M e d i c i n e A ve 2 The Evolution of Medical Journals Carroll Dowden M edical publishing, a field with roots that go back almost 200 years in the United States, has evolved dramatically in the past two decades. While there are many trends, sub-trends, plots and subplots in the story, three stand out: • Triumph of specialties over primary care. Following the money, publishers have shuttered venerable titles in the multi-specialty field and introduced many new titles to serve specialty markets. Publishing has witnessed an astonishing triumph of specialization, which is a trend that parallels changes in medicine itself. • Evolution into brands. Responding to changes in technology, increases in costs, greater competition from new communications channels, and shifting allocations of advertising dollars, publishers have surrounded their legacy journal businesses with new enterprises. Journals have evolved into brands with numerous line extensions. 136
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