In the early 1990s I spent the weekend at the home of a friend’s parents, both of them GPs. I’d recently started work as a political news reporter on the GP magazine Pulse. “Never read it,” said my friend’s dad. “I’m a BMJ man through and though.”

He’s now retired, but whenever I visit a well-thumbed copy of the latest print journal sits on his desk. At the time I did not ask how he defined a “BMJ man,” but now realise he likes the journal’s general readability, and its mix of peer reviewed research and educational articles, editorials, and obituaries. At the time he had little interest in medicopolitical news which the BMJ’s competitor titles for UK family doctors (Pulse, GP, and Doctor) covered comprehensively.

I thought of my friend’s father two weeks ago at the annual meeting of the BMJ’s editorial board, a group of internationally renowned and active clinicians, clinical academics, and health policy experts. A large part of the meeting was spent discussing what the BMJ should be covering in the year ahead, but there was also a long discussion about what distinguishes the journal from the world’s other general medical titles (Lancet, NEJM, JAMA, PLoS etc).

What, in other words, is the journal’s unique selling point? What is it that its readers like and value? Is its “Britishness” a strength or weakness, particularly to international readers? How can it appeal to both primary care doctors and secondary care doctors? Does the voice of patients have a place in the journal, and if so, how? What about other health professionals? Should it cater for them too?

When my friend’s father was working as a GP in Herefordshire the BMJ was a very different beast. It carried less news, there was no website, blogs, podcasts, videos, or iPad edition, there were no arresting cover images (the blue cover doubled as a table of contents). Nowadays the journal employs both doctors and journalists, it runs campaigns and investigations, offers Cleveland Clinic CME points, carries both UK and international news, and uses email alerts and social media to let readers know when new articles appear online each day.

In a typical week we now publish almost 100 articles online (excluding blogs and multimedia). This forces readers to filter in some way. How can we make that easier? One board member suggested badging our international offering BMJ World, as the BBC does. Another proposed that we recruit a UK editor to commission and curate articles most relevant to UK readers (although arguably we do this already when we decide what goes in print each week, and which articles to promote on our designated homepage for the UK). We explained a recent decision to scale back on medical humanities content (no more reviews, for example) because they fared poorly in reader panel surveys and in online hits. This was felt to be a shame. There was a similar call to commission more articles on ethics.

Most board members weren’t aware of these recent changes. At lunch one said the journal’s readability was doubtless because of the journalists on the staff. Another responded to an update from us about recent campaigns and investigations (transparency, research ethics etc) by describing us as “an objective haven for tough issues.”

We also talked about influence and impact, particularly internationally. One board member suggested partnering more formally with newspapers like the New York Times, which not only covers many of the articles we press release but also highlighted the annual “dose of fun” in our Christmas issue. We do partner with other publications and channels UK organisations (the Daily Telegraph and Channel 4 Dispatches for many of our investigations.

There were comparisons with other international titles. The NEJM website was commended for the way it clusters articles online. The board liked PLOS commentaries that accompany research papers and are written by someone at the journal.  Authors appreciate being able to ask pre-submission queries and like to see their articles covered in mainstream media (the BMJ’s press office, incidentally, works hard to ensure press released articles get covered by national and international media, and we have a PR agency in New York with excellent access to medical correspondents).

Some of this feels a world away from the needs of a Herefordshire GP, and it is a challenge to balance the (sometimes conflcting) information needs of UK readers working in primary and secondary care alongside those of international researchers, and doctors in developing countries. Perhaps there is no such thing as a BMJ man or woman anymore?

David Payne is editor, bmj.com, and readers’ editor