This guest post is by Brandy Schillace, most recently Editor-in-Chief of BMJ’s journal Medical Humanities. Dr. Schillace is a historian whose recent non-fiction includes Mr. Humble and Dr. Butcher: A Monkey’s Head, the Pope’s Neuroscientist, and the Quest to Transplant the Soul (2021) and fiction debut is The Framed Women of Ardemore House: A Novel (2024). Her forthcoming book The Intermediaries: A Weimar Story (WW. Norton, 2025) explores the world’s first center for homosexual and transgender rights.
My very last issue as Editor in Chief of Medical Humanities, on disability and technology (by disabled scholars), has now been published. There are many factors in my decision to step down — after 17 years editing two consecutive journals, it was time.
But there’s more, and I feel we should talk about the climate of publishing — a climate that is changing. When I began in 2007, editing a medical anthropology journal for Springer, I had more complete control of the editorial process. Articles came to me directly, I sent them personally to reviewers, who replied directly to me, and when a piece was accepted I worked one-on-one with a dedicated copy editor. It was a lot to juggle, but offered great quality control. Ours was a top ranked publication with a high Impact Factor; we processed a lot of material — and yes, that was lots of paper shuffling. But we had an associate build a database of reviewers, and we managed just fine. Imagine! You sent a paper to the editor! And she had it copy edited!
Then, in 2010 or so, Springer required all of their journals to use a new online system. On the one hand, this was a bit easier on me…the system kept track of where papers were in the process, who was reviewing what and so on. I didn’t love it. But I didn’t hate it either. Yet. Unfortunately, though, the system made other things invisible. Who actually ran the thing? Technologies do not look after themselves. Instead, it was kept up by online assistants who worked overseas — largely in India. It looked like we were just using plug and play software, but in fact there were people keeping all that tech going; ghost workers in the machine. Except I couldn’t just speak to them if something went wrong. And it was about to get worse; the publisher took away my copy editor. I was forced to send things through the new system to be copy edited — and that, too, happened overseas.
There were now teams of people editing all genres of work with no specificity to their background or assignments, and usually without English as a first language. Citations were a nightmare. These folks weren’t to blame; if anything, they were victimized by the system, too, and rarely got any credit for their good work. But every time something went awry, I would reach out to my contact, who had to reach out to their contacts, and so on in three time zones. It took forever to fix even basic problems, but that’s not all. I was losing control of the process and unable to see the whole of it clearly. Reviewers got mad at the system too. Authors hated it. But these new online publishing systems had now become ubiquitous.
I left that journal to take over Medical Humanities in 2017. The publisher was smaller than Springer, and I had far more contact with people at every stage of production — all good things. The online system was, however, a beast. No better than Springer’s and possibly worse. Yet again, all copy editing was handled overseas. Due to our mix of contributors from various humanities disciplines, it made sense for us to use Chicago Manual of Style. It crashed the system, both the software and the system of people working at each stage. It had to do with the particular interface, but also the four levels of people, time zones, and language issues among the full set of us who were now involved. Every stage took ages, but ultimately I had the support of a good network of people, including an assistant through BMJ, and my associate editors and colleagues. We could just about manage. But let’s skip ahead.
I had begun the big push to diversify our journal, with the support of the Institute for Medical Ethics (IME). The IME co-managed the journal with BMJ, and through their good offices, we started “Path to Publication”, a means of helping those without institutional support get into print. Early career scholars, researchers from the Global South, disabled and otherwise marginalized people would now have the opportunity of dedicated editorial support. It was a lot of work. For my stipend, which I divided among myself and associate editors, I spent about 25 hours a week on this. But at least I had the support of the publisher, who was at that time very keen on diversity and inclusion. Then, about 2-3 years ago, things began to change — not at the Institute of Medical Ethics, but at the publisher itself.
There was a reorganization. Several roles were combined, and I found myself dealing with a new set of people. I felt that at least one level of support had been lost in the fray. It was harder to reach people, and it took longer to move issues forward. What happened? Covid, maybe. But in addition, Plan S in the UK was putting pressure on everyone to go open access (OA) or risk having their funding pulled. In theory, OA sounds very good. In reality, it just meant someone else had to pay for open access fees. Not the funding bodies. Not the publisher. Usually the authors themselves. We were publishing a lot of humanities work, much of it by those who lacked well-financed institutional support; further, requiring heavy fees (in the thousands) to publish their work would end all of our diversity efforts. Even with a generous waiver program from BMJ for developing countries, the OA fees would turn the journal into an echo chamber of a few well-funded researchers from select institutions. We pushed back. But a new emphasis on profit, and on publishing more and more papers had taken hold. I was continually asked why I wasn’t accepting more papers, faster? Meanwhile, systemic problems persisted, and already overtaxed authors and reviewers were giving up on us.
That didn’t stop us from publishing edgy DEI work. One of our most important pieces was about white supremacy culture in medicine. There was a lot of blowback; I got a lot of ugly emails. Thankfully, BMJ (and the IME) stood by my decision to publish it and I’m grateful for that. But the fury around this piece should have tolled a warning bell. More changes were on the horizon.
Not long after, I began to get notices from behind the scenes people — those who received articles before I did, through the online system. They were ‘flagging’ articles they deemed ‘problematic.’ Now, they often had a reason for this. Perhaps the author hadn’t completed the patient anonymization, or there was an ethical problem with the research that needed addressing. It was an attempt at being efficient, at catching trouble before it ate up reviewing resources. But that also meant someone else was determining the disposition of submissions before I could read the work. It’s easy to see how this affects decision making — it would be much harder for me to read these pieces from an unbiased perspective. I never encountered an issue where the behind the scenes auditors actively went against my decision. However, I know some journal editors did. In another BMJ journal, a paper accepted by the Editor-in-Chief was later pulled by the publisher. Maybe there were good reasons for it, but this new system of pre-review cast a distressing shadow over editorial freedom. It’s not an outright check on that freedom. Not yet. And I’m sure much of this is being done in the name of safety and efficiency. But I’ve watched as one by one, decisions that used to be the purview of editors have been overtaken or eliminated. And it’s everywhere.
I am proud of my work at Medical Humanities, pleased at what we achieved. And I am not here to attack either of my past publishers. There are many good things that have come from my time as an editor. I enjoyed working with BMJ and still prefer it to many other institutions (and they did fight for me, and for papers I wanted published and authors I wanted protected). But the academic publishing world is not what it was. My experiences are evidence of a revolution that stretches from academia to funders private and public. It has been accelerated by Covid and by the political turn from DEI, from diversity and autonomy as good things — to ‘problematic’ things. And perhaps most salient: we are simply not profitable.
I wish all luck and strength to those stepping into editorial shoes. And I can hope things will get better. But with the encroachment of AI, I imagine things will get worse before they get better — as evidenced by the recent resignation of an entire board of the Journal of Human Evolution. We must be very careful, for we are losing something precious. And that makes it harder for everyone.
Discussion
9 Thoughts on "Guest Post: An Editor’s Perspective on “My Very Last Issue.”"
Sure value the candor…very useful…kudos and best wishes to Brandy…Dwaine Rieves
That is very depressing. As you say, Brandy, the most salient aspect seems to be the journal’s unprofitability.
Thanks for sharing your experience and calling attention to these developments. Scholarly publishing’s sole raison d’être is to build knowledge on solid foundations. That purpose is threatened when publication is subject to extraneous criteria and revision is entrusted to unqualified personnel. The enterprise can’t be reckless as to whether articles assess the existing field fairly, honestly represent results, account for potential bias and are verifiable through replication. It won’t survive a crisis of harm resulting from bad faith, botched investigations and insufficient review.
A shame. A while ago, much of academic publishing operated as a service to the community: primarily one of format creation and distribution, with editorial quality control in the hands of a Society, a Board or handled in-house. Business efficiency, profitability and growth did not and does not always perfectly align with the needs of all communities and those within them.
Let’s be clear as to why there is so much increasing automation and outsourcing for journals. We all love the idea of journals being handcrafted, bespoke, artisanal efforts. And yet publishers of all stripes (not just the big commercial publishers) are under immense pressure to reduce prices and to increase the speed at which they publish. This pressure comes from researchers, their institutions, and their funders. APCs are too high. Subscription prices are so high they are causing a serials crisis. It takes forever to get a paper through peer review and published, so instead let’s just publish everything immediately and then figure out if it’s true later on.
The response here is a rational one to market pressures. The most expensive parts of running a journal are the human parts, any place an actual human being has to interact and spend time with the manuscript. So the solution is to reduce costs through automation and outsource everything possible to overseas vendors. That’s what the research community appears to be asking for, rather than expressing a willingness to pay more for slower, higher-touch, but likely higher-quality journals. Have you seen any funders offering to pay extra for better copyediting? I certainly haven’t.
I imagine that the for-profit model of publishers also plays a large role. Human labor is the most expensive part of running a journal, but publicly owned publishers also have the added competing interests of maximizing their own/shareholders’ profits.
Cutting labor costs (by outsourcing, automation) is certainly more feasible than asking shareholders to please be okay with smaller profits—I don’t really know how to address that aspect, but I think it is important to at least recognize the role of shareholders (and increasing profits as the ultimate bottom line of companies) as an outsized source of the pressure in academic publishing to reduce costs and increase growth.
I largely agree, but don’t think the argument can be limited to for-profit publishers or those that are publicly-owned and have shareholders. Privately-owned publishers without shareholders can certainly be just as profit-driven as those who sell stock. Further, more and more not-for-profits publish their journals through partnerships with those same for-profit organizations, so the line can be very blurry.
And not-for-profits are often in the same position as those with shareholders, they just serve a different set of masters. Many of the larger university presses are under obligation to bring in certain levels of financial return to their host institutions, and the smaller ones need to remain self-sustaining in an environment where costs go up every year. At research societies, the journals program is often expected to bring in significant amounts of funding to pay for the work the society does on behalf of its community. Very few programs are entirely free from financial pressures.
Further, the smaller non-profits are under immense pressure to reduce costs in order to remain competitive with the larger publishers. The larger publishers benefit enormously from scale, and pay lower costs for everything, allowing them to set lower prices (and bring in higher surpluses) than the smaller publishers can afford. If you’re a small non-profit, you need to set your OA journal APC at a rate comparable to that of the competitor from the big publisher that is paying less for everything than you are. Hence a need to cut your own costs, often through outsourcing and automation, in order to keep up with the competition.
The response from academics can be to do the journal work themselves in ‘Diamond’ scholar-led mode, as I have done for decades, without insultingly high APCs, outsourcing editorial functions to cheaper labour markets, or removing the editor from actually editing articles. There is an assumption in the comments that journals need to be ‘commercial’. They do not. All the problems mentioned in the post stem from ‘market pressures’ – cutbacks and cost-savings from the publisher’s side. Our own zero-budget journal manages fine without being subjected to any market pressures at all, and we publish in the 60-80 articles a year range, plus book reviews and a whole section run by Global South scholars. No APCs or paywalls since 1994. It really is not that hard.