Ghostwriters
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When eight to eleven percent of authors in major medical journals admit to having had someone secretly help them write their papers, you know that medical research as an academic discipline is seriously compromised. The true incidence of this must be much higher since many would not admit to this even in a survey. The problem is that the ghostwriter is usually a person in a drug or medical-device company whose sole goal is to push a product. It is easy for a busy researcher to let another person write a review article and then just go along with the sales pitch parts. The physician saves time while also being financially rewarded; however the physician lacks ethical standards. The New York Times pointed out recently, "As Washington tries to revamp the health care system, concerns about ghostwriting are taking on new urgency. One of the underlying assumptions of the health care overhaul effort is that money can be saved and medical care improved by relying more heavily on research showing which drugs and procedures are the most effective. But experts fear that the process could be corrupted if research articles are skewed by the hidden influence of drug or medical device makers.". In my opinion, it has already been corrupted and attempts to pick effective therapies will be governed by special interests. Ghostwriting, as we know it now, will end but the influence of drug companies and medical device makers will continue to erode the academic medical "scientific" community. What then can be done to help to decrease this influence? Journals need to open up the review process to practicing physicians with no direct paid connections to academia. And while many physicians who are in practice are not interested or capable of this, there still are plenty who are capable. Those in academic medicine need to rethink what their mission is starting from amply rewarded medical school administrators. Strict ethical rules must be enacted and medical schools should include these issues within student course work. American higher medical education has led to many Nobel prizes including the 2009 prize; however, American leadership in the medical world will not continue without ethical conduct in our medical academic research community.
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