Presidents don’t generally write full-fledged articles in the pages of scholarly, peer-reviewed medical journals. But President Barack Obama isn’t like most presidents.

Yesterday, the onetime Between Two Ferns guest appeared in the pages of the Journal of the American Medical Association (JAMA), becoming the first sitting president to write a full article in a publication seen as one of the most important in academia. (George W. Bush did write a commentary in 2004, however.)

The topic he discussed? The rollout of the defining legislation of his presidency, the Affordable Care Act (ACA). The article spoke favorably of the work that bears his signature, while emphasizing that more progress needs to be made.

“Americans can now count on access to health coverage throughout their lives, and the federal government has an array of tools to bring the rise of healthcare costs under control,” the article, which noted his current job in the author affiliations, stated. “However, the work toward a high-quality, affordable, accessible healthcare system is not over.”

Among the improvements floated: a push for a single-payer option for healthcare.

JAMA accompanied Obama’s scholarly work with three separate editorials, including one written by Peter Orszag, the director of the Office of Management and Budget at the time that the Affordable Care Act was passed.

JAMA Editor-in-Chief Howard Bauchner, M.D., in a post discussing the president’s article and accompanying editorials, noted the challenges the law created, while generally speaking positively of the law’s results.

Although the president outlines numerous future challenges, such as further expansion of Medicaid, controlling the increase in drug prices, and the need for greater competition in certain healthcare markets, he does not specifically directly address the 20 million to 25 million individuals who remain uninsured or the increase in healthcare costs in the private sector. However, there will never be a randomized clinical trial of healthcare expansion in the United States; only observational data will be available. Accordingly, while some will dispute the findings and extent of progress described by the president, ultimately the data are critical and speak extremely well of the early years of the ACA.

How did this article come about? To put it simply, President Obama had some help, in the form of assistants (he specifically credits Matthew Fiedler, Ph.D., and Jeanne Lambrew, Ph.D., for their help in writing the article) and researchers on the White House staff.

However, one thing he did not have, according to JAMA spokesman Jim Michalski, was special treatment by the editors of the publication.

“The article by President Obama was treated in the same fashion as other Special Communication articles, including undergoing rigorous internal review, two revisions of the manuscript, and subsequent modifications during the editing process as the revised manuscript was reviewed again by the Editor-in-Chief and Executive Editor,” Michalski explained to the Washington Post on Monday.

Surprisingly, it’s not Obama’s first time being published in the journal. In fact, it’s something of a bookend for the president, who, in 2008, while still a Senator from Illinois, wrote a commentary discussing his healthcare strategy, as did his competitor, John McCain.

(Jonathan Ernst/Reuters)