While I was down in Austin at SXSW this past week, there was a rare glimpse into the big egos that run the journal business in the world. As you may know, publishing research articles is a business, and because it involves prestigious reputations — both on the journal and academia side — there is a lot of ego involved. Lots.
So imagine if you’re sitting at the head of one of the world’s most prestigious and respected journals, the Journal of the American Medical Association (JAMA), and an academic — not from Harvard or Yale, but from Lincoln Memorial University — calls you on the carpet for failing to conduct a very good peer-review on a peer-reviewed paper appearing in JAMA:
Jonathan Leo, a professor of neuroanatomy at Lincoln Memorial University, wrote a succinct and reasonably worded letter to the British Medical Journal noting that a study on the use of the antidepressant escitalopram (Lexapro) in stroke had concluded that the drug was better than other treatments, when in fact the data supported no such claims.
He also noted that the authors had failed to disclose their ties to the drug makers Forest Laboratories.
The response from JAMA’s editor-in-chief, Catherine DeAngelis was both unprofessional and immature:
“In a conversation with us, DeAngelis was none too happy to be questioned about the dust-up with Leo.
“‘This guy is a nobody and a nothing’ she said of Leo. ‘He is trying to make a name for himself. Please call me about something important.’ She added that Leo ’should be spending time with his students instead of doing this.’
Sorry, but when you fall down on the job like this, you deserve to be criticized. JAMA’s reviewers should’ve caught the bias in the article before publication, and had it corrected. Furthermore, the lack of disclosure about the author’s conflict of interest is exactly the kind of thing that the public will no longer stand for.
JAMA’s response is just unfathomable, but taken in the context of JAMA’s big egos, perhaps more understandable. Thankfully there are other outlets for publishing this sort of information, and researchers (and other professionals) will no longer be bullied by editors who disagree with their point of view. JAMA’s homepage makes no note of the controversy. Sticking your head underground is no longer a good enough response.
Read Mind Hack’s take on it: JAMA editors pressure antidepressant whistle blower
Read Furious Season’s take on it: JAMA Editor In Chief “Upset” At Researcher For Pushing Conflict Disclosure At Journal
Read e-Patients.net’s take on it: I Am “A Nobody & A Nothing” & I’m Proud Of It!
Read the WSJ blog entry: JAMA Editor Calls Critic a ‘Nobody and a Nothing’
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3 Comments to
“What Was JAMA and Catherine DeAngelis Thinking?”
Dr Grohol:
I would guess you are trying to be respectful and professional, and I applaud your take at this site, but let’s call it for what it is these days with my “colleagues”:
ego not just run amok, but out of control.
Money corrupts, folks, it is probably the worst addiction this culture has to deal with these days, and physicians are not immune to it, in fact, they may be more prone to it.
How do I avoid it as best I have done? I use the adage from “Field of Dreams”: build it and they will come. Be a responsible, ethical, moral, and caring physician, run your practice under the principles that you know foster good care, and people you will instinctively be able to develop a good rapport and alliance will come to you and spread the word, and you as the physician will survive financially.
It is that simple and applicable.
What pisses me off to no end is few seem to embrace that basic foundation these days, and patients are getting equally inappropriate in their expectations as well. And, insurance has been the driving force to this erosion in care, meds are just the icing on this polluted cake.
My opinion, but one of years of experience.
Thanks for the post!!!
TF,
What does the issue of patients being inappropriate in their expectations have to do with the DeAngelis controversy? I find your posts greatly frustrating because you make so many excellent points only to take unfair shots at patients that have nothing to do with the issue at hand.
AA
AA: (and others reading this discussion)
If you read my posts at the sites I comment at, like here, Carlat’s blog, and Clin Psych, I seem to take shots at everyone who exercises poor judgment, including my colleagues–psychiatrists and PCPs, like I did at the beginning of the comment. Hey, sometimes even myself! What I find so incredulous is people being so outraged I call out patients who have poor judgment and should know better when they come to a doctor for help. Is there some unwritten law that patients can never be wrong or inappropriate? Note I call them patients, not clients or customers. And, from talking with seasoned people who work retail and services, the customer is NOT always right, but always has the right to speak out.
I am trying to note that everyone in the health care process plays a role in the ongoing struggles at hand–doctors, patients, insurers, and politicians.
Don’t agree, that is your choice and opinion.
By the way, since you take me to task at these other sites, you rarely agree with me anyway, so let’s be honest about your position in this debate about mental health care. You do not like psychiatrists overall per the tone of your comments, so if I am wrong in that assessment, I apologize and your future writings will show moderation.
By the way, when over 70% of patients come to me and expect to leave with a prescription while hemming and hawing about a referral for therapy, that is a poor judgment call to me. And their spouting about commercials and drug company sponsored literature is not the best source for facts and guidance. And that is where I tie it in to this blog post.
Again, just an opinion. Have a nice weekend.
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Last reviewed: By John M. Grohol, Psy.D. on 19 Mar 2009
