Covering ourselves
Authors: Trevor Jackson
Journal: BMJ (2007)

The front cover of this week’s BMJ is the first to rely solely on words since we redesigned the journal at the beginning of this year, and even since we introduced regular cover pictures in 2002. The dangers of trying to find one clear, recognisable image for a topic like circumcision—which receives two quite different treatments this week, as the subject of our Head to Head debate (doi: 10.1136/bmj.39406.520498.AD and 10.1136/bmj.39406.523762.AD) and our Clinical review (doi: 10.1136/bmj.39385.382708.AD)—might seem obvious. Fortunately, the typographic possibilities inherent in the word itself are visual enough.

Some readers might ask why the BMJ has to be visual at all, especially those who still lament the passing of the blue covers that, until five years ago, displayed each week’s full list of contents. One obvious answer is that medical journals have to compete in an increasingly crowded and visual marketplace, vying for attention not just with each other but with other types of publications and media. Another answer is that medicine itself is extremely visual.

But perhaps a better answer, and one in the spirit of this week’s personal view (doi: 10.1136/bmj.39419.666042.59), is that designing a cover out of the mass of material that goes to make up a weekly journal is a form of leadership. When David Lewis, a general practitioner in Worcestershire, was a senior medical officer in the Royal Air Force medical branch, he realised that listing protocols and guidelines for junior staff to follow was a form of cowardice. “The courageous leader not only writes down the wisdom, but accepts responsibility for its assimilation and implementation,” he writes. Dr Lewis eventually abandoned the protocols and guidelines and held regular team meetings instead. We use a parallel strategy with our front covers: instead of listing everything and leaving readers to find their own way through it, the BMJ seeks to prioritise, to summarise, and to set the agenda.

Last month we asked readers to tell us what they thought of the BMJ’s 2007 covers. Comments varied from “They’re terrific—congratulations” to “Getting uglier and uglier over time.” This last response might have been prompted by the cover of 24 February (www.bmj.com/content/vol334/issue7590/index.dtl), which featured a close-up of a child’s nose sutured after a dog bite. It caused a few complaints at the time and was the least popular in the survey, suggesting that although doctors are used to seeing things that other people find unpalatable, some prefer not to have to do so at home. Other dislikes on covers included brand names and “glossiness.” The two most popular covers were a London underground map used to illustrate the complexity of impact factors (17 March; www.bmj.com/content/vol334/issue7593/index.dtl) and a pair of red boxing gloves (20 October; www.bmj.com/content/vol335/issue7624/index.dtl) for a research paper on boxing and brain damage.

What front cover ingredients did readers say they liked? “Something simple with the minimum of clutter”; “something that catches my eye”; something “striking.” We hope we have achieved all three this week.