Every physical therapist and physical therapist assistant knows that each entry-level educational program has a limited number of "seats." No matter how many applications a program receives, it can accept only a set number of students. If the number of applicants rises, then the proportion of applicants who are accepted (acceptance rate) must decline. In the same way, the Journal of Geriatric Physical Therapy [JGPT] can publish only a limited number of print pages each year. No matter how many submissions we receive, we are able to accept only a portion of those manuscripts.

Thanks to the dedicated work of previous JGPT editors, our submission rate has increased substantially over the past few years. As a consequence, we have adjusted our acceptance rate downward. Given the current submission rate of well over 200 manuscripts per year, our acceptance rate is now about 15%. This change has both positive and negative aspects.

On the positive side, this is an opportunity to ensure that the high quality of JGPT articles is elevated even further. We can, and do, now require that manuscripts demonstrate not only strong and sound science, but also exceptional clinical relevance. Manuscripts representing relatively lower levels of evidence, such as case reports, studies without a control/comparison group or period, or studies with inadequate statistical power to detect differences, are extremely unlikely to be accepted. Scientifically strong studies that are not directly pertinent to the practice of physical therapy are also not likely to make the cut. Because clinicians are more motivated to read research articles if studies are perceived to contain clinically beneficial knowledge, publication of clinically relevant articles supports evidence-based practice.1,2 Both academic and clinical readers benefit as publication quality continues to rise. The JGPT itself will also benefit: if our Impact Factor and SCImago journal rankings also continue to rise, we are able to attract additional outstanding investigators and authors to submit their work here.

There are also negative aspects to the widespread decline in scholarly journal acceptance rates. In 2012, economist and Vanderbilt professor John P. Conley described the growing problem and several undesirable consequences.3 According to Conley, 20 years ago there was an average lag time to publication of 9 months and acceptance rates ran at 20%, while today lag times are on average 2 years and acceptance rates in the most highly-esteemed journals hover between 5-10%. For clinicians, academicians and investigators alike, the potential reduction in scholarly output and knowledge translation to the field is problematic. If the ideal acceptance rate falls in the 20-30% range, as Conley purports, journals are rejecting a substantial number of publication-worthy manuscripts with potential value to their respective fields.

For tenure-track academicians who must "publish or perish" and investigators who must demonstrate a track record of publications in order to obtain grant funding, low acceptance rates are a major barrier to success. Authors under pressure to publish then revise their rejected manuscripts and submit them elsewhere, leading to increased submission rates. For editors and reviewers, high submission rates accompanied by low acceptance rates mean an increased workload and greater pressure as they attempt to distinguish between manuscripts in the top 5-10% versus those in the next 5-10%.

A high submission rate signals the success of a journal. It is, in a way, a luxury for editors who can then be confident they will have a subset of good manuscripts from which to choose. Yet, the necessary commensurate reduction in the acceptance rate complicates that selection process. The JGPT editorial team has taken steps to address the challenges posed by this change. First and foremost, we have set accept/revise/reject rate targets for the various stages of the review process so that our eventual acceptance rate is about 15%. These targets are not set in stone, and editors are free to make exceptions for outstanding manuscripts.

We revised the Instructions to Authors with several aims in mind: to reduce the number of submissions that are not a good match for the JGPT, to clarify the requirements for manuscript content and formatting, to require reporting of measures of clinical significance in addition to statistical significance, and to require authors to explicitly discuss the clinical implications of their findings. We also edited our Letter of Invitation to peer-reviewers to explain our increasing emphasis on accepting only those manuscripts with both sound science and direct clinical relevance. Currently, we are substantially revising the template available to peer-reviewers so that all reviewers clearly understand the high level of quality we seek in each manuscript, and to better standardize the content of the reviews we receive. Each reviewer will be sent a copy of the updated reviewer template as soon as final edits are completed, and the template will be available for their ongoing use on the JGPT Editorial Manager website.

To publish a greater number of worthy manuscripts while staying within budget, many scholarly journals have moved away from the traditional and costly print-page format. Some have adopted a hybrid print-plus-online format (which we have done temporarily, to reduce the backlog of accepted papers and shorten the lag time to publication), or an online-only format. In this way more articles can be published for the same cost. Just as increased cell phone use preceded the demise of the public pay phone, increased computer availability and ease-of-use may tip the scales of reader-acceptability towards hybrid or online-only journals, and the era of print-only journals will come to a close. Our aim at the JGPT is to provide high-quality evidence to the field in a timely manner, and we will always strive to do so using whatever format works best for our readership.

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