CMA Journal Slides Down Razor Blade

The Saturday, 4 March '06 Toronto Globe and Mail tells of recent difficulties at the once-venerable Canadian Medical Association Journal.

Not a pretty sight, but one that readers of this blog -- and folks like Dr. Jerry Kassirer, CMAJ ed board member and formerly editor of the New England Journal -- have become sadly inured to.

The bare facts of the controversy are difficult to fully capture here. Apparently, according to journalist Gloria Galloway's Globe and Mail piece, the publisher, one Mr. Graham Morris, fired the editor, Dr. John Hoey, for committing the sin of editorial freedom: scheduling an editorial that looked into certain pharmacists' alleged practice of grilling women seeking the morning-after pill.

Apparently the pharmacists' organization was sufficiently unhappy about the piece (and how did they know about it?) to pressure the publisher for withdrawal. And apparently he acceded. Then, another issue erupted, over practice-privatization, and a critical piece from the editors was overlain by another, less critical one.

It became a trifecta, finally, when the new Acting Editor, Stephen Choi, felt compelled to resign in protest over the Association's rejection of "an editorial governance plan that called for the CMA to accept the independence of the editor-in-chief."

There are lots of ways to read this controversy, and it's best to keep our powder dry until we learn more. But that last step in the trifecta, the CMA's refusal to assure editorial autonomy, may in some ways amount to the likely key in understanding what's going on. A classic power struggle within medicine's increasingly less-hallowed halls. Here it seems drearily familiar. To quote the late great Jack Webb: "The story you are about to see is true; the names have been changed to protect the innocent."