Shattuck lecture--The general medical journal: for readers or repositories?

General medical journals seek newsworthiness but face obstacles because of their usually slow publication schedules and because of contents that readers find either obscure or contradictory to long held beliefs. In addition, since medical news has become "big news," general medical journals find themselves in competition with both the lay press and the medical giveaways. One effect of the escalating public interest in medical news is that general medical journals that are reliable and have maintained their newsworthiness are increasingly cited. These journals thus eventually transmit research findings to the public as well as to the health-care professions. To help prevent exaggeration and misinterpretation by the lay press and by the public, general medical journals must evaluate submissions in a broader than traditional context. Nevertheless, newsworthiness is an appropiate goal for such journals.