, JBJS case connector. The whole point of the case connector was to try to identify rare cases that people could get together and see three or four to see how it could be handled if they had a similar case.
We got Ed to do the JBJS surgical techniques, which he's continuing to be involved with.
And then a little bit later the, well, I think those were the main ones and open access came slowly later. But there was a lot of, a lot of discussion about open access during the years I was there and it became to fruition more during the years you were there. But the open access conversation started pretty
[00:10:08] Speaker A: early and it, and is still, still ongoing to a, to a very, very, very heavy degree, that's for sure.
[00:10:18] Speaker B: Were there ever times, Vern, where okay, so you're launching, you know, you're going from the flagship journal making up, you know, it's a pretty, pretty important decision to say we're going to add other, we're going to improve or increase the family of journals. But there ever a time when you launched a journal early on and there was like a sentiment to say okay, you know, maybe, maybe we shouldn't, maybe we shouldn't launch more or, or you know, every journal goes through an evolution, I imagine and I imagine JBGS reviews early on or case connector early on, there may have been mixed reviews until it kind of took off like now we know retrospectively looking back, you know, it was a pretty big success.
But in the early phase, did it feel like that?
[00:10:58] Speaker C: I think the one that was a little bit harder to get going was the surgical techniques. But Ed really stuck with it and has made it a good success.
The other ones seemed to go okay, just was gradually going up. But I think we'd had so many manuscripts, I think the peak year we had about 2,700 manuscripts for the flagship journal. And so it appeared that there should be plenty of information available to split off into these other journals. And then Kent's idea also was to go to twice a month for the journal, which allowed us to not to load up one big one journal with double the articles that actually I think worked out to be pretty well, pretty well received. The thing that did not was not very well received initially was the submission price, and I think that still may be an issue.
But the reason that that was done was primarily to try to decrease the number of level four studies which we had suspicions that people were submitting just to get excellent reviews. And then even if they got rejected, they, they could buff up their paper and allow it to get published somewhere else. And I think it did have that impact. And I'm a little surprised other journals haven't gone to that model very much. I talked recently with one of the cardiac surgeons who said that they had been considering it.
And I don't know outside our field if other people have, but I think for us it worked well.
[00:12:35] Speaker A: Well, Vern, you've had a lot of big jobs in our field, and I know for each one of them you've probably got one thing you're most proud of.
So what would you say that that would be for your term as editor of the Journal of Bone and Joint Surgery?
[00:12:52] Speaker C: Well, that is a really hard question for me because, I mean, the Journal is so special for me that I think that it's really important. I was under presidential line at the Academy when it became a member benefit, and then I was editor when it did not no longer became a benefit.
So I was sort of unhappy about that. I think the fact that we were able to expand to these multiple journals to give us a little broader footprint in the publishing world, I think is probably the, the highlight for me. But just being able to try to preserve the quality of, of the journal and to do what was ever possible, to make it as good as it could be, was something I'll be proud of.
And the ability to work with the team, there was something that I'll always remember as well. They were such dedicated people that I love to work with and make the place a special place.
[00:13:53] Speaker A: Amen to that. I think Mo and I both have really understood to the depth of commitment to the mission of the journal to actually impact and improve patient care, as is very apparent when you watch people do their jobs around the Journal.
And there are 30 some odd. Now, I don't know the exact title total, but it probably would be mid-30s employees led by Jason Miller and Betsy Biller and Christina Nelson, who you've known for a long, long time. And these folks are really great leaders and work, work and promote a great team in Boston.
Mo, you got got a last question for.
[00:14:37] Speaker B: Yeah, I do, I do. And again, I actually genuinely, I think I might know how you might answer this because I, I feel we're probably aligned on this one, but maybe I'm not. But so this might be interesting for me to hear from you and our listeners is as you see, what's happening to publishing, Vern, I mean, you know, it's been. I mean, there's been dramatic transitions happening in the world of publishing, often in relation to our readership is changing, our readership's access to information is changing. And we're seeing many journals think about going, leaving the print, going to online only, and we're seeing that transition happening rapidly.
What are your thoughts in general about where publishing is going and particularly, you know, elements of print versus, you know, just online only and the shorter snippets of time, people are really focusing and we're fighting for that attention.
[00:15:32] Speaker C: I love the printed journal, but I'm an old person.
I think that's what we're used to.
Certainly the online versions have become very popular among younger colleagues that I still have some association with.
I think that the speed of publication with the online version is a benefit that the printed journal has difficulty dealing with.
At least years ago, when I was involved, that was always a timed thing to publication. I think it still is. I was looking at your report just from today, and I think it's still six months or more before it gets published from the time it gets submitted. So I think that the timely publication with online things is going to continue to be an issue.
I hope the printed journal survives, but with the ad revenue down and costs, economics is going to be the deciding factor in the long run. But what you've done with it, to revive the covers and the approach to the different articles that you've done, I think is probably the best way to try to deal with this, to make it a much more attractive journal and try to make it more varied. And the fact that they can get this information now in print in a way that's more difficult to get online.
So hopefully it stays in there.
[00:16:52] Speaker B: Yeah, I mean, I must say there's something. I don't know, Mark, if you feel this way, and I'll stop here after this, but having something in your hand and reading it, whether it's on a plane or in a shop or anywhere you are, it's really. It's hard. No machine can replace that feeling, at least for those of us who have grown up with it. So I'm fully, fully committed to doing everything I can to fight, to fight as long as we can, the good fight of keeping print in play for many of our.
Of our readers. Actually, I think around the world who really enjoy that.
[00:17:22] Speaker C: Well, you've done a great job in starting that right now with the new changes.
[00:17:27] Speaker A: I agree completely. One thing you might think about Mo is I don't know when the last time we did a, an eight years in practice based survey. With the last data that I saw that our readers under the age of 40, it was still 58 to 60% prefer the print and particularly the trainees, because the feedback we got was you can put the journal in your coat pocket or in your backpack and you can pull it out faster than you can load the app or go to the webpage. And I don't know if that's still the case, but that's something we definitely need to continue to pay attention to.
Certainly the changes you have made make it way more interesting and the range of topics discussed is quite broad and that's all good.
[00:18:19] Speaker B: You're absolutely right. You know, the challenge I think we're gonna, all of us are facing, the publishing world is facing is access to information. Used to be, well, you know, you know, it went from, you know, I'll read the, to read something and then I want it at my fingertips, which is I want the whole paper on my fingertips. And now it's almost like I just want the answer. So you'll type it into a chatbot of your particular interest and you just want the answer. Now the goal is, is where's that answer coming from and where is the data? But I think that is kind of, and the interesting part is, is, I mean, all of us, every journal, every publishing is going to have to evolve to where the future is taking us. I'm hopeful though, that in an age of machines that the greatest value asset will still be, you know, being human will still be the most valuable asset we have.
And I continue to believe that. So that that's where I'm going to stick cards and being human as much
[00:19:12] Speaker A: as we possibly can, that's a great position. I think we agree with that. And Vern, it's been great chatting with you and congratulations on your myriad contributions as a leader in the pediatric orthopedic community and at Children's of la and all of the thousands of patients you've treated and hundreds, if not thousands of surgeons you've trained and the contributions you made to the journal. And you were a great editor to work with and I always enjoyed our conversations and our collaborations and congratulations on all of that that you've accomplished.
[00:19:52] Speaker B: Absolutely.
[00:19:52] Speaker C: Thank you very much. And I enjoyed my time there tremendously. And I know that both you Mark, and you both are doing a wonderful job.
Proud to see how well the Journal is doing.
[00:20:02] Speaker A: Amen.
[00:20:03] Speaker C: Great.
[00:20:04] Speaker B: Thank you so much for everything.
[00:20:05] Speaker A: All right, Have a great day.
[00:20:06] Speaker C: Take care.
[00:20:07] Speaker B: Take care.
