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Ghostwriters go bump in the medical journals.
M. Night Shyamalan couldn’t make this story scary.

Peter J. Pitts
Medical Progress Today
December 16, 2005

On December 13th the Wall Street Journal ran a front-page article titled “Ghost Story.” It was certainly meant to scare readers. It disclosed that some articles in medical journals are drafted by professional medical writers and then edited (often heavily) by the bylined authors before they are published. Not surprisingly, sometimes these medical writers are paid by pharmaceutical companies.

This article, while well-written, represents only the latest example of the media positioning anything paid for, promoted, supported, encouraged, approved, or assisted by Big Pharma as immediately suspect, if not downright dangerous. Consequently, a practice that is an “open secret” somehow deserves banner headline treatment and immediate remediation.

The real question on the table is whether it’s right and appropriate for pharmaceutical companies to be involved in the drafting of medical journal articles that are based on their own studies of their own products. The answer is – yes.

But is it right and appropriate for pharmaceutical companies to blur the line between marketing and science? That’s a better question, but it presupposes that all marketing is bad and all science is good – and that this is what is happening in this case.

Still, let’s pursue that proposition. Who would think marketing and science make poor bedfellows? Cui bono? The people at the front of the anti-marketing, pro-science queue are the editors of our medical journals. If these self-appointed Sultans of Science cease to be the singular gatekeepers of new scientific information, it will be in part because medical writers are now manning those same gates. But none of this speaks to whether science has in fact been compromised, or whether medical writers add real value to the crafting of journal articles. The canard that ghostwritten articles in any way denigrate the nature of the material may, in fact, be little more than an attempt on the part of medical journal editors to discredit the pharmaceutical industry on an ad hominem basis. In any other context, this kind of personal attack would be embarrassing, and might even backfire.

The next time you read an op-ed in your favorite newspaper by a well-known person, consider if a ghostwriter was employed. Answer: Probably. Next time you hear your favorite politician give an address ask yourself if the speaker wrote the speech. Answer: Probably not. And then ask yourself this – does it make a difference? If the article or the address truly represents the beliefs of the “byline,” then it’s like that TV commercial, “We don’t make a lot of the things you use. We make a lot of the things you use better.”

Personally, I’d rather read articles that are well written. I also believe that if the incursion of professional writing assistance makes the articles better – and improves the presentation of information without distorting it - then that’s good marketing and good for medicine, because it tends to make dense data more easily understandable and sets it into a therapeutic context.

Before engaging in more attacks via innuendo, medical journals have a responsibility to define exactly what practices and what articles they are objecting to and allow the industry and the authors involved to respond in a public forum.

In the meantime, let’s remember that not all ghosts in the machine are scary.

Peter J. Pitts is a former Associate Commissioner at the Food & Drug Administration and Senior Vice President for Global Health Affairs at Manning, Selvage & Lee.

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