cited several trends as motivations for starting a new open-access general medical journal. These included the expansion of global investment in scientific research, the migration from print to digital delivery of journal content, and calls to ensure the benefits of funded scholarship were made readily available worldwide. 2 By any measure, JAMA Network Open has been an extraordinary success. Since 2019, we have seen submissions increase from 3100 to nearly 15 000 in 2023. Our publication rate has grown from a few articles published every Friday to a mean of 40 articles spread across the workweek. Importantly, the quality and reach of the articles has increased in tandem. In 2023, JAMA Network Open published 1960 research articles, and 202 of these were reports of clinical trials. Articles published in JAMA Network Open last year had more than 30 million views and 73 000 media mentions. 3 JAMA Network Open's impact factor is one of the highest among general medical open-access journals. There are many reasons that JAMA Network Open has emerged as the world's leading large-volume open-access journal, including its synergy with the other 12 journals that comprise JAMA Network. What cannot be overstated in the journal's growth and success has been the commitment and vision of its first editor in chief. With Immense Gratitude to Frederick P. Rivara It is nearly impossible to express the appreciation that the medical community, the entire JAMA Network, and JAMA Network Open have for Dr Rivara for his leadership during the past 24 years. Dr Rivara became editor in chief of Archives of Pediatrics and Adolescent Medicine, now JAMA Pediatrics, in 2001. While shepherding the journal through its name change and integration into JAMA Network, JAMA Pediatrics became the preeminent journal focused on child and adolescent health. In 2018, he became the editor in chief of JAMA Network Open. It was Dr Rivara's vision and commitment to excellence, including rigorous external peer review, multilevel editorial oversight, external statistical review of all published manuscripts overseen by internal statistical editors, and the same worldclass editing and production processes offered at all JAMA Network journals, that has guided JAMA Network Open.As with all journals, particularly large-volume open-access journals, there is a potential tension between the need to publish a certain number of articles and the scientific rigor of the research reported in those articles. As one of the initial cadre of associate editors, I can confirm Dr Rivara never wavered from his focus of publishing the best science. An objective example of this is the 12%