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Letter on Use of New England Journal of Medicine as a Cash Cow

Virginia T. Latham, M.D.
President, Massachusetts Medical Society
860 Winter St.
Waltham, Massachusetts 02451

Dear Dr. Latham, 

The week before last, those of us on a New England Journal of Medicine email list serve, which normally provides weekly announcements about the contents of the forthcoming issue of the Journal, received a surprising message entitled CASHCOW. The message described a get-rich-quick publishing scheme, promising that any participant could “earn $50,000 in the next 90 days by sending e-mail.”  (see attached first page of this e-mail)

The scheme was in no way organized by the Journal (it arose from CASHCOW@aol.com), and, not many hours after its dissemination to the list serve by a journal employee, the new editor, Dr.Jeffrey Drazen, apologized for this “administrative error” and promised to prevent a recurrence.

It is ironic, however, that this recent CASHCOW mistake under the Journal’s new regime is so in tune with a more ominous, purposeful CASHCOW mistake at the Journal.  During the past several years unprecedented conflict has roiled the relationship between the Massachusetts Medical Society and its flagship publication, The New England Journal of Medicine.  Indeed, one member described the Journal as the Medical Society’s “cash cow.”  The conflict has centered on the Society’s desire to cash in on the Journal’s well-deserved reputation for excellence by sponsoring or “cobranding” profitable subsidiary ventures, such as spin-off publications, of dubious merit. As a result, and in order to resolve the conflict, a distinguished editor, Dr. Jerome Kassirer, was fired. His able successor, Dr. Marcia Angell was pushed out of the Journal after serving as the Interim Editor because of the hostile environment created by the Society.  As a letter published in the Journal protested: “The Massachusetts Medical Society’s decision to fire Kassirer because he refused to squander the Journal’s reputation for excellence confirms my cynicism about medicine in the modern era: the only thing that matters is the bottom line.”

An accident led to the Journal’s recent email broadcast of the CASHCOW scheme. But it is no accident that the new editorial regime installed by the Medical Society has moved to milk the Journal for cash and to do so by altering the content of the journal itself. The choice of Dr. Drazen, a researcher with extensive ties to the pharmaceutical industry, as the new editor has surely bolstered the Journal’s attractiveness to drug companies and other advertisers. Longtime, highly respected national Journal correspondents economist Robert Kuttner and Dr. Thomas Bodenheimer, whose columns documented and sounded warnings about the increasing commercialization of health care, including the dangerous power of the pharmaceutical industry, have been asked to leave. Dr. Drazen told Dr. Bodenheimer, before firing him, that he found the prior editors’ policies concerning authors’ financial conflict of interests ? i.e. links with the pharmaceutical industry ? too strict. Dr. Drazen indicated that he wanted to make a “clean break” with such past traditions.

The Journal’s reputation for scientific and editorial excellence, unbowed by commercial pressure, has grown for two generations under the leadership of editors Dr. Franz Ingelfinger, Dr. Arnold Relman and Drs. Kassirer and Angell.  This reputation and the public’s interest are now under serious threat as the new regime, apparently willing to make major concessions to the appetite of its cash cow, is moving dangerously backward. We urge you to take steps to reverse this unfortunate and destructive trend.

Sidney M. Wolfe, M.D.
Director, Public Citizen’s Health Research Group

David U. Himmelstein, M.D.
Associate Professor of Medicine
Harvard Medical School

Steffie Woolhandler, M.D., M.P.H.
Associate Professor of Medicine
Harvard Medical School

First page of referenced email

From:                            CashCow@YAHOO.COM
To:                                 TOC-L@society.massmed.org
Date:                            1/11/01 3:37AM
Subject:                        CASH COW 

This is a one time message, if it reached you by mistake please accept
my apologies, disregard and delete. Thank you. 

Dear Entrepreneur:

Please take the time to read this. It can start you on the road to an
easier life as an internet businessman/woman.

Thank you. 

EBIZ = 1,2,3…4 CASH! 



3.      GO BUY A BIG BAG…

4.      ALL THE CASH! 



 INCREDIBLE $0 to $50,000 in 90 days!!!

 Dear Friend, 

You can earn $50,000 or more in next the 90 days sending e-mail. Seem
impossible? Read on for details.


Thank you for your time and interest. This is the letter you’ve been
reading about in the news lately.  Due to the popularity of this letter….