Editors and teachers with standards: a dying breed

I read with interest the absorbing review of Jerome P. Kassirer’s memoirs by Sanjay Pai (1). The review brings out the essence of the man and his memoirs very well and enhances the respect and the admiration for the legendary editor. Peer reviewed print journals still remain the gold standard of dissemination of new research in spite of the availability of other methods. However, as the reviewer writes, the times are changing. If the editors who uphold the highest standards of medical publishing are removed then the whole body of knowledge being published can come under a cloud. Recent news in the lay media about non-disclosure of conflict of interest by the editors of the venerated ‘Harrison’s Principles of Internal Medicine’ is one such example of the importance of integrity in the editorial process (2).

The reviewer also discusses Kassirer’s views on the mindless application of technology. The reasons for overuse of technology like practising defensive medicine, the laissez faire approach and, perhaps, profiteering are the root causes of the problem; but a more insidious happening is the lack of teachers who can teach good clinical medicine and the decision-making process which Kassirer is known for. In the absence of a clinical approach, technology becomes the substitute, initially, and then the norm. This is significant in view of the clamour (and definite need) for increasing the number of medical colleges and the uptake of students.

But just as editors with integrity are being driven out of the system, so too are good clinical teachers unwilling to associate themselves with colleges with low ethical standards, started often by businessmen and politicians for profit and power, compounding the problem. Good editors and good teachers are being driven on a slow march to extinction which does not augur well for the medical profession.