Probably only the most scrutinizing eye would pick out the subtle change on the cover of AFP that appeared a couple of issues ago. If you'll look at the line just under the journal name, you'll see we've added two small words to the phrase “published by the American Academy of Family Physicians.” The phrase now reads “A peer-reviewed journal of the American Academy of Family Physicians.” But the fact that we've just added those words to the cover doesn't mean that we've just added peer review to the editorial process.

AFP has a long-held peer-review process organized through efforts of the Washington, D.C., editorial office located at Georgetown University Medical Center. Editor Jay Siwek, M.D., and his editorial staff members Taiya Olayinka and Lindsey Clark oversee the peer-review process. Each article published in AFP has been reviewed by at least one family physician reviewer and one reviewer who is a sub specialist in the topic area. Here's how the peer-review process works:

All manuscripts submitted to AFP undergo an initial review by Dr. Siwek, who determines whether the manuscript merits acceptance into the peer-review process. Manuscripts passed for review are assigned to a two-to four-member panel of reviewers that always contains at least one family physician representative.

The reviewers are asked to perform a methodical evaluation, with results reported on an evaluation form. Reviews are blinded, of course. The reviewers' evaluation forms and detailed commentaries are returned to Dr. Siwek, who determines whether the manuscript merits further consideration. If so, the manuscript and reviews are submitted to one of AFP's medical editors for further critique. The medical editors play a crucial role at this point in performing their own assessment as well as assimilating feedback from the reviewers and Dr. Siwek. The medical editor composes a letter outlining the revisions required for acceptance of the manuscript.

Once the author receives comments from the reviewer, she or he has two to three months to carry out revisions before resubmission. Revisions are then reevaluated by the medical editor and returned to Dr. Siwek, who makes one final evaluation to ensure that the manuscript is now complete and ready to enter the publication process. This process screens out two-thirds of unsolicited manuscripts submitted for publication.

So, if AFP has been doing this all along, why are we just now adding the label to the cover? It's a good question, and one we sought to answer by gathering information from readers. First, we asked readers if they knew that AFP was a peer-reviewed journal. Then, we asked readers to define “peer review” to see what this term means to them. What we found is that while most readers value the peer-review process and agree on what it is, some readers are still confused about whether AFP is a peer-reviewed journal. And since, after all, we never used the label before, we decided that, just for the record, AFP's cover should now include those two important words: peer reviewed.