This Mark Twain quote may be more apt than ever – “It ain’t what you don’t know that gets you into trouble. It’s what you know for sure that just ain’t so”. I have been reflecting on this after discovering something I, and I suspect most doctors, was unaware of.
The ‘father’ of modern international scientific, technical and medical (STM) publishing was the late media tycoon Robert Maxwell long before he became (in)famous for a variety of reasons.
Before to WWII, most STM books and journals were produced by learned societies for their members. After the war, publishers saw commercial opportunities and in 1951 Maxwell bought Pergamon which in 1991 was sold to Elsevier.
As Maxwell’s empire grew, Permagon remained the jewel in the crown. Over
40 years it published 7000 monographs and launched 700 journals. Maxwell liked to name them beginning with “International Journal of…”. Medical journals were and remain to this day a highly profitable business. This is largely driven by demand for reprints of papers published.
Does Maxwell’s involvement matter? I don’t know. Obviously, publishing must be profitable because if not, the publication ceases to exist. However the increasing number of medical journals necessarily needs an increasing number of papers. Could quantity reign over quality? Could papers be more likely to be published if reprint demand is higher?
Medical practice prides itself on being evidence based. Yet as practising doctors we are obligated by time constraints to assume that the basis of the evidence is sound. It likely is. But there are increasing murmurings that papers on certain topics face censorship not because of any scientific reason but because of politics.
One step before this is getting funding for research. This also has become increasingly political. We don’t know what we don’t know or what we are not allowed to research.
Medical practice prides itself on being evidence based. Yet as practising doctors we are obligated by time constraints to assume that the basis of the evidence is sound.
Perhaps this reached its zenith when Scientific American’s editor was forced to resign after calling Trump voters (the 77+ million, not Trump himself) the “meanest, dumbest most bigoted group”. She is absolutely entitled to her opinion, but had to clarify that it didn’t reflect the position of Scientific American. Would a Trump voter have any confidence in being published in that magazine?
We advance through medicine largely by bowing to those above us and not asking difficult questions. We need to be more questioning. What if what we know for sure, ain’t so?