The Trouble with Medical Journals  book cover
1st Edition

The Trouble with Medical Journals

ISBN 9781853156731
Published September 15, 2006 by CRC Press
312 Pages

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Book Description

It is a turbulent time for STM publishing. With moves towards open access to scientific literature, the future of medical journals is uncertain and unpredictable. This is the only book of its kind to address this problematic issue.

Richard Smith, a previous editor of the British Medical Journal for twenty five years and one of the most influential people within medical journals and medicine depicts a compelling picture of medical publishing. Drawn from the author's own extensive and unrivalled experience in medical publishing, Smith provides a refreshingly honest analysis of current and future trends in journal publishing including peer review, ethics in medical publishing, the influence of the pharmaceutical industry as well as that of the mass media, and the risk that money can cloud objectivity in publishing.

Full of personal anecdotes and amusing tales, this is a book for everyone, from researcher to patient, author to publisher and editor to reader. The controversial and highly topical nature of this book, will make uncomfortable reading for publishers, researchers, funding bodies and pharmaceutical companies alike making this useful resource for anyone with an interest in medicine or medical journals.

Topic covered include: Libel and medical journals; Patients and medical journals; Medical journals and the mass media; Medical journals and pharmaceutical companies: uneasy bedfellows; Editorial independence; misconduct; and accountability; Ethical support and accountability for journals; Peer review: a flawed process and Conflicts of interest: how money clouds objectivity.

This is a unique offering by the former BMJ editor- challenging, comprehensive and controversial. This must be the most controversial medical book of the 21st Century
John Illman, MJA News

Lively, full of anecdote and he [Smith] is brutally honest
British Journal of Hospital Medicine

Please note that the reference to Arup Banerjee on page 100 of this book should be to Anjan Banerjee. We apologise to Professor Arup Banerjee for this oversight.


Table of Contents

Introduction: medical journals are probably a force for good but need considerable reform 
The nature of medical journals
Why bother with medical journals and whether they are honest?
What and who are medical journals for?
Can medical journals lead or must they follow? 
What are and what should be the values of medical journals?
The processes of pubishing medical research
The complexities and confusions of medical science
Peer review: a flawed process at the heart of science and journals
Problems in publishing medical research
Research misconduct: the poisoning of the well
The death of the author and the birth of the contributor?
Publishing too much and nothing: serious problems not just nuisances 
Conflicts of interest: how money clouds objectivity
Editorial misconduct, freedom and accountability: amateurs at work
Important relationships of medical journals
Patients and medical journals: from objects to partners
Medical journals and the mass media: moving from love and hate to love
Trying to stop failing the developing world
Medical journals and pharmaceutical companies: uneasy bedfellows
The highly profitable but perhaps unethical business of publishing medical research
Ethical accountability of researchers and journals 
Relations between research ethics committees and medical journals: guarding the probity of research
Ethical support and accountability for journals: an ombudsman, an ethics committee, and next?
Libel and medical journals: proper constraint or against the public interest?
The case that concern with ethical issues in publishing medical research is overdone
The future
Ethical manifestos for four different futures for medical publishing

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Richard Smith, Chief Executive, United Healthcare Europe. Former Editor of BMJ and Chief Executive of BMJ Publishing Group


5 Stars: This book is important to the general reader
I enjoyed the book - a real page turner!
Amazon customer review, Oct 2006

5 Stars: Editors unaccoutable as kings!
A stonking good read ... Wonderful stuff!
Amazon customer review, Oct 2006

5 Stars: A new classic
This book is a must read for anyone who practices medicine or conducts, peer reviews or publishes research. While the subject matter is extremely serious, with profound and unavoidable lessons for doctors, researchers, editors, reviewers and publishers, it is also highly entertaining thanks to Smith's story telling which makes each chapter a joy to read. The book has a broader remit than its title would suggest. It is as much about the state of medical research as a whole and its consequences for medicine, as it is about publishing. A new classic - highly recommended- 5 stars
Amazon customer review, Oct 2006

Lively, full of anecdote and he [Smith] is scrupulously honest
British Journal of Hospital Medicine

A punchy book that deserves to be read...All human life is in this book, which makes plenty of pertinent points...It is a real page-turner, and I recommend it.

Richard Smith, a former editor of the British Medical Journal, has written a witty, readable and provocative account of the current and future role of scholarly medical journals...I suggest you drop heavy hints for this book to be added to your birthday present list.
Learned Publishing

I read Smith's book with interest and was concerned greatly by some of the accusations he made within its pages.
Pharmaceutical Marketing

Amusing ...
The Times

This is an absolute must read book. It is beautifully written, but the content is quite devastating. I read it from end to end in one sitting and was riveted throughout. Any illusions one might have had about the integrity of scientific research, the veracity of papers, and the altruism of journals are shattered forever. But the demolition is done with such a lovely blend of logic, humour, anecdote, and evidence that it really does make a cracking good read. It should be a standard text for all courses in scientific subjects, never mind medicine, as it would open students' eyes to the dangers of taking published work for granted. If you buy no other book this year, buy this one, and then reflect on which of your colleagues most need a copy too, and either a) give them your copy or b) buy some more.
Evidence-Based Medicine: Primary Care and Internal Medicine, BMJ, August 2008

The Trouble with Medical Journals is truly an eye opening book. Smith is able to lend instant credibility to his claims as a former insider of that world. This book is highly recommended for all medical libraries. With its clear conversational tone and broad coverage of research and publishing, it will be useful for doctors, researchers, and librarians, as well as consumers and patients.
Medical Reference Services Quarterly, Vol 26, 4, 2007

This must be the most controversial medical book of the 21st century, with the same kind of explosive impact as Ivan Illich's critique of the limits of medicine, Medical Nemesis (1976).
Medical Journalists' Association News, Feb/Mar 2007

A valuable educational resource for editors and reviewers, and a gold mine of data for journalologists.
The Journal of the European Medical Writers Association, Vol. 16, No. 2, 2007