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The American Association of Clinical Endocrinologists (AACE) recognizes the various “interests” that physicians have. This is reflected in our Position Statement on Physician/Industry Relationships,3 which states “There is no inherent conflict of interest in the working relationship of physicians with industry and government. Rather, there is a commonality of interest that is healthy, desirable, and beneficial.”
Medical journal editors are among those who have “commonality of interest.” These interests include the public, the scientific community, the journal's readership, the advertisers, and the organizations they serve. A few notable examples of this commonality of interest are those which Mayo Clinic shares with Mayo Clinic Proceedings and the American Medical Association shares with the Journal of the American Medical Association.
Historically, and I would argue justifiably so, our editor-colleagues have been entrusted with substantial power to influence the practice of medicine. At the same time, we have expected them to be balanced and transparent. Hirsch points out that this trust may be subject to violation and that such violation may never be entirely preventable despite exhaustive disclosures and onerous restrictions on editors. Indeed, the theory that closely monitoring and regulating physician interaction with industry is the key to ensuring integrity has yet to be supported by balanced scientific evidence. Nonetheless, Hirsch makes a cogent argument that disclosure requirements for journal editors who are entrusted with accepting or rejecting manuscripts or who publish their own manuscripts should be as rigorously scrutinized as those being aggressively promoted for the medical community at large—perhaps no more, but certainly no less.