Monday, July 10, 2006

Journal Wars

Richard Smith, former editor of the British Medical Journal has thrown down the glove in his seething editorial about the New England Journal of Medicine's VIOXX debacle. Call it 'Journal Wars - Episode I' between the New England Journal of Medicine and the Journal of the Royal Society of Medicine:

"The New England Journal of Medicine was made great by
Franz Ingelfinger, who banged on every important door in
Boston urging researchers to admit their best studies to the
journal. The journal assumed the effortless but often
genuine superiority of Bostonians so well described—but
also ridiculed—by Henry James. To some this felt like
arrogance, and the journal has always been hated as well as
admired. Often the motivation for such hatred may have
been jealousy or resentment at failure to make it into its
hallowed pages.

Ingelfinger was followed by Bud Relman, and the
journal grew richer as well as grander. The Massachusetts
Medical Society, the owner of the journal, made US$88m
from publishing in 2005. My guess is that the journal
accounts for at least US$75m of that and that its profits are
probably at least US$15m. The society has grown fat on the
profits and is keen not only to keep the profits coming but
also to exploit the brand. This has led to tensions between
the journal and the society, and those tensions were in many
ways the undoing of Jerry Kassirer and Marcia Angel, the
successors to Relman. Both Angel and Kassirer after leaving
the journal published books bemoaning the excessive
influence of the drug industry, while the society
appointed a new editor, Jeff Drazen, who was depicted
by some as a creature of the industry. He had had financial
connections with 21 drug companies between 1994 and

There's lots o' gold in them there journalistic hills....especially if you make $700,000-$830,000 a pop for one article reprint paid for by the drug company that sponsored a trial published in your journal. Oh, and don't think for a minute the New England Journal of Medicine isn't playing with politics, too. Stay tuned for 'Journal Wars - Episode II,' starring Hilary and Barack.


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