Goal Posts and The New England Journal of Medicine

  SCIENCE TIMES : The New York Times, Tuesday, March 20, 2012

PROFILES IN SCIENCE:  Arnold S. Relman and Marcia Angell

A Drumbeat on Profit Takers:  The former editors of the New England Journal speak in one voice against the commercial exploitation of medicine. by Abigail Zuger

According to this article, from 1977 to 2000 one or both Dr. Relman and Dr. Angell “filled top editorial slots at The New England Journal of Medicine as it grew into perhaps the most influential medical publication in the world…”   Beginning in 1980 Dr. Relman began writing editorials against profit-making hospitals, laboratories, and investor owned medical businesses.  He wrote, “…medicine must serve patients first and stockholders second.”   Later, in 1991, he thought that market forces were influencing doctors’ judgements.  He has continued to write articles and books on this subject.

Dr. Angell has critically focused on the pharmaceutical industry, their influence over studies validating their products, that manuscripts submitted often omitted any mention of a drug’s side effects, or were not submitted because the studies made the drug look bad.  One didn’t know what was suppressed, what selected, “whether the goal posts were changed so that good six-month data was offered for publication instead of bad one-year data.”  

Further on in the article Dr. Thomas H. Lee, a Boston cardiologist  and an associate editor at the journal states “They (Drs.Angell and Relman) were in the right place at the right time…They rode the wave.  They did a lot of good things.  The Journal became hugely prominent in their time…”

If goal posts are changed in a field game, such as football, it changes the game.   The comment about riding a wave, in this case is a surfing metaphor about the prestige and popularity of the New England Journal of Medicine increasing (the wave) and the editors who rode it.

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