Medical Journals Should Disclose Conflicts Just Like Their Authors

In every medical journal, authors must disclose all conflict of interests that might exist to the editors of that journal as a condition of publication.  However, as we are increasingly becoming aware, journal editors do not have to disclose payments they receive from outside sources (pharmaceutical industry, special interests, the government) to publish content in their own journal.  I think they should.

Medical journals, especially those with large physician "reach," are being used less for scientific endeavors and more for political or marketing agendas.  Of course, this is nothing new, in medicine, but it's high time medical journals understand that with the availability of information on the internet, that "special arrangements" with various entities might not remain so private any longer.  As I noted in my earlier blog post regarding the simultaneous publication of a non-peer reviewed white paper in the Annals of Internal Medicine and The Lancet and this publication's association to recent revelations concerning the finances of the American Board of Internal Medicine and their Foundation, such a practice risks jeopardizing their scientific credibility, especially if those revelations are found to be credible.  Legitimacy is an important asset to medical journals and medical journal editors should be aware that physicians who are increasingly being subject to political agendas are growing increasingly frustrated at this covert practice.

More recently, we've seen the editorial decision of another medical journal, the Journal of the American Medical Association (JAMA), decide to allow the conflict of interests of choosing Press Ganey Chief Medical Officer Thomas H Lee, MD as an editorial author for a discussion surrounding the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) in their 10 Dec 2014 issue.  Also, the fact that pointed questions to a webcast supporting the ABIM's MOC process had many questions cherry-picked by the moderators.  I have no problem with a journal siding with one opinion or the other provided there is full disclosure about the financial relationships of the authors of the paper AND those of the journal itself.  But any legitimate discussion requires the disclosure of real or potential conflicts of interests held by the journal to critically review the credibility of what is published. Any double-standard regarding the disclosure of conflicts of interest should not be tolerated by the medical community, especially by physicians who struggle to improve the care of our patients in our evolving health care system, especially when that health care system appears to be increasingly hostile toward physicians and their patients.

-Wes