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J Thorac Cardiovasc Surg 2001;122:419-420
© 2001 The American Association for Thoracic Surgery

Editorials

Peer review: Recognition and responsibility

Andrew S. Wechsler, MD

From the Department of Cardiothoracic Surgery, MCP Hahnemann University, Philadelphia, Pa.

Received for publication March 26, 2001. Accepted for publication March 26, 2001. Address for reprints: Andrew S. Wechsler, MD, Department of Cardiothoracic Surgery, MCP Hahnemann University, 230 North Broad St, Mail Stop 111, Philadelphia, PA 19102-1192.



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I remember when, a number of years ago, I received my first request to review an article for The Journal of Thoracic and Cardiovascular Surgery. The Editor was Dwight McGoon, a giant in the field in his technical prowess and intellectual capacity and a warm and encouraging mentor for many. The first thought that ran through my head was that he had misaddressed the envelope. Why would anyone care what I thought? That feeling passed quickly and was replaced by a sense of importance and validation. Apparently, my meager contributions to the literature had actually been read by someone, and I was thought to be at least a "peer," if not an expert. The last thought that came to mind was whether or not I would have the time or interest to do the review. I studied every aspect of the paper, wrote a review, showed it to a senior colleague, asked if he thought it was okay, and finally submitted it. I thought my review was fair and critical but not unreasonable. I understood the work that it took to assemble any collection of laboratory or clinical investigations, and I knew the author had tried to make a contribution to the literature and to add knowledge to our field. I think I sent a copy of the request for the review and my review to my chairman (and perhaps even to a few close relatives). I know I thought my wife would be intensely interested in my thoughts about this manuscript, and couldn't understand her indifference or her queries about when we were going to be able to get the washing machine fixed. In short, I was flattered and challenged, and I wanted to help. I had seen the reviews of my own manuscripts when they came back to me. I understood the time and effort that it took to prepare them and appreciated that someone cared about the work my colleagues and I were doing.

Today, the shoe is on the other foot. The Associate Editors, my editorial staff, and I send requests to many reviewers each day. However, I am frequently incredulous at the responses that we get. Many of the busiest surgeons in this country and abroad consistently return well-reasoned, constructive, insightful, timely reviews. How do they find the time to do it? At the other extreme, colleagues of ours receive manuscripts for review and do not even bother to respond. To my amazement, many of these individuals are the same people who have published frequently in our Journal, debate at length with reviewers, and are given the opportunity to submit greatly enhanced manuscripts as the consequence of the hard work of our reviewers. Is there something inherently different today about our specialty and the people who enter it and achieve success compared with 25 years ago? Have our intrinsic values changed? Am I overreacting to the actions of the few who do not represent adequately the responses of the many? Am I unduly upset because frequently the "few" are recognized as "leaders" in our specialty? Part of the problem apparently is one of decreasing reimbursement, enhanced focus on "productivity" by department chairs and deans, devaluation of academic achievement by making the criteria for academic advancement in society memberships less stringent, and the increased clinical workload that we all feel. I am intrigued by the concept of "academic days" that have been bestowed on some of our colleagues in other specialties. What is an academic day? What happened to an academic life?

The Journal is critically dependent on high-quality peer review if it is to remain a high-quality journal and maintain the highest citation index of any journal in our field. We welcome new peer reviewers to our ranks and encourage any reader who has published clinical or laboratory work to provide us with his or her name and interest in participating.

The Journal recognizes peer review as an important part of the academic process and believes that exceptional performance should be rewarded. To this end, we have established the title "Distinguished Reviewer" to designate those individuals who from time to time send us reviews of uncommon depth, insight, and effort. {These reviews occur in response to complex articles that will play an important role in the way we think about and practice our specialty.} When provided to the authors of manuscripts, these reviews greatly enhance the quality and utility of articles subsequently published in the Journal. They impart wisdom and stimulation to younger investigators.

Each time the Journal receives such a review, we acknowledge the extraordinary effort of the reviewer with a letter and make note in our database that the reviewer has made an important contribution to the Journal and to his or her colleagues. When a reviewer has accumulated five such congratulatory letters, that individual is identified as having achieved the status of a "Distinguished Reviewer." We do not care about seniority or national/international status. We care that this individual has distinguished himself or herself by the sacrifice of time and effort to help another member of our specialty. We acknowledge the designation of "Distinguished Reviewer" by publishing this list of names in the Journal, by writing an appropriate letter of recognition to the individual, and by writing a letter to the head of that individual's department or unit, clearly identifying this academic accomplishment.

We hope that this designation will be recognized in the same way that original manuscripts, research grants, presentations, and teaching hours are recognized by those in a position to influence the careers of such people. Peer review is a legitimate form of "academic productivity" and should be recognized as such. Does designation as a "Distinguished Reviewer" count as much as the submission of several manuscripts to journals in one's curriculum vitae? I think it does. Should it play a role in academic advancement? I think it should. Should it provide recognition for individuals within national organizations? I think it should. Does participation in peer review identify one as "expert" in at least some facet of one's chosen specialty? I think it does. Does peer review or the opportunity to participate in it carry with it a critical responsibility? You answer the question.




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