The Elsevier-Merck publication scandal made this week’s edition of NPR’s On the Media. In “Peer Pressure,” radio journalist Bob Garfield interviews Peter Lurie, deputy director of Public Citizen’s Health Research Group.
There’s something very familiar about the way corporations botch public relations. It’s too tempting to take the defensive position, yet this reaction is more hurtful to a company than admitting fault and taking swift corrective action. As Lurie explains:
the initial refusal of the publisher [Elsevier] to acknowledge that there was a problem and initially to refuse to investigate it makes it seem even worse. I mean, these are people who are in principle committed to notions of free speech and the exchange of ideas as being important, and yet when they come upon a very obviously irregular practice within their own ranks, they try to turn a blind eye to it, dismiss it by saying, this happened many years ago.
Lurie sees biomedical journals as ripe for conflicts of interest because publishers often depend heavily on big pharma for advertisement and reprint sales. While most biomedical journals insulate the business side of publishing from the editorial side, Lurie is skeptical that the editorial process can truly avoid the influence of big money. He states:
And so, that temptation will always be there, and until such time as we develop a system of providing more objective information to physicians, we’re going to have to worry about the veracity of what is being consumed by the doctors.
This sounds like Lurie is blaming the system, which is fine, but his system sees doctors as merely the victims and not part of the problem. Doctors are intermediaries between pharmaceutical and device-manufacturing companies and a potentially huge and lucrative market of customers. One should therefore expect that company sales reps, using any influence they have, will attempt to influence doctors in any way possible.
But the influence also goes in the other direction. You will notice that the Australasian Journal of Bone and Joint Medicine contains an honorary editorial board of professors, specialists, and department heads. While I cannot say if these individuals gladly received financial compensation to have their names so prominently displayed on the journal masthead, they certainly received symbolic (academic) compensation for their participation. Without their involvement, the development of a piece of marketing disguised as credible journal would have been more difficult to pull off.
If Lurie wishes to blame the system for the publishing fiasco, he cannot paint doctors as the victims. In this case, they lent their authority to a fraudulent journal. Without their participation, the ruse would not have been as easy to pull off.
When it comes to eroding trust in medical information, doctors are part of the disease. Let’s hope they will also be part of the cure.