In December 2003 the BMJ published a devastating critique of clinical research in the form of a spoof article about a new research company called HARLOT Plc (How to Achieve positive Results without actually Lying to Overcome the Truth), which could “guarantee positive results for the manufacturers of dodgy drugs.”
Figure. Smith: A trendsetter. Photo by: BMJ
On the eve of his departure, BMJ editor Dr. Richard Smith said this fictitious article is one that stands out among the hundreds BMJ has carried during his 13-year tenure, because it typifies his approach to editing.
“Reading a journal should be a pleasure, not a chore,” said Smith, 52, who has worked at the journal for 25 years. “At the BMJ we've tried to make it as entertaining as possible. I think humour is very powerful.”
The article on HARLOT Plc underscores his pledge to confront bias and bad science in research and in medical journals, something he has also tackled through the UK Committee on Publication Ethics.
He was among those to initiate discussion over author's conflicts of interest as well, something he says is still a “substantial issue” given that “a lot of medical journals are an extension of the marketing arms of pharmaceutical companies.”
Smith left BMJ July 31 because “it is time to do something different.” He will be the new chief executive of a European arm of United Healthcare Group (UHG), one of the biggest health care companies in the world. The UK-based UHG aims to identify vulnerable elderly patients and keep them out of hospital by providing alternative care. While Smith's move may be a radical change it certainly doesn't mark the end of his journal career. “Ironically, it could be that I write more,” he says.
Smith predicts that 2 projects he started at the BMJ have enormous potential to change the face of that journal and medical publishing in general.
Now that technology can allow a system of peer review that is completely open he would like to see “open peer review” take place on the Internet so that reviewers and authors can take part in a real time exchange of views.
His second prediction is that BMJ's Electronic Long Paper Short (ELPS) project will transform the journal. “The future is not just on paper or just online — it is using the strengths of both media,” he says. While online articles may be in a multimedia form and include raw data, the paper journal will include summaries and will become more journalistic.
Ironically, the same technology that has created these opportunities for journals may undermine their very existence. Ominously, Smith's resignation letter talked of “great threats” facing the BMJ.
The movement to make original research freely available online is progressing rapidly with the launch of the Public Library of Science's PLoS Biology and later this year, PLoS Medicine. The latter will compete with general medical journals, such as BMJ.
BMJ itself will bring in some user charges for BMJ.com next year, although the original research will remain free. Smith says the move to restrict access was inevitable. — Colin Meek, Wester Ross, Scotland
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