Abstract

How would you feel if the Royal Society of Medicine promoted the sale of cigarettes? What about if the president and trustees decided to hold a seminar sponsored by poppy farmers? Or the chief executive decided to close the academic department and replace it with a department of human trafficking? What would you do with your membership? Would you be proud of your involvement with a scientific society? Would you be happy to contribute to meetings and conferences in the knowledge that you were furthering your career in a respected organization, even though it was making a healthy profit by unhealthy means? Just in case you were beginning to wonder if I was building up to a climactic announcement, you can relax. As far as I understand it, the RSM is flourishing by entirely reputable means. But can we say that about all publishers? Some of the larger ones have been criticized for years for behaving like parasites, sucking every last drop of effort from authors, reviewers and editors, simply to boost their operating income and please their shareholders. Now Reed Elsevier—considered by many in the world of publishing to be the biggest, baddest wolf of them all—finds itself under attack for promoting arms sales. Richard Smith identifies the cynical contradiction at the heart of this approach: ‘Surely the company's business mission would be impossibly confused: would the company be in the business of killing people or keeping them alive?’ (pp. 114-115) Scientific publishing is a major part of Reed Elsevier's armoury, responsible for just under half a billion pounds of its profits. It publishes some of the world's best journals, including The Lancet, which has established itself as the world's premier journal for global health as well as being the weekly medical journal most feared for its piercing critique. Indeed, The Lancet's editors famously rebuked Reed Elsevier for its support of an exhibition for the arms trade. Last month, the Joseph Rowntree Charitable Trust—a displeased shareholder—sold its shares in the publishing giant over the same malign entanglement. Now Smith calls for authors, reviewers and readers of The Lancet and other Reed Elsevier journals to orchestrate a campaign. ‘This is where Reed Elsevier is vulnerable,’ he urges. ‘Were those researchers to go elsewhere, the company would promptly pull out of arms exhibitions.’ One strong motivation to publish in The Lancet is its high impact factor (24 and rising)—that is, if you care for impact factor. Mabel Chew and colleagues studied impact factors in seven general medical journals over an 11-year period, and interviewed ten journal editors (pp. 142-150). They confirmed what we know: that impact factors have been rising over the last decade. They also confirmed what we suspected: that deliberate editorial practices and manipulation were a factor in this rise. Despite their successful manipulation of impact factor, journal editors were dissatisfied with it as a measure, leading the authors to conclude that their study adds weight to the need for complementary measures. The problem is that the hypocrisy of publishers is mirrored by the hypocrisy of editors. They might be dissatisfied, but too many of my illustrious colleagues are hell-bent on doing whatever their conscience allows in pursuit of a higher impact factor and a stronger marketing message. I have an alternative: forget this impact factor obsession and try one of Nick Black's walks through London's medical history. This month, he takes you to the lost hospitals of St Luke's, home to seven of the leading hospitals of the 19th century (pp. 125-129). Or you could walk to the Strand offices of Reed Elsevier and throw some rotten eggs and ethical indignation in support of The Lancet. It is a journal whose history, standing, and integrity matter far more than its impact factor ever could.

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