Dr. Bridges
As the newly named editor in chief of A&R, the ACR’s flagship journal, S. Louis Bridges Jr., MD, PhD, looks forward to continuing its coverage of advanced technologies, new therapy alternatives and clinical issues, while expanding its global appeal and engaging readers through expanded interactive services.
Dr. Bridges is physician in chief and chair of the Department of Medicine and the Franchellie M. Cadwell Professor of Medicine at the Hospital for Special Surgery (HSS), New York, as well as chief of the Division of Rheumatology at both HSS and Weill Cornell Medical College. His new role on A&R adds to a long list of volunteer positions he has held over the years, including president of the Rheumatology Research Foundation, member of the ACR Executive Committee, chair of the ACR Committee on Research and chair of the Arthritis and Musculoskeletal and Skin Diseases Study Section for the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
While preparing to begin his five-year term as A&R’s editor in chief, Dr. Bridges reflected on his background and interest in rheumatology-related volunteering, including journal editing, and shared his thoughts about continuing the journal’s evolution as a timely and important publication, one with clear benefits for both rheumatology researchers and clinicians.
The Rheumatologist (TR): What has been your journey in the rheumatology field?
Dr. Bridges: I grew up in rural Louisiana. I got my bachelor’s from the University of Notre Dame and my medical degree from the Louisiana State University School of Medicine before doing my internship and residency in internal medicine at the University of Texas Medical Branch. Then I did my fellowship in the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham (UAB), and that’s where I became interested in research and ended up getting a PhD in microbiology following my rheumatology fellowship. From there, I started a research lab program of my own.
TR: How did that transition into an interest in moving toward leadership?
Dr. Bridges: When I was a researcher, I started thinking about possible leadership roles, and it just went from there. I became involved in voluntary positions for the ACR, which I have continued for most of my career. I [was] director of the Division of Clinical Immunology and Rheumatology at UAB for 12 years (2008–20), and in 2020, I joined HSS—I signed on just a couple of months before the pandemic was declared. Being chair of medicine at HSS is very different from most other departments of medicine because our entire hospital is focused on musculoskeletal medicine: We have doctors specializing in metabolic bone disorders, infectious diseases and perioperative medicine, and both adult and pediatric rheumatologists. We rely on our colleagues across the street at Weill Cornell Medical College to provide coverage of other subspecialities.
TR: Do you have experience in the clinic too?
Dr. Bridges: I’ve always seen patients, but since I came here to HSS, my job involves overseeing a big staff. That has limited the amount of time I can see patients, but I still very much enjoy it.
TR: It sounds like your jobs with HSS and Cornell keep you plenty busy. Why did you decide to add the role of editor in chief of A&R to your list of things to do?
Dr. Bridges: As I mentioned, I’ve always been very devoted to ACR. That had its start when I was a junior faculty member, and someone suggested I might want to start reviewing articles for A&R. It sounded like fun, so I did. That got me very interested in the journal. In fact, the first ACR committee I ever served on was the Committee on Journal Publications. Through that committee, I got to meet A&R’s editors, and it was great. I have to say, I idolized them. It was a wonderful experience getting to know them.
Then in 2010, Joan M. Bathon, MD, was named to a five-year term as editor in chief of A&R. [Editor’s note: Dr. Bathon is a professor of medicine in the Division of Rheumatology, Columbia University Vagelos College of Physicians and Surgeons, New York.] Joan and I had collaborated previously quite a bit, and she asked me to be a co-editor under her, and I quickly accepted. I really enjoyed that role. When Richard Bucala, MD, PhD, became the next editor in chief of A&R, he asked me to stay on as co-editor, and I was delighted to do it. [Editor’s note: Dr. Bucala is the Waldemar Von Zedtwitz Professor of Medicine, a professor of pathology, epidemiology and public health, chief of the Department of Rheumatology, Allergy & Immunology at Yale University, New Haven, Conn.; and rheumatologist in chief of the Yale New Haven Health system.] In all, I was co-editor of A&R for seven years, but then had to step down when I became vice president of the Rheumatology Research Foundation in 2017.
When Rick’s five-year term as editor in chief concluded, I was planning my move to HSS, so the timing wasn’t right for me to apply. But then this year when the current editor in chief, Daniel H. Solomon, MD, MPH, was finishing up his five-year term, I gave it serious thought, and discussed it with both him and Rick. They gave me a lot of great advice, and I was really happy to apply for the position. [Editor’s note: Daniel H. Solomon, MD, MPH, is professor of rheumatology at Harvard Medical School, Boston, and Matthew H. Liang Distinguished Chair in Arthritis and Population Health in Rheumatology at Brigham and Women’s Hospital, Boston.]
TR: You’ve been involved in journal editing over many years. Why is that something of interest to you?
Dr. Bridges: It stems from curiosity. As I was contemplating applying for the editor-in-chief position, I read an article titled something like “Why on Earth Would I Ever Want to be the Editor of a Journal?” It talked about how editors get to see the great science that’s underway and push forward what they think is going to be the most important work to advance the field and to improve patient care. Those things all appealed to me. I’ve always enjoyed not only writing, but learning from other people’s work. I like to review grants, and have done that through my volunteering with the NIH and the Rheumatology Research Foundation.
Overall, editing manuscripts gives me the opportunity to learn what the most important questions are; to learn what researchers and clinicians are thinking in terms of different diseases and how they may apply new technologies; and to get a handle on the next steps and innovations to improve patient care. An editor oversees the publishing of good articles that are going to really advance the field. It’s a great responsibility, really, but I am looking forward to it.
TR: As you take the helm of A&R, what direction would you like to see the journal take?
Dr. Bridges: That’s a good question. Under the leadership of Dan Solomon, A&R now has the features “Expert Perspectives on Clinical Challenges” and “Notes from the Field,” and has also added new review articles and tried different article types, including some that don’t get cited frequently but are important to advancing the field of rheumatology. I’m looking at what he has done with the journal, while also acquainting myself with the team from ACR and from Wiley [the publisher]. As I get a feel for the people, the journal and the role, I may decide to make a few additional changes.
Dan and I have already talked about some directions the journal could take. One thing we have talked about relates to clinical trials. Clinical trials are the among the most cited journal articles, but manuscripts describing the really large and important clinical trials usually go to general medical journals such as The New England Journal of Medicine or JAMA or Annals of Internal Medicine. We’d like to see more impactful clinical trials in A&R, which has the benefit of a rapid review turnaround. So that is something I would like to move toward.
On another front, the ACR and A&R already have many collaborations with partners in South America, Africa, Asia and Europe. Manuscript submissions from Asia in particular are growing, so I anticipate building on that and making A&R an even more global journal. That includes continuing to work closely with Josef Smolen, editor of Annals of Rheumatic Diseases, which is the EULAR journal.
Beyond that, I would like to explore new ideas to get our readers to be more engaged with the journal through our website. One idea is to focus on engaging clinicians, including those who are in communities that don’t have an academic medical center. I am weighing options now, but it’s going to take me a couple months to get my feet wet before deciding what would have the most benefit.
TR: Thinking about the A&R audience and their interests, what do you see as the current hot topics?
Dr. Bridges: AI is a very hot topic right now. Everyone seems to include the words artificial intelligence or machine learning in their papers and their grant applications. However, unless a researcher uses correct assumptions and trains their models on the appropriate databasesthe findings might be difficult to interpret properly. That is also something we have to consider when reviewing manuscripts.
Another very hot topic is chimeric antigen receptor (CAR) T cell therapy, which is seen as a huge advance for refractory disease, but the financial cost today is on the order of $1 million per patient. Yet another topic centers on the new technologies that allow us to see the DNA and RNA in the cells of diseased tissue: the genes they are expressing, the 3D models for transcriptomics. This allows a high level, broad view of disease processes that could ultimately have a big impact on advancing research that can be applied in the clinic.
These new technologies and therapies make this a fascinating time to be in research and clinical medicine, but at the same time, we need to put them in perspective in terms of how they can be used—and their results interpreted—to really change the lives of our patients. That is something A&R can facilitate by publishing manuscripts looking at long-term effects of novel interventions.
TR: How will the new editorial team at A&R approach that dual emphasis on the research and clinical sides?
Dr. Bridges: We have wide-ranging expertise on the editorial team. Our three deputy editors and three co-editors and I have complementary expertise. For example, Kenneth G. Saag, MD, MSc, my friend and colleague from UAB, will be one of the deputy editors, and he’s a clinical trialist, implementation scientist, and expert in gout and osteoporosis. [Editor’s note: Dr. Saag is UAB’s director of the Division of Clinical Immunology and Rheumatology, a position previously held by Dr. Bridges.]. Other deputy editors are Mariana J. Kaplan, MD, of NIH and Karen H. Costenbader, MD, MPH, of Brigham Mass General/Harvard Medical School.
In the coming months, I will be emulating Dan Solomon’s approach to editorship of the journal: The members of the editorial team take on manuscripts in their areas of knowledge, follow the chosen manuscripts from start to finish and recommend which should be published. That standard approach should continue to be very successful. Dan and his team have done a terrific job at publishing leading basic and translational research studies, while also helping to guide clinicians in the medical management of patients with rheumatic diseases.
TR: You sound excited to get started in your new role as editor in chief of A&R, even if it does add to your overall workload.
Dr. Bridges: A lot of people tell me I choose jobs based on how difficult they are! But really, this new post is a natural progression. I started out as an article reviewer, then became advisory editor, then a co-editor, and I enjoyed all of those roles. I like reading and scientific thought. I enjoy thinking of ways innovative approaches can improve patient care and outcomes. As an editor, I will get to do all of that, plus solicit manuscripts, look at guidelines, delve into clinical trials—all sorts of different things. The editor in chief is a big job, and it’s a highly visible one. I feel very honored to be in the role for A&R.
Leslie Mertz, PhD, is a freelance science journalist based in northern Michigan.
