News roundup

Canadian journal accepts need for major overhaul

Quebec David Spurgeon

The Canadian Medical Association (CMA) and its subsidiary, CMA Holdings, have accepted all 25 recommendations of a governance panel that has called for sweeping changes in how the association’s journal, CMAJ, has been run.

The association set up the panel after a dispute about the dismissal of two senior editors, which led to the resignation of most members of the journal’s editorial board and drew widespread international criticism. Proposals even included replacing the journal with a new completely independent one (BMJ 2006;332:687).

The panel’s recommendations included the transfer of direct ownership back to the association, to which 90% of Canadian doctors belong. The restructuring is designed to ensure the editorial independence of CMAJ and to avoid a repetition of the kind of dispute that resulted in the dismissal of the editor in chief, John Hoey, and his deputy, Anne Marie Todkill (BMJ 2006;332:503).

In an implicit reference to that dispute, the panel recommended that the association, as owners, should not have greater access than the media to potentially controversial editorial content. And, more pointedly, it added that the association “shall have no right to alter the content of any such editorial material. Any response from the CMA intended for publication in . . . CMAJ should go through the same process as all third-party submissions to the CMA.”

The panel also made recommendations designed to protect the job security of the journal’s editor in chief, giving a newly strengthened journal oversight committee the responsibility for making recommendations “regarding any proposed dismissal of this individual.”

The association’s board “shall not dismiss the editor in chief without first seeking the advice of the journal oversight committee,” and a two thirds majority vote of the association’s board should be required for such dismissal. The editor in chief’s term of employment should be five years with the possibility of renewal or extension and, if termination occurs before the expiration date, the editor in chief should be paid in full if the termination was done “without cause.”

The panel acknowledged that the journal had made a modest profit in recent years and said that philosophically the panel had no objection to this for a medical journal like CMAJ. “But it would be concerned if profitability might be identified or inferred as the primary driver for such a journal, rather than, for example, scientific, medical and editorial integrity in keeping with [its] mission statement.” The risks of this occurring were increased in the current structure, the panel said.

Dr Ruth Collins-Nakai, the association’s president, says in a statement on the association’s website, “The report we have received from Mr Richard Pound, chair of the expert panel, and members provides a sound governance model for . . . [CMAJ]. This model will contribute to a strong, vibrant and editorially independent future for the journal and will help insure its continued reputation as one of the world’s top peer-reviewed medical journals.”

She said that its recommendations will serve as important guideposts to help the journal’s editor, publisher, and owner achieve greater balance among sometimes competing interests and will provide a mechanism to deal with problems of accountability. The panel received 103 submissions in response to a general call for comments and received input from another 17 editorial, publishing, and educational organisations. It also commissioned an independent research report from Gilles Paquet, professor emeritus at the School of Management and senior research fellow at the Centre on Governance at the University of Ottawa.

Gordon Guyatt of McMaster University commented that the panel’s recommendations seemed to be excellent protections for a new editor. Dr Guyatt withdrew a successful series of articles that had been published in CMAJ after the dismissals of the editor in chief and his deputy. When invited to join the panel he declined because he had lost confidence in the participants and the process. Dr Guyatt based his comments on what he had read in the press because he was on holiday when the report was published and was unable yet to read the complete text.

“Eliminating the holding company, the suggestion that owners do not have advance access to [possibly controversial editorial] material and should not alter [such] material; the five year contract [for the editor in chief]; and firing decisions being referred to the oversight committee, are all positive,” he said.

Regarding the recommendations for choosing the editor, Dr Guyatt said that if it were made clear that independence and an independent process of selection was what they were after—and if in fact the association adopted that—it would go a long way towards solving the problems.

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