The Economics of Medical Hypotheses and Its Successor (part 1 of 2)

A successor to Medical Hypotheses, titled Hypotheses in the Life Sciences, will soon be published. I asked Bruce Charlton and William Bains, the founder of the new journal, about the economics of the situation.

ROBERTS Did Medical Hypotheses make money for Elsevier? How much did it cost to run per year (leaving aside time contributed by you and the editorial board)? How much of that did Elsevier pay?

BRUCE CHARLTON  Medical Hypotheses did for sure make money for Elsevier – but I was never allowed to see the accounts.

I was told circa April 2009 that that the journal still made a profit even after page charges were abolished in early 2009 (income from things like subscriptions, sales of reprints including paid downloads, but mainly from its share of internet access ‘bundles’ via ScienceDirect – which is purchased mainly via library subscriptions from colleges etc).

Costs were my salary plus a share of the Elsevier editorial team – the journal secretary, the person who put together the issues and the manager – i.e., three main people at Elsevier each of whom worked on a group of journals.

Before 2009, when Medical Hypotheses still had page charges, the journal will have been very profitable since it had the above sources of income plus about page charges at about 60 dollars per thousand words, for a journal of between 160-240 pages, with about 500 words per page – that’s roughly 50 thousand dollars extra income per issue – with 12 issues per year that is roughly half a million dollars p.a. in page charges alone. Over seven years as editor I must have generated a few million dollars income for Elsevier.

So – in my opinion Elsevier’s behavior with Medical Hypotheses does not make business sense, since it lost them a lot of income and risked even more. Also hounding a successful editor, and sacking him before the contract was finished and with issues for 2010 un-compiled (and with nobody lined up to replace me) did not make business sense, nor did the mass of bad publicity all this generated for Elsevier.

My inference is that an individual or group in Elsevier senior management – perhaps Senior Vice President (USA) Glen P Campbell, who began the whole business and who has remained personally active in it (including the appointment of the new editor) – I guess that Campbell took a personal interest in Medical Hypotheses and in my editorship for reasons unknown to me – and drove the whole process.

The most sinister aspect of the whole thing for me is that senior Elsevier managers are now exerting personal influence on the content of the scientific literature and the conduct of science (overseeing appointment of editors, new restrictions on editorial conduct etc) – and they are doing this not for business reasons, but presumably to pursue their own private agendas.

The strict legalistic definition of academic freedom
(for what it is worth — see writings by Louis Menand)
is that academics be autonomous in the conduct of academic work (conduct, appointments, promotions, reviewing etc). The Medical Hypotheses Affair shows Elsevier very clearly in breach of academic freedom, and every competent editor will immediately recognize this fact.

In addition, in the later stages of the journal, Elsevier managers were also involved in covertly selecting (i.e. rejecting) what they considered ‘controversial’ Medical Hypotheses papers – the papers were intercepted after I had formally accepted them and held back, some were later rejected.

Elsevier also employed the Lancet (which they own) to choose ‘peer reviewers’ for the Duesberg and Ruggiero papers and arrange to have them rejected (using criteria quite different from those of Medical Hypotheses).

So that we know for sure that the Elsevier owned Lancet (one of the most prestigious medical journals in the world – perhaps the most prestigious?) is nowadays in the pocket of Elsevier management, and willing to do dirty jobs for them.

Yet there has been no outcry against Elsevier’s breach of academic autonomy from senior journal editors (nothing from the editors of Nature, Science, Lancet (understandably, since they are Elsevier employees), NEJM, JAMA, BMJ etc.). This silence means, I take it, that these senior editors are not any longer autonomous journals, but are nowadays in the pocket of their own publishers and live in fear of their own jobs.

The Medical Hypotheses affair is therefore a straw in the wind: an indicator on a small scale of what is happening at the larger scale: i.e. the thoroughly dishonest and hypocritical state of modern science and academia, and the domination of the content and conduct of science by outside interests.

But the unusual point that is not well understood is that key aspects of these outside interests are not always operating in profit maximizing ways. My understanding is that senior managers (in the private and public sector) are ‘using’ – even exploiting – their organization’s resources in pursuing personal goals – engaging in a kind of moral grandstanding, in making large gestures which show how ‘ethical’ they are in their views – at everyone else’s expense.

This can be most clearly seen in the ‘Green’ ‘ethical’ behaviours linked to the Global Warming scam – senior managers have shown themselves willing to sacrifice efficiency in pursuit of large moralistic policy gestures of ‘caring about the planet’ with which they become personally associated (recycling schemes, fair trade, campaigns of ‘save energy’ or promote public transportation among staff etc – none of which are actually effective in terms of real world effects, but which are effective in expressing ‘concern’).

Such moral gestures are invariably designed to appeal to elite PC opinion – it is a major form of status competition among the elites. My guess is that something of this sort is behind what happened at Medical Hypotheses: a senior manager or group of managers at Elsevier probably wanted to show themselves and their peers that they were taking a strong ‘moral’ stance against people who published AIDS-denialist papers.

10 Responses to “The Economics of Medical Hypotheses and Its Successor (part 1 of 2)”

  1. dearieme Says:

    The heart on the sleeve outweighs the brain in the skull.

  2. G Says:

    “My understanding is that senior managers (in the private and public sector) are ‘using’ – even exploiting – their organization’s resources in pursuing personal goals – engaging in a kind of moral grandstanding, in making large gestures which show how ‘ethical’ they are in their views – at everyone else’s expense.”

    I’m far from anti-union, but I do see this type of behaviour among militant union leaders (even low-level leaders) who just want to be seen to be championing a cause, usually at the expense of union members. It is another case of moral vanity trumping profit or even careerism.

    Happens that I posted recently about anger towards AIDS denialists. I read Kary Mullis’s account and it seemed like there were questions to be asked, to say the least. It is funny/maddening to see ‘liberal’ people try to suppress debate, because these same people condemn censorship in virtually every other context. I suppose I say this because AIDS, like climate-change, is a perennial concern of educated liberals.

    You ever read They ran an article that listed Mullis as one of a number of ‘clearly insane’ Nobel winners, along with Brian Josephson, who studies ESP. I couldn’t believe my eyes! You become a household-name nutcase for holding an unorthodox scientific opinion? It’s not like he said AIDS was created by the Masons or anything…

  3. Seth Roberts Says:

    I saw that list. As one New Yorker editor would tell writers, “don’t get it right, get it written.”

  4. Stephen M (Ethesis) Says:

    BRUCE CHARLTON ought to open up a competing journal, starting with the papers they excluded.

  5. Stephen M (Ethesis) Says:

    What this reminds me of is a book I read in the late 70s about young millionaires. The profiles had a very large number of people who had been working on masters in business or economics and had stumbled on the fact that many business had parts there were worth more than the total value of the business itself.

    You could thus buy the business, break it up and sell the parts and make a substantial profit. All of this occurs because the people running the business and the owners (stockholders) have divergent interests. Most of them were flunked for writing thesis with this as the topic — their professors were certain that such a condition could never occur.

    What the profs missed was that these guys were the market forces that created a correction. Then, in the 90s, the trend began of people who sucked the revenue out of businesses, not in diversions (such as the ones evident here) but in excess ceo, etc. pay. Again, capture at work. In many of those cases you can make a business substantially more profitable by taking it over, firing the management team and replacing them with one that costs millions of dollars less.

    But capture, in all of its forms, is fascinating to watch. Sad in Charlton’s case as well.

  6. G Says:

    Stephen, what you wrote reminds me of Adam Curtis’s excellent documentary series The Mayfair Set. I am forever trying to get people to watch his work; I think it’s important. It happens that I pasted all of episode two into the following blog-post, but I would rather you watched it from the beginning; episode one is easy to find with a Google video-search.

  7. Stephen M (Ethesis) Says:

    And if Duesberg may be even partially correct, it is extremely dangerous that the proper scientific process has been so ruthlessly distorted and subverted simply to exclude his ideas from the official scientific literature.

    The real value in examining theories, especially ones that are wrong, is that refuting them is much more powerful than denying them. In addition, in refuting things, one learns. In denial, one avoids learning.

  8. johannes borgstein Says:

    elseviers has now built a digital network that controls over 800 of the most important medical journals, both at the submission end and at the online access end.
    we should be asking ourselves who is elseviers? and what are their interests
    i suspect it is not a moral issue but a commercial issue
    curiously, the previous ceo of elseviers was also a paid director of GSK

  9. lemmy caution Says:

    I am not sure. If “Medical Hypotheses” had the possibility of hurting the reputation of other Elsevier publications, it may make financial sense to drop “Medical Hypotheses” even if it is making money. Especially if they can find some less controversial magazine to put into its ‘bundles’.

  10. Laura Fisher Says:

    In response to the sacking of Dr. Charlton I have decided not to renew my subscription to Medical Hypotheses or its successor. I would hope others would do likewise.

    AIDS and its “cause” are not the only important medical topics to be willfully distorted for the sake of political gain. About 46% of physicians in the US now are employees, rather than being self-employed. I believe this makes them bureaucrats and as such their first loyalty is to their employer, the bureau. Any loyalty or commitment they may have to their patient takes a second seat to their alliance with their employer.
    I have found Paul Berman, Shelby Steele and Thomas Sowell most helpful in my attempt to understand these very bad behaviors on the parts of intellectuals and bureaucrats. Insofar as one’s best effort to sort out what is good science-based medical treatment clashes with that of the bureau, one tends to keep quiet lest one become its next target.