Re: Arnold Relman's NEJM Editorial about NIH/E-biomed

From: Phelps, Charles (
Date: Mon Jul 19 1999 - 14:36:42 BST

Steve, I am really enjoying this ongoing dialog you've created. Thanks
for doing it and carrying on the discussion. I am returning this to you
alone, since I don't know who all your email lists go to, but I'd be
happy to have you send this out to whomever you think appropriate. (It
is not intended as a letter to the NEJM however). Discussion follows:

In part it helps for those not familiar with Dr. Relman and the
standing of the NEJM to understand their position. They have a market
stature so great that it dominates all other medical journals, and
probably all other journals in the world (possibly only excluding
Science and Nature). Their citation index is about 20 per article; the
next best (in a not too recent look) was JAMA at 12. Most other
journals are in the realm of 2 - 4 or lower in the field. Thus the NEJM
has an extraordinary stature and power that they are obviously loathe
to give up. The new medium threatens them more than any other

Dr. Relman (and his predecessor, Franz Ingelfinger, MD) carved in stone
what was once known as the Ingelfinger Rule, which is now commonplace:
"We won't consider a manuscript for publication in the NEJM if it's
been published elsewhere." They have a very strict definition of
"elsewhere" to include all sorts of things that many people would not
consider publication.

Their current stature and the tight control of pre-release of content
are self reinforcing under current rules. They highlight "top" articles
with a concurrent editorial ("commentary") and often a press release.
This keeps NEJM articles in high visibility and they are (because of
the very high and hence attractive stature of the journal and very
stringent refereeing standards) of very high quality generally.

Obviously the NIH proposal threatens a part of this because the
immediate newsworthiness of documents already available on an e -
server diminishes. Yet a widespread and widely used NIH system would
make it impossible for the NEJM to boycott manuscripts placed on the
e-server (just as the physics journals could not boycott articles
posted on Los Alamos). This is the major source of Dr. Relman's

Charles E. Phelps, Provost
University of Rochester
200 Wallis Hall
Rochester, NY 14627
Voice: 716 - 275 - 5931
Fax: 716 - 461 - 1046

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