COMMENTARY

October 2002: A Brief History of Medscape as I Know It

Priscilla Scherer

Disclosures

October 09, 2002

Introduction

When Peter Frishauf created Medscape in 1995, his primary goal was to disseminate as much medical information as possible to the broadest and biggest professional audience possible, and to do it at no cost to the reader. Starting out, Medscape provided full-text articles from the journals produced by its parent company, SCP Communications, plus a few others from publishers that were persuaded to join the Medscape Publisher's Circle. This expanding collection of articles comprised the extent of Medscape's content. Many of us who watched the process were convinced the amount of Publisher's Circle content would eventually dry up.

Except it didn't. The rapid growth of the Publisher's Circle partners surprised a lot of us, including plenty of medical publishers who had turned down the chance to reach millions of readers worldwide, who apparently didn't care about a wider audience, academic inquiry, or altruism.

The model and the Publisher's Circle survives; indeed, it flourishes, and Peter's goal of disseminating vast quantities of reliable medical, surgical, healthcare, and technical information has been met several times over. Medical and scientific publishers have begun, albeit slowly and deliberately, to "get" it, and are approaching Medscape instead of the other way around. So, along with numerous original articles and case reports, conference coverage, CME programs, and so on, Medscape posts a growing variety of articles, commentary, and research first published in a number of print journals with a primarily clinical focus.

A few of these Medscape partners deserve special mention here. Relatively early on, the tech-savvy American Association of Neurological Surgeons joined the PC partners with their online journal, Neurosurgical Focus , and we've been proud to make these high-quality, peer-reviewed, single-topic issues available to a widening audience. (In addition to great descriptive articles, NF provided us with some of our first video.) Likewise, Seminars in Neurology has supplied fascinating, practical reviews of some of the more complicated neurologic disorders. In July 2002, the journal Spine began posting selected original research reports and commentary on Medscape Neurology and Neurosurgery and Medscape Orthopedics.

I'm proud to tell you now that Nature Medicine has become the newest member of the Publisher's Circle, with 2 articles from the September 2002 issue. This relationship is particularly pleasing to me because through it, we're adding a bit of basic science to the mix of mostly clinical articles in our archive. In addition, we're posting what Nature Medicine calls "News and Views," a column that brings bedside relevance to the basic bench science article.

The 2 articles chosen this month, "Irradiation Induces Neural Precursor-Cell Dysfunction" and "Limitations in Brain Repair," are especially relevant to neuroscientists and clinical neurologists and neurosurgeons, given the optimism surrounding neuroregeneration that has been kindled by recent advances in stem cell research. As noted by Snyder and Park in their analysis of the article by Monje and colleagues, "now we must deal with the fine print in our contract with developmental biology." They argue that neuroregeneration is (obviously) complicated and challenging, and its success or failure depends, among other things, on the milieu of discrete pathologies of individual diseases that manifest differently at different phases even within the same patient. And that's not nearly all.

Snyder and Park discuss more of this conundrum, emphasizing how each new piece of research raises more questions than answers. This, of course, is the nature of scientific inquiry, as the questions stimulate the search for solutions. Meanwhile, they caution that "patients are ill-served" when we -- physicians, scientists, journalists, publishers -- get caught up in the hype. "Circumspection is not a retreat from the promise of the neural progenitor cell, simply an acknowledgement of the sophistication that will be required to exploit them properly."

I welcome your suggestions and criticisms. What would you like to see on the Medscape Neurology & Neurosurgery site? Are you interested in contributing an article? Please email your ideas to me at neuroeditor@webmd.net. (If your concern is technical, please contact medscapecustomersupport@webmd.net.)

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