Challenges at the Pharmaceutical—Physician Boundary

F or many years, there has been a necessary but at times uneasy relationship between companies that produce medications and physicians who prescribe them. Often, research physicians develop information that the companies apply to commercial production of targeted products. The price of such development is huge and leads to aggressive promotion of specific products, with various measures and inducements that range from the blatant to the subtle seeking to influence physicians. A larger and larger proportion of physicians have a major part of their research funded by pharmaceutical companies, so much so that some prestigious journals have recently stated that such funding will no longer disqualify individuals from being guest editors or reviewers. There are few if any prominent academics who would qualify unless this changed. There have been several prominent cases—Dr Nancy Olivieri, for example—of corporate interference with the dissemination , with support for them, one may add, from major institutions. In parallel, there has been development of the in-house editorial staff— " ghost writers " as they were labelled in an investigative report in a recent CBC program. They may work with articles after they have been submitted and massage them so that the authors, when they receive them after review and with comments, are clear that a significant change of content and emphasis has been made. The Journal has seen this on occasions , and the overall quality and balance of the manuscripts have been acceptable to reviewers. The report, however, suggested that some writers produce articles using information from the company about its products, and then the company seeks clinicians in practice to have their names used as the authors. Let us be clear that there is no problem with having help with the writing of articles—indeed some research institutions now openly employ people with these skills—as long as there is a clear declaration of such involvement in the acknowledgement section, but it is absolutely unacceptable to represent as one's own scholarly work the prepared work of pharmaceutical companies' contract writers. With people ever more busy and the ever-present pressure to publicize " product, " whether as scientific papers for the academician–clinician or as the later R&D results from the pharmaceutical marketer, as a medical publisher we must be ever diligent to assure not only the appearance of boundaries but also to reaffirm their reality. The Journal has recently encountered the need for heightened clarity in …