On January 2, 2000 (one day before my 60th birthday), I became the editor in chief of JAMA. It was not a position I'd sought, but I had been convinced by the chair of the search committee, my colleagues on the JAMA Editorial Board, and my husband that it was the right thing for me at that time. As it turned out, they were absolutely correct. Considering the history of the previous 14 JAMA editors, all of whom had been fired, I accepted this position only after it was agreed that (1) I receive a 5-year renewable contract (instead of the usual annual renewal); (2) I would be appointed as a senior vice president (SVP), not the proposed vice president; and (3) I would report to a Journal Oversight Committee (there had never been one before) for all editorial issues and to the executive vice president (ie, the chief medical officer) of the AMA for administrative issues (instead of reporting to the AMA's SVP for business, to whom the previous editor and the publisher had reported). All of these negotiations proved to be vital to success.
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