At a critical moment in the movie Jerry MaGuire, Tom Cruise declares to Renée Zellweger, “You complete me.” With less drama, this is what TRACK comments since the last issue do for the Annals’ articles.
The articles being discussed were written by experts. They were peer reviewed by other experts and revised on the basis of these reviews. One article was interpreted by 2 editorials. Another was accompanied by a series of journal club questions. And yet, reading the online discussion completes these articles in important and unexpected ways. In some cases, the online discussion adds information. Other times it provides context, interpretation, or diverse relevant experience. Now and then it even reveals passion.
For example, one of the evaluators of the human papilloma virus (HPV) vaccine adds new scientific information on the vaccine efficacy in different subgroups.1 This information both reinforces and adds nuance to the interpretation2 of a study of counseling adolescents about HPV and cervical cancer prevention.3
The article by Nicholson and colleagues on preventive induction of labor4 invoked both erudition and fervor. Discussants include the lead author, an editorialist, experienced clinicians, and researchers. Their challenges relate not only to the interpretation, dissemination, and next steps from a controversial obstetrical procedure, but also to how new knowledge is shared and advances.5–13 Without the discussion, the article is less complete and our (re)action less informed and wise.
Application of the findings of an intervention study for patients with medically unexplained symptoms also is made more complete by commentors.14 These discussants question the feasibility of the cognitive-behavioral intervention in primary care practice and question its mechanism of action.15,16 As noted by the authors in response,17 this discussion points to a research agenda for this classic primary care problem.
A study showing that religious physicians are not more likely to care for the poor18 is brought to life by readers. This discussion challenges us to understand both religion and spirituality broadly and incites us to act on that understanding.19–23
The study by Dietrich and colleagues of a practical cancer screening intervention24 yields validation25 but also an unanswered cry for more information on factors that are important in disseminating successful interventions into clinical practice.26
Consultants’ perspective of working with 349 small and medium practices27 provides a fitting counterpoint to a study of the effect of electronic medical records on quality of care.28 They note that just adding the tool is insufficient. “Office systems and culture must be reviewed, evaluated, and likely redesigned.”27
The need for wholeness is brought to the fore by discussion of “Toward an Ecosystemic Approach to Chronic Care Design and Practice in Primary Care.”29 In responding with gratitude to his insightful readers,30,31 Soubhi invokes Hardin’s “Tragedy of the Commons,”32 reminding us of the interconnectedness of the complex systems in which we work and live. In this sense, “you complete me” is a statement of the goal of health care, and an ecological perspective is needed to minimize unintended consequences.33
John Frey’s portrayal of the enduring career and life of John Geyman34 is amplified by the online comments of some of the giants whose life he influenced—Phillips,35 Gerard,36 Rosenblatt,37 and Scherger.38 These discussants remind us of how much our interactions with others are vital to completing our lives.
Please help to complete the exchange of ideas at http://www.AnnFamMed.org.
- © 2007 Annals of Family Medicine, Inc.