Sackings at the Canadian Medical Association Journal and editorial independence

543 EDIT ORIAL S able. To suggest that these can be minimised by having all such decisions reviewed by a specialist is highly optimistic, especially given the decreasing availability and inequitable access to such resources. While recent improved access to psychological therapies through partnerships in general practice, 11 and proposed direct referral mechanisms to clinical psychologists, 12 are most welcome, it is not yet clear whether these developments will increase access for patients with bipolar disorder to the more intensive and targeted therapies they require. From a primary care perspective, the most useful mental health guidelines tackle the tough issues that cross a GP' s desk on a daily basis. 9 Where are the best sources of self-help, self-monitoring, detailed illness descriptions, and family education to be found? Are there high quality e-health resources available? 13 What options are available to a GP when patients become a danger to themselves or their reputations? How should a GP deal with poor compliance? What are the cost implications for patients of particular management plans (eg, costs of travel to specialist appointments)? What should the GP do when specialist services are not available? What are a GP's responsibilities when the patient doesn't return for follow-up appointments and/or medication monitoring? How should a GP document mental health consultations in their medical records? What other clinical or management resources are available? Is additional training required to deliver the therapies recommended in the guidelines? While the recommendations presented by Mitchell et al, 3 and the related technical summaries, do provide useful clues, insufficient attention to these practice-based issues risks an overall negative rating from the target audience. References 1 Goodwin GM. Consensus Group of the British Association for Psycho-pharmacology. Evidence-based guidelines for treating bipolar disorder: recommendations from the British Association for Psychopharmacology. General practitioners' response to depression and anxiety in the Australian community: a preliminary analysis. A clash of purpose between a journal's editors and its owner 20 February 2006 may well be the day that marked the beginning of the decline of the CMAJ (Canadian Medical Association Journal) as a widely respected national and international journal. On that day John Hoey, Editor-in-Chief of the CMAJ for 10 years, and his Deputy Editor Anne Marie Todkill were summarily dismissed by Graham Morris, the president of CMA Media Inc which publishes the CMAJ. 1 As to the reasons for the firings, Morris said, " I felt that …