“It seems to me the time is rapidly approaching when we must have more pediatric journals in this country. No one realizes more than I do the pressure on a pediatric journal at the present time. The only question is that of money.” These words were voiced by Dr Clifford Grulee, then executive secretary of the American Academy of Pediatrics (AAP), at the first annual meeting of the organization, held Atlantic City in June 1931.1 At that time there were two pediatric journals being published, theAmerican Journal of Diseases of Children, a publication of the American Medical Association (AMA), and the Archives of Pediatrics, a private publication.2
The founders of the AAP were committed to providing high-quality continuing medical education to its members. In addition to scientific meetings, attempts were made to provide pediatricians with educational material in the form of monographs and news bulletins. Soon after the establishment of the Academy, the need for a new pediatric journal under the sponsorship of the Academy was recognized by Dr Grulee and other leaders in the organization.
The journal was designed to have scientific value and to allow free discussion of the social aspects of pediatrics.3 It was to be divided into 4 parts: 1) original articles; 2) proceedings and reports of the AAP; 3) special features (these became a center of controversy); and 4) advertising.
Dr Borden Veeder, Professor of Pediatrics at Washington University in St Louis, Missouri, was asked to make the initial contact with the C. V. Mosby Publishing Company that was located in the same city. In November 1931, Dr Grulee was authorized to negotiate a contract with the C. V. Mosby Company with the following provisions:
the Academy agreed to underwrite 400 subscriptions at $5 each;
the $5 was to be included in the annual dues of Academy members;
nonmember subscription rate was to be $8.50;
editors and editorial board members would be appointed by the Academy;
policies, articles, and advertising review were the responsibility of the Academy; and
the Journal of Pediatrics was to become the official publication of the Academy of Pediatrics.
The C. V. Mosby Company would own the journal, assume complete financial liability, and be responsible for distribution and solicitation of advertising.4
The Executive Board of the AAP appointed Dr Veeder and Dr Hugh McCulloch, also a clinical professor of pediatrics at Washington University at St Louis, as co-editors of the new journal. The original members of the editorial board included Drs Kenneth Blackfan, Thomas B. Cooley, Harold K. Faber, Robert A. Strong, Philip Van Ingen and Clifford G. Grulee (ex-officio).5 The first issue of theJournal of Pediatrics was published in July 1932, 2 years after the first organizational meeting of the AAP held in Detroit in 1930.
In the early 1940s, Dr Edgar E. Martmer, assistant secretary appointed by Dr Grulee, began to analyze the contract with C. V. Mosby and strongly argued the AAP to assume ownership of the journal. The journal had become a highly successful publication with the number of subscriptions increasing with the growth of the Academy. The membership of the AAP had increased from 400 Fellows in 1931 to 2200 by 1946. It was estimated by Academy officials that C. V. Mosby's annual profit from the Journal of Pediatrics was $44 000, a figure that was probably $10 000 to $15 000 too high.6
The company was unwilling to open its books but offered the Academy $3500 to $4000 per year as a share of the profits. At the last moment this was increased to $16 000 divided between cash and a reduced subscription rate. This offer was refused at the meeting of the Executive Board in Pittsburgh in February 1947 and the decision was made that the AAP should take over ownership of its journal. The C. V. Mosby Company continued to publish the Journal of Pediatricswith Dr Veeder remaining as editor.
The new Academy journal, Pediatrics, was to be published by Charles C. Thomas of Springfield, Illinois. The Thomas Publishing Company was to be responsible for soliciting advertising and promoting the journal outside the Academy. The Banta Company of Menasha, Wisconsin, was selected as printer.
Drs Hugh McCulloch, Anderson Aldrich, Allan M. Butler, Harold K. Faber, Arild E. Hansen, Rustin McIntosh, Irvine McQuarrie, Edwards A. Park, Grover Powers, and Joseph Stokes Jr resigned from the editorial board of the Journal of Pediatrics and accepted positions on the editorial board Pediatrics. As vacancies occurred on the board, other pediatricians were appointed including Dr Alton Goldbloom, Paul Harper, L. Emmett Holt, Jr, Herbert Miller, Ralph V. Platou, Mitchell Rubin, Francis F. Schwentker, and Milton J. E. Senn. The first issue of Pediatrics appeared in January 1948. Contributing editors were Drs John Hubbard, Leona Baumgartner, and Felix Hurtado of Havana, Cuba. Later, Drs Fredrico Gomez and Myron Wegman were appointed as contributing editors. It is of some interest that Dr Grulee, executive secretary of the AAP, was also serving as the editor of the AMA publication, the American Journal of Diseases of Children.
A publication committee was formed by action of the Executive Board. Its charge was to manage the financial and business aspects of the journal including negotiations with the Thomas Publishing Company.
The first issue of Pediatrics, volume 1, number 1, published in January 1948, included Dr Lee Forest Hill's presidential address, given at the annual meeting of the AAP in the fall of 1947. It also included a message from Dr John Toomey, then president of the AAP, a report of the meeting of the Executive Board held in Washington DC in July 1947, and articles on public health, trends in legislation, nursing, and medical social work. Subsequent issues included publication of seminars, round tables, and symposia presented at the annual meetings.
By November of the first year of publication, Dr McCulloch reported that 290 articles had been received, providing enough material for issues through June 1949. The rejection rate was 40%. The editorial office was moved from St Louis to Chicago when Dr McCulloch took the positions as chief-of-staff at La Rabida Sanitarium in Jackson Park and medical director of the Council on Rheumatic Fever of the Chicago Heart Association.
Ownership of Pediatrics proved to be a successful venture for the AAP. The annual cost to the AAP for publishing the new journal was $100 000, including an annual salary for the editor of $2500. Subscriptions, which were part of the annual dues, were increased to $10 per year. The cost of advertising was $100 per page per issue. By the end of June 1949, 79 firms had advertised in Pediatrics,which produced an advertising income of $45 000 the first year. In contrast to the earlier years, membership subscriptions today are $60 per year, which is included in annual dues, and subscription cost to nonmembers is $120 per year. The charge for color display advertising is now $3000 per page per issue and $145 for 30 words or less for classified ads.
It was reported to the Executive Board in June 1949 that the journal had shown a profit of $11 000 for the first 18 months of publication. Income the second year was reduced because of an increase in the cost of paper and an overrun on the projected number of pages per volume. Because of a strike at Banta, printing of the journal was delayed for a short period of time, which was met with concern by the advertisers.
Beginning in July 1949, Spanish translation of abstracts inPediatrics were published. Translation costs were $500 for 12 issues. Abstracts were published intermittently throughout the 1950s but interrupted mail service between the United States and Latin America often delayed their publication and in 1956 they were discontinued. A few manuscripts were received from academic pediatricians in Latin America, but difficulties in translation limited their publication.
When the new journal was first published, there was little change in the content from the Journal of Pediatrics; however, as the AAP assumed more control over the policies of the journal, changes began to occur. The organizational chart showed the editor of the journal to be responsible to the Executive Board. The editorial board was responsible for reviewing and approving scientific articles, but matters of policy were to be decided by the Executive Board.
A series of letters/articles entitled “Pediatrics and the Public” were under the sole editorship of Dr Ned Park, former chairman of the department of Pediatrics at Johns Hopkins University. Dr Park was responsible for selecting the articles and editing their content. The column became a contentious issue among some members of the Executive Board.
An article in the column describing a prepaid medical care plan in the Seattle area came under discussion by the Executive Board. None of the doctors described in the plan were permitted membership in the Washington State Medical Society because they were practicing “contract medicine.” It is not known if pediatricians practicing in the group were members of the AAP, but pediatricians throughout the state were openly criticized for being members of an organization whose journal was promoting “socialized medicine.”7
Allan Butler, a member of the AAP Editorial Board, also wrote an article for the column that was published in the November 1948 issue ofPediatrics that was highly critical of the policies of the AMA. Despite the fact that the AAP came into being largely over differences with the AMA, there was a feeling among some members of the Executive Board that the AAP should refrain from publishing articles that could alienate the AMA. It was decided headings for future columns should state that “Statements appearing in this column do not necessarily reflect the opinion of the Editors nor are they to be interpreted as the official opinion of the Academy.”8
Because several members of the Executive Board felt the articles in “Pediatrics and the Public” leaned too much toward “social changes,” Dr Park was asked to present his views to the Board. His remarks focused on the importance of informing pediatricians of changes that were occurring in the delivery of health care. He was also candid in his comments about the AMA stating that “the editors of the journal of the American Medical Association have done and are now doing serious injury and incurring grave responsibility in allowing the medical profession in this country to remain in ignorance of the true state of affairs in the field of medical care.”9 It was to the Executive Board's credit that the AAP supported federal funding of medical education and research, a policy that was opposed by the AMA.
Dr Park subsequently resigned from the Editorial Board and Dr Harper, his associate at Johns Hopkins University, was appointed editor pro tem of the column “Pediatrics and the Public.” The column continued to be published until 1956.
Another series of articles entitled “Trends in Health Legislation and Administration” was written by Dr. John P Hubbard. These were reports on national legislative issues and the activities of the Children's Bureau of the US Department of Health, Education, and Welfare. The articles were criticized by some who felt they were of little interest or value to the practicing pediatrician.10
During the latter part of 1950, there were ongoing Executive Board discussions about the performance and costs of the Thomas Publishing Company. Self-publishing was considered; however, it was finally decided that it was beyond the capability of the staff and Dr. Christopherson was authorized to renegotiate a 15-year contract with the Thomas Publishing Company. The contract provided for a 30% increase in advertising charges and additional income to the AAP. It was also agreed that transactions, committee reports, and business of the Executive Board would not be published in the journal but printed and distributed in another form.
In a report to the Executive Board in 1951, Dr McCulloch reported on his discussions with the editors of the Journal of Pediatrics and the Journal of Diseases of Children and an agreement was reached on the acceptance of manuscripts. TheJournal of Pediatrics would accept articles of interest to general practitioners and practicing pediatricians. Articles accepted by Pediatrics would be more scientific, presenting advances in pediatrics. The base of articles would also be broadened to include surgery, psychiatry, social work, and nursing in fields directly related to pediatrics. The AMA would continue to be responsible for the highly technical articles that would be published in the American Journal of Diseases of Children.
There were extended discussions by the Executive Board on how the members of the editorial board should be selected. It was decided that the editorial board could make nominations to fill vacancies, but the Executive Board would have the power to veto any nomination made by the Editorial Board. The Executive Secretary and the President of the AAP were to become ex-officio members of the Editorial Board.
The first supplement to Pediatrics with separate pagination was published in May 1952. It was a report of the Committee on Improvement in Child Health summarizing the recommendations made by pediatric educators in a series of meetings held in 1949 and 1950. The total cost of the supplement was $800. Today, the cost of a supplement is $800 per page.
There was continued concern about delays in publication. TheJournal of Pediatrics was received regularly the first week of each month, while Pediatrics had a mailing date of the 25th, a deadline that was seldom met. Further delays occurred in June and December because of indices that were included in those issues. It was decided that the subscribers would be notified of the publication date and every attempt would be made to adhere to it.
An attempt was made to obtain manuscripts from speakers at the annual and spring meetings for publication in Pediatrics. This was only partially successful because many of the presenters refused to provide a written manuscript of their presentation. Articles were also solicited from presenters at the annual meeting of the American Pediatric Society and the Society for Pediatric Research. The editor also requested funding that would enable him to solicit review articles and to pay the writers $50 per article. For several years, a regular feature in the journal was a column by Dr. Grover Powers entitled “Medical Education.”
Because of the financial success of the journal, some members of the Editorial Board felt they should have something to say about how profits were spent. The Executive Board responded that thePediatrics belonged to the AAP and that disbursement of income was the prerogative of the Executive Board.
At the May 1953 meeting of the Executive Board, the resignation of Dr Allan Butler from the editorial board was accepted and Dr Charles Janeway was named as his replacement. Dr Irvine McQuarrie also submitted his resignation and his place on the editorial board was taken by Dr Charles D. May.
On March 22, 1954, Dr McCulloch resigned as editor ofPediatrics. A committee of the Executive Board was appointed to review candidates for editorship from names submitted by the Editorial and Executive Boards. After considerable discussion, Dr May was chosen by the Executive Board to become editor effective June 1, 1954 at a salary of $5000 per year. At the time of his selection, Dr May was professor and chairman of the Department of Pediatrics at the University of Iowa.
Dr May made several important changes that improved the efficiency of the editorial office. Pediatrics appeared regularly on the expected date of arrival. There were an increased number of manuscripts submitted. A President's page, and Letters to the Editor were added to the publication. Edward Shaw was asked to join the Editorial Board as a representative of the practicing community. To improve the efficiency of the editorial office an assistant editor was added. Specific editorial responsibilities were assigned to the Thomas Publishing Company.
In July 1957, Dr May announced he was moving from Iowa City to New York City to accept a position as Executive Director of the Physicians' Council for Information on Child Health. The Council was financed by industry and consisted of 21 physicians, several of whom were members of the AAP's editorial board and two who were past presidents. The purpose of the organization was to review and approve medical writing and industry advertising. An approval would permit a display of the Council's insignia.
Because the paid editor of Pediatrics was also serving as Executive Director of another organization, legal concerns were raised about the AAP's liability for actions taken by the Physicians' Council for Information on Child Health. After a lengthy discussion, the Executive Board voted to renew Dr May's contract.11
Delegating editing to the Thomas Publishing Company soon proved to be an unsatisfactory arrangement and Dr May assumed the entire responsibility for editing manuscripts. In an effort to reduce the editing load, the Executive Board employed a part time copy editor at the AAP headquarters who would edit manuscripts forwarded to him from the editorial office in New York.
A meeting was held in May 1960 that included Dr May, the Editorial Board of the AAP and three representatives of the Executive Board. It was at that meeting that Dr May voiced his objection to the hiring of the lay copy editor in Evanston, preferring instead to use staff physicians at local teaching hospitals to edit manuscripts on an ad hoc basis.12
A second point of disagreement between Dr May and the Executive Board representatives was the restriction put on editorials. The Executive Board had passed a resolution that any editorial dealing with social, political, or economic issues should be approved by the Executive Committee of the Executive Board before publication. The action stemmed from several editorials the Board felt were inconsistent with AAP policy. Dr May objected to the restriction on his “editorial freedom,” and declined to author future editorials. At this meeting, Dr May also reported that he had stepped down as Executive Director of the Physician's Council for Information on Child Health although he continued to maintain ties with the organization.13
The final confrontation with the Executive Board occurred when Dr May gave a lecture at a District of Columbia Chapter meeting on the “New Pediatrics” which was later reported on the front page of theMedical Tribune, a proprietary publication. The article was attributed to Dr Charles May, Columbia University, College of Physicians and Surgeons and Editor of Pediatrics. The theme of the article was that pediatrics as it was currently practiced was not a specialty and that training should be extended to 3 years and should only be for highly specialized pediatricians. (Pediatricians at that time were required to take only a rotating internship and 2 years of pediatric training to become eligible for board certification.) He also expressed the view that general practitioners should care for the “rank and file” of pediatric cases. This concept had previously been discussed with pediatric departmental chairmen, but not with the hierarchy of the AAP.14
A second article published by Dr May in the Journal of Medical Education attacked industry and its advertising in medical journals. He quoted figures of the advertising income of medical journals, expressing the opinion that owners of these journals could not be depended on to control the quality of advertisements because they were so lucrative. This article had been circulated to physicians in the Physician's Council for Information on Child Health before publication, but not to the Executive Committee of the Executive Board.15
The Executive Board reacted to these two publications by terminating Dr May's employment as editor, effective October 1961. The pediatric academic community was critical of the actions taken by the AAP, which resulted in a significant reduction in the number of manuscripts submitted to Pediatrics for publication (personal communication with Dr McKay).
Dr Clement Smith was appointed editor of Pediatrics in January 1962 and served with distinction until his retirement in 1974. In 1965, he was joined by Dr Thomas E Cone, Jr who was chosen initially as book editor and later as an associate editor. Dr Cone assisted Dr Smith in selecting articles for the journal that met the needs of practicing pediatricians (personal communication with Dr Lucey), and his historical fillers were enthusiastically received by readers of the journal. The Editorial Board was expanded to include representatives of the pediatric subspecialities to serve as reviewers. Dr Smith worked well with the central office, coordinating his activities with the copy editor in Evanston. The editorial office was located in the Boston Lying-in Hospital but eventually was moved to Boston Children's Hospital.
Approximately 280 manuscripts were received the first year of Dr Smith's editorship. By the third year over 600 original articles were submitted for publication. A 200-word abstract by the author was required, to appear at the beginning of each article. With the AAP's interest in the delivery of health care, articles on practice management began to appear in the journal in the early 1970s. A 10-year cumulative index was published in 1958 and a similar 20-year index was made available in 1968.
In 1966, it was decided not to renew the contract with the Thomas Publishing Company and to bring publishing in-house. A staff of seven people, including a full-time copy editor, was assigned the task at the central office. It wasn't until 1972 that the AAP entered into a contract with Retlaw Publishing Company to solicit advertising and to promote the journal in this country and overseas.
Dr Smith's differences with the chief executive of the new publishing company led to his retirement in 1974.17 One of the points of contention was the dispersion of advertising in the journal. In the beginning, advertising only appeared in the front and back sections of the journal. The publishing company urged the dispersion of advertisements throughout the journal to increase the sale and price per page of advertising. A compromise was finally reached to divide the journal into 3 sections of scientific articles with advertisements inserted between sections. Dr Smith also expressed on many occasions his concern about the influence of the formula companies on AAP policy.17
Dr Jerold Lucey was serving as chairman of the Editorial Board at the time of Dr Smith's resignation and a search committee made up of members of the Executive and Editorial Boards selected him as editor. Dr Robert Haggerty was designated as co-editor and Dr R. James McKay named as editor of books. The editorial office was relocated in Burlington, Vermont.
In 1980 Dr Haggerty stepped down as co-editor to become editor ofPediatrics in Review and Dr McKay assumed the position of associate editor. In 1991 Dr Birt Harvey was named associate editor. About this time, the cover of the Journal was changed from green to white and what had been known as “the green journal” became “the white journal with the green stripe.” With Dr Harvey's resignation in 1994, Dr Ralph D. Feigin was selected to become associate editor and Dr Russell W. Chesney became consulting editor, positions they still hold today.
Under Dr Lucey's editorship, Pediatrics has grown and prospered. More than 1400 manuscripts are submitted for publication each year. Even with a rejection rate of 82%, the backlog of articles became so great that in April and June of 1992, supplements were published that included only articles that had previously been accepted for publication. At the same time, provisions were made for a shortened turnaround time for acceptance and publication of articles of major significance.
A monthly electronic version of the journal became available in January 1997, which expanded the number of articles that could be published by the journal. The electronic version is now viewed internationally on the World Wide Web. The journal is also available on CD-ROM, which is distributed to libraries in developing countries.
In 1981, Williams & Wilkins was chosen as publisher and its subsidiary, Waverly Press, as printer. The publisher assumed responsibility for redacting the articles as well as soliciting advertising. In 1993, Waverly Press was replaced by Cadmus Journal Services as printer forPediatrics.
International publication of the journal began with a contract with Doyma Publishing Company in Spain in 1979. Since then, international publication has been expanded. In 1998, with the assistance of advisory boards in other countries, the journal is being published in Jordan, Brazil, India, Italy, Portugal, Spain, and Russia. Negotiations for a Chinese language version to start in 1999 are in progress. The total circulation for foreign language editions is now more than 20 000.
In 1997 the circulation of the English version of the journal reached 60 500, including 900 copies sent monthly to Japan. The journal has the largest combined circulation of any pediatric journal in the world. The expanded distribution of the journal is expected to provide high-quality continuing medical education to pediatricians worldwide for years to come.
The author wishes to thank AAP Archivist Dr John Zwicki for gathering the material used in the preparation of this manuscript.
- ↵Dialogue between Dr Clifford Grulee and Dr Borden S. Veeder, Annual Meeting of the American Academy of Pediatrics, June 13, 1931
- Nelson WE
- ↵Pease MC. American Academy of Pediatrics (History of) June 1930 to June 1951. Evanston, IL: American Academy of Pediatrics; 1951:138
- ↵Executive Board minutes, American Academy of Pediatrics, November 1948
- ↵Executive Board minutes, American Academy of Pediatrics, June 1957
- ↵Executive Board minutes, American Academy of Pediatrics, October 1957
- ↵Joint meeting of the Editorial Board and Executive Board American Academy of Pediatrics, May 1960
- ↵Executive Board minutes, American Academy of Pediatrics, April 1961
- ↵Personal communication with Robert Frazier
- Copyright © 1998 American Academy of Pediatrics