Receiving AFP on your desk is routine; you probably never even think about how it gets there. Perhaps you have written a manuscript for AFP and have wondered why it takes time process that involves many people in several states. First, submitted manuscripts are evaluated by the editor, Jay Siwek, M.D., at Georgetown University Medical Center in Washington, D.C. Manuscripts are reviewed based on their quality and usefulness to AFP readers. If selected, manuscripts then go through a peer review process, in which each manuscript is reviewed by at least one family physician and two experts in the subject discussed. Depending on the topic, the latter may be family physicians or subspecialists in another discipline.

In addition to peer review, AFP’s medical editors work with authors to ensure the highest quality content. The AFP medical editors, who are family physicians, reside in Georgia, Michigan, California, Kansas, Tennessee, North Carolina, Pennsylvania, Utah, and Washington, D.C. Most communication among authors, the George-town office, the peer reviewers, and the medical editors takes place electronically; e-mail has greatly increased efficiency.

After authors have made revisions in accordance with peer reviewer and medical editors’ requests, manuscripts are accepted for publication by Dr. Siwek. Then they are sent to the Leawood, Kansas, office where a group of professional editors prepare them for publication. These team members are professional journalists who focus on providing the best information to family physicians in the most readable form. This team works closely with Dr. Siwek; Mark Ebell, M.D., the deputy editor; Kenny Lin, M.D., the editorial fellow; the other medical editors; and AFP authors to prepare manuscripts for publication. This process is time consuming, but I think you will agree that the final product demonstrates its value.

While the words are crucial, the illustration and layout of a publication are important as well. Appropriate illustrations and layout add clarity to an article and enhance readability and understanding. Most of the clinical illustrations in AFP and the journal’s widely recognized cover illustrations are planned in an interaction between the editors and AFP’s art coordinator, Dave Klemm. Dave, who is based at Georgetown, works with a number of prominent medical illustrators nationwide who create the cover illustrations, anatomical drawings, and other artwork for AFP. The production department in the Kansas office includes graphic designers who lay out the articles based on established templates. This process involves taking all elements of an article and arranging them to be visually appealing and to work well with the article text.

The production department also organizes the advertising pages and intersperses them with the editorial content—a complicated process called imposition. Final editorial and advertising pages are then sent on computer disk to a vendor in Kansas City who prepares the final files and editorial page proofs. The production department does a final check of the proofs and sends the computer files to our printer in Minnesota. Printing more than 180,000 copies of AFP twice a month requires a variety of press capabilities and a complex bindery system.

Meanwhile, the circulation department in the Kansas office prepares an electronic file of all the names and addresses of AFP’s subscribers. Both the cover address labels and the clinical quiz answer cards have a bar code applied with an ink jet system. This allows the Kansas office to automatically record CME data when quiz cards are returned.

If you have been receiving AFP for several years, you probably noticed that the frequency has increased. Until 1992 it was published 12 times a year. In response to requests from readers and advertisers, the frequency was increased to 16 issues per year, then to 20 in 1997, and finally to 24 issues a year in 2000. As the frequency increased, the publishing steps described above obviously had to be adjusted. Fortunately, advancing technology has helped us keep up with the demands of publishing 24 issues a year.

This entire process is governed by policies and procedures to ensure that we continue to publish the highest quality journal for family physicians. Experts in many professions and in many states are all working together to ensure that your copy of AFP arrives on your desk on time twice a month, and that it is written, illustrated, and designed for clarity and quality, as you have come to expect from AFP.