-: Good afternoon everyone.
Welcome to the March Ethics Grand Rounds.
It's a pleasure to welcome Professor Kenneth Iserson
who is Emeritus Professor at the University of Arizona
College of Medicine in Tucson.
Dr. Iserson has had a, what else can I say,
a truly extraordinary career.
He was one of the first emergency physicians certified
as a specialist more years ago than I'll mention.
He got his MD from the University of Maryland, and his
qualification in surgery at Mayo Clinic
and then emergency medicine residency at Cincinnati General.
Since 1984 he's been basically at the University of Arizona,
Tucson except for a brief stint
at the University of Chicago where he got his qualification
as a senior fellow in bioethics
and hence the connection here.
What's been extraordinary about his career
is his extraordinary academic productivity
in virtually all areas of emergency medicine,
ethics and beyond as well as doing extensive tours
in relief work as a resident or physician in charge
in various relief efforts, military and otherwise
literally around the world.
This morning, for example, we discussed with some detail
his stint at the Mount Monroe, Murrow, Mount Murrow?
-: McMurdo, McMurdo Station. -: McMurdo in Antarctica
where he cared for Antarctic workers over what,
a month or so? -: A year and 1/2.
-: Oh wow, that's 18 months so I stand corrected.
So he has been recipient of numerous awards
in emergency medicine including
the President's Volunteer Service Award in 2010
among many others.
He's the author of numerous, numerous publications
as well as for any medical students that are present,
the 9th edition of a guidebook
for getting into residency programs titled
"Getting Into Residency" hence that's available
from the Galen Press.
So without further ado from me
please welcome Professor Iserson.
(audience applauding)
-: Thank you very much, John.
Thank you very much, John.
It's a pleasure to be here in Texas again.
I used to live over in Fort Worth on the military base.
Carswell for you young ones who never heard of it.
And really happy to be talking about open-access journals.
So before we start I'd like to recognize
two special people, I got a signal from the video guy.
Crew Member: Oh no, it's set up.
-: Oh, okay, okay.
Two special people, at least two, can you raise your hands?
Librarians who are here.
Three, okay, excellent.
They are your go-to resource after this talk
about all the material I'm gonna be talking about,
and they're going to be your biggest help
in deciphering the confusing area
that I'm going to be speaking about today.
And it's Open-Access Medical Journals:
Promises, Perils and Pitfalls.
Promise, the best thing since sliced bread.
The peril, you're gonna fall into a big
pit of quicksand and the pitfall is
it's gonna destroy your career.
Aside from that everything's fine, don't worry about it.
Okay, so the learning objectives.
At the end of this talk you'll be able to identify
the various types of open-access journals in general, okay.
You're going to be able to use several methods
to differentiate legitimate versus illegitimate
open-access journals, and there is a handout.
Some of you may have gotten it already.
If not the librarians have it, they've put it together
with a list and it's very similar
to the list that I'm going to go through with you
about how to differentiate legitimate
and illegitimate open-access journals.
And I'm gonna describe, and you'll be able to describe
some of the ethical pitfalls inherent
in the open-access journals.
Three big questions, what's the problem,
why is it important, and how common is it?
Over the past 15 years since we first started
using open-access journals, they became available
the number has increased dramatically.
And they are constantly publishing
or saying they're publishing lots and lots of papers.
There's two groups, well there's actually three groups
that have to be concerned about this.
There are the well-funded, well-established
non-humanities academics.
Medical, basic science with grants.
They don't have a lot to worry about
and I'll tell you why in a second.
The third group are in developing countries.
They don't have money, they don't have money
to do their research, they don't have money
to do their grants and they definitely don't have money
to help with publishing costs.
And then there's the group in the middle.
They're trying to become established academics.
They may be in the humanities or semi in the humanities
or they are clinical or basic science
and they just don't have grants.
Each has different problems.
Now, open-access, what does it mean?
It means that they put it on the web and you can access it.
It's very straightforward.
Okay, and there's lots of this material out there.
How many of you are clinical?
Okay, we have some clinical people, good.
You get procedural and informational videos.
I wish I had those when I was a resident.
They would have been awesome, they're very helpful.
Guidelines from professional organizations
We see these all the times.
Free articles that are already on the web,
and open-access allows easier collaboration worldwide.
And one of the things we're seeing right now
is open-access is dramatically helping the whole world
in its fight against COVID-19.
When we had SARS we had to wait to have things published
and people would look at it and then
they'd start developing the next step.
That's happening in hours or days now.
As soon as the COVID was genetically sequenced
people started using it to say, we can develop a vaccine.
As soon as they some progress on the vaccine
people went further than that.
They're getting epidemiologic data.
Some of it is reasonable, some of it isn't,
but it's moving very quickly
and that's because of open-access.
But then we have the illegitimate journals.
They provide a breeding ground
for unethical publishing practices,
and I'll talk about some of the ones that exist.
There's no regulation for open-access journals.
There is no regulation.
And so it's like the Wild West of publishing.
Okay, what are some of the problems?
The open-access publishers misrepresent what they offer,
what standards and practices they use.
For example, we review your paper, no.
It's gonna be widely disseminated
through all of these repositories.
Mm, generally not, okay.
When you go for promotion or tenure or a new job
P&T committees now know to look for those kind of journals
and they'll throw out your application
or they'll deny you a promotion or tenure.
It wastes effort, if you spent money and time
and other people's time doing research
and you go into one of these open-access publications
frequently the illegitimate ones, not the legitimate ones,
you frequently are not gonna ever be able
to find your paper again, but you've already signed over
the copyright and so you can't get it back.
Lack of archived content, that's what we're talking about.
And then it decreases
the general confidence of research literature.
Here a couple things that were published
about open-access in general.
And they talked about Wild West of academic publishing.
Bohannon, and we'll see his name show up
in just another minute, the players are murky,
the identity and location of the journals and the editors
and the financial workings are purposely obscured.
There's a network of bank accounts
based mostly in the developing world.
It's really, really, it's kind of like the drug world.
It's really subversive
and not quite illegal but it should be.
On the other hand Roos wrote, open-access is a good thing.
And we'll see that it really is, the whole thing
about the COVID-19 sharing of data, that's a great thing.
Okay, but especially in the developing world
people have all these academic credentials
and are getting into teaching positions
and research positions and all their stuff
is basically illegitimate or unverifiable.
Okay, so I said we'd see Bohannon's name again, here it is.
He submitted an article.
His author was Ocorrafoo Cobange, a biologist
from the Wassee Institute of Medicine in Asmara, Eritrea.
Well, no such university exists
and no such researcher exists.
The article had obvious serious flaws
ethically and in research method.
He submitted it to hundreds of open-access journals.
98 rejected it, great.
157 accepted it.
Now this is one of those real obvious bogus papers.
Three of the accepted papers
were from well-known publishers, okay,
and he published this in "Who's Afraid of Peer Review?"
That was one of the big reveals
about illegitimate open-access publishing.
So why are legitimate researchers affected?
You do good research, you want to get it published.
Who's drawn in by these illegitimate OA publishers?
People who are young and don't know any better.
They're inexperienced.
They feel the publish or perish mandate.
Nobody in here ever felt that, right?
(audience laughing) No?
Yeah, the old guys are sitting there,
yeah, well, that's a long time ago, I don't have to worry.
Yes, but if you're young and you're trying
to make a name for yourself in academia you have that.
Ego, you're solicited, it comes in your email.
Did anybody today get a solicitation for?
Yeah, one, only one?
Yeah, sure, okay, I counted the ones I got,
I had on my email when I woke up this morning.
I had 20 solicitations, okay.
So okay, frustration, you couldn't get your paper published
in a couple places where you sent it off to.
And I'll just go ahead and send it to one
of those fly-by-night places.
And lack of guidance, that's why you want your librarian.
Know who your librarians are.
They're a great resource.
I've worked with medical librarians, reference librarians
my whole career, it's been great.
So who's harmed by publishing in these,
this gray, murky area?
Authors, academic evaluators, people looking to hire you
or to promote you, potential employers, or grantors,
clinicians who are reading this and believing it's real,
media who are generating it to the public,
and the public who receive this information.
This is the big promise.
Easily fulfilling your publish and perish obligation.
We're gonna publish it right away, don't worry about it.
So we want your article!
They give a false impression that it's a legitimate journal.
They describe conferences or publications that
they have sponsored or whose results they have published.
Editorial board invitations.
Some of you will be getting those.
Will you be a member of our editorial board?
Sometimes, will you be the editor of a special edition?
Yeah, what's your field?
Student: You looking at me?
Kenneth: Yeah.
Student: I'm a medical student.
Kenneth: You're a medical student.
Student: Yes, sir.
-: Well, would you like to be the special editor
of the, wait, wait, wait, of the edition
on engineering of ant farms?
(students laughing)
Student: I don't know what that means.
Kenneth: Yeah, yeah, neither do I,
but that's the kind of thing you're going to get, right.
Harassment, you're going to get repeated emails
from these people, and the more you publish
the more of these you're going to get.
Okay, here are some of the things in emails
that you can use to spot fake, illegitimate OA publications.
Oh, this is for the conferences, I'm sorry.
I've taken a slight detour because one of the big things
they're doing now is they're sponsoring conferences,
supposedly sponsoring conferences.
You're invited to the conference.
You send us your article, you pay the money,
and by the way you get a continuing education credit
as soon as you pay the money
and we will publish your article for that, yeah.
Of course you never see the article
and your CME credits are usually worthless.
They say you are invited to the conference.
People don't usually invite you
to these kind of conferences.
They use free emails to advertise.
If you see that, forget it.
A Gmail account for example or a Hotmail account.
If you're invited or notified about a legitimate conference
it will come from an organization.
Usually in a fancy tourist destination during high season.
So basically you should know that you're going on vacation.
There's no conference.
Multidisciplinary conference, we are going
to talk about electrical engineering
and genomics and astrophysics.
No I don't think too many people have that kind of diversity
in their knowledge or interest.
Free offers of accommodations occasionally
or meals usually don't pan out.
Key speakers are charged.
If there's a quack review and acceptance process.
Unusual payment method, can't use a credit card.
Can't use a credit card, you've gotta send a bank transfer
usually to a personal bank account
in Upper Mongolia or something similar.
No refund, and there's always a claim
that it'll be indexed in a major index, but that's not true.
So okay, how gullible are you?
I'm an African prince and I have this bank account
that's really in your name and just send me $50,000
or something, okay, or, and I got one of these just,
it was a phone call.
Your grandson is in jail and he needs money to bail him out.
Well I don't have a grandson so that wasn't a problem, okay.
This is a real solicitation I got
and it has most of the red flags,
and that's what you're gonna be looking for.
I hope all is well and trust you are doing splendidly.
Almost every first line is like that,
and this is better English than most of them.
You're an expert in blah, blah.
We'd like your article, your next article.
And if there's a journal once in a while
they will actually give you a URL for a journal website.
If you go to it luckily now Google puts up at the top
illegitimate journal comments
about how it is an illegitimate journal but you have to go.
Notice, "The New American Journal of Medicine."
Anybody an internist here?
Okay, you are, there's a journal,
"American Journal of Medicine."
It's a respected journal,
but there's no "New American Journal"
so that's one of the things, okay.
Okay, how common are the solicitations?
I told you how many I had gotten.
Here are a couple, 48 hours, these were the most egregious.
"Drug Target Insights," we're interested
in publishing your research.
They said there is a publishing charge.
They usually don't say that up front,
but they didn't specify the amount.
The "Integrative Journal of Ortho and Traumatology."
Final call, we've notified you and we need one more paper.
We need one more paper to complete our journal.
As soon as you send it in, accepted.
Okay, that's okay, and then of course
the conference invitation, nobody's going to China right now
so you don't have to worry about that, okay.
Now, there are legitimate
and respected open-access journals.
They are legitimate, they are respected.
Legitimate researchers publish in them,
and these are just some of them, okay.
But there are illegitimate journals that have similar names.
The legitimate ones,
the "Journal of Cancer Science & Therapy."
The illegitimate one,
the "Journal of Cancer Science & Therapeutics."
Very close, you have to be very careful.
Believe or not the
"Journal of Sports Medicine & Doping Studies"
is a real journal, okay, be careful, okay.
Opportunities and barriers
with legitimate open-access publishing.
We have to talk about that
because you're going to be involved,
if you do any publishing, you're going to be involved
with legitimate open-access publishers.
The basic underlying thing you have to remember
is someone has to pay.
It doesn't suddenly appear without processing.
You know, we're not talking about printing
but there's an editorial process,
there's a formatting process.
Someone has to pay for all of this.
Maintaining the website, someone has to pay, okay.
Business support, there is a business support
and archiving, just getting it into the appropriate archives
and notifying people so you have to remember that people
have to pay anywhere along the line for these things.
Now these are the four general types of open-access journals
and I'm gonna talk about each one.
Okay the green, the gold, the platinum also called silver,
platinum or silver, and the hybrid which is combination
kind of like your Prius, okay.
Green, some people call that second-class publishing.
It really isn't, and there's all kinds of green publishing,
but basically they accept preprints
which means before it goes to peer review.
They take postprints after there's layout
from a other journal.
You can send it to a repository.
Some of you know about ResearchGate, okay.
They'll take these, and there's others.
Your university may have a repository.
The library, does the library have a repository here?
An open-access repository?
Man: Yes.
Kenneth: Yes, we do, okay.
And sometimes my library gets annoying.
Send us a copy of, you know.
Okay, okay, relax, calm down.
But you can publish them and then they're available online
for free, it costs you nothing.
And these have not been accepted in a journal yet.
There are some that are higher level repositories
and some just for specific things.
For example the Cold Harbor Repository is for basic science
more or less, basic biological science
and then they have some for not biological science.
You can put things in there and they will replace it
with a published article once you get it done
and it's for scientists to look at their colleagues' work
and comment on it.
It's discipline-specific unless it's from the university.
And if it's from your university or ResearchGate
it's funded from outside, and I have no idea
how ResearchGate is funded, okay.
All right, there's the Web of Science.
Now that, there's a subscription charge to access that,
but for you to see the articles,
and I suspect that your library has a, yes it does.
It has a subscription to Web of Science
so you can go on it and look, but to put your article
on Web of Science is free, it's open-access, okay.
So sometimes it's also called the gray literature,
but gray literature is another term.
When you go to Wikipedia, please don't plagiarize Wikipedia.
That's so easy to discover.
That's just a sidebar.
But Wikipedia is gray literature.
It's not peer reviewed, it's just out there
and it's available, okay, but it can be very important.
It can also be government documents which are important
and you may have to cite in some of your things.
Okay, so that is free.
Green is free, green is easy, green is not published
as you think if it's in a journal as being published,
but you can cite it, okay.
Gold, and there's all kinds of gold.
There is 14 karat gold, there is fool's gold.
I mean, all kinds of gold.
So we're talking about a gigantic group, it's pay to play.
You pay a fee and we will publish your article
in a legitimate open-access journal, okay.
This is where we get into trouble
because the illegitimate open-access journals
say the same thing, and we'll look at the difference.
How can you tell a legitimate gold access
from an illegitimate gold access?
Okay, but they're pay to play.
You pay, they'll do it.
One of the big ones is, with the legitimate is,
I'm sending you the article, please review it
for your legitimate open-access journal, okay.
It goes through a review process.
They say, okay, we want these changes
and then we'll do it but to publish it
it's going to cost you this much money, how much money?
It varies, it can be as little as a few hundred dollars.
It can be $5,000, depends on the nature of the journal.
And this is legitimate and if you have big grants who cares?
If you're in the humanities or in a third-world country
not so good, okay.
The illegitimate ones it's, you wanna submit your article?
Okay, now that you submitted it, please forward $500 to us.
As soon as you do it'll be published.
Eh, not so good, okay.
Platinum or diamond, that is, okay,
some of you are wearing platinum or diamond rings, right?
They were given to you, it's a gift.
Oh well, if it's related to marriage, you know.
But okay, but we'll presume that it's a gift, okay,
and that's what this is.
Platinum and diamond group of open-access journals,
we will look at your article and if we publish it
it will get open-access immediately and it's free
and you don't pay.
At the bottom here are some legitimate open-access
platinum journals that anybody can submit to
and if they accept your article it is published immediately
or after the revisions they ask for and it is free to you
and to people who want to read it.
In ethics, since this is an ethics conference
the "American Medical Association Journal of Ethics"
is the best known.
BMC, the "British Medical Ethics" is another one,
and the "Canadian Journal of Bioethics" is another one.
And who pays for that?
For the AMA journal, it's the AMA, they pay all the costs.
British Medical pays them, Canadian Medical Association
pays 'em, "Journal of the American Heart Association,"
they pay for their articles.
That's platinum, there are very, very, very few platinum
journals available now.
Things may change.
This is rapidly changing area.
And then there's the hybrid journals.
You submitted an article to
the "American Journal of Medicine."
They say, fine, we like your article, we'll publish it.
Would you like to publish it open-access?
'Cause that's an option in our journal.
You know, we have the hard copy
and then we have the ones e-only,
or both print and open-access.
Yes, I'd like to do both.
All right, that'll be $1,000.
Or, they've accepted it.
No, I'd rather it just be in print.
Fine, then it's only available to subscribers,
people who have subscribed
to the "American Journal of Medicine."
And that's happening more and more and more.
There's another tricky thing
that some of these publishers are doing.
You send something in to the "Journal of Pathology," okay.
I don't know why, but okay, but you did and it was accepted.
No, I'm sorry, it wasn't.
Well, we didn't quite like it.
We've had another similar article so we can't publish it.
But here's a link to our sister journal that's open-access
and you can submit it there,
and I'm sure it will be published,
but if it is you'll probably have to pay $1,500.
Very unethical behavior by a lot of publishers now,
and if you're submitting papers you'll see that, okay.
Okay, Plan S, we're not gonna go deeply into Plan S
because it's changing day to day also,
but it's coming mainly out of the European Union,
what's left of the European Union and some funders
like the Gates Foundation, they are basically saying
that there can't be an embargo on the papers.
Things can be used that are published.
It's gonna be open-access.
It's the idea that we first had about open-access journals
is they'll be legitimate, they will publish,
they won't charge you exorbitant fees,
and everybody will have access to 'em.
We'll see what happens.
It's supposed to go into full effect in 2024
but don't hold your breath.
Oh, here, here's one thing that you need to know
just in general, the CC-BY, the Creative Commons License.
For those of you who are publishing or using things
off the web and especially images,
if you look for Creative Commons License,
and it'll be right there on the page
or associated with the illustration.
If you have that and you can take that image,
you can put it in the article you want to publish.
You just have to put the Creative Commons citation down
and publishers will publish it,
and I've used that many times, and it's very useful.
Okay, so it's often very difficult
to distinguish between the two types of gold journals,
the legitimate and illegitimate.
We're gonna talk about how to identify questionable journals
just knowing, as you'll see, that it's not that simple.
But you've got the list from your library,
and these are gonna go over some of those things
and some others, here are some of the questions
you have to ask, okay, and this is from an article we had
in "Academic Medicine" last year.
We're gonna go, okay, journal familiarity.
Have you heard about the journal?
Have your colleagues heard about the journal?
Have your librarians heard about the journal?
Okay.
Is it sponsored by a legitimate organization?
You belong to the American Society of Anesthesiologists.
Is it their journal, is it an offshoot of their journal?
Is that what it says?
Have you read the journal before?
Have you seen an article cited from that journal?
Does the journal's name have something strange in it
like it says "American Journal of Dermatology"
but the English that you're reading isn't American English.
In fact, it's nobody's English, that's pretty common.
Okay, does it look like it's coming addressed
to multiple different audiences simultaneously?
The "Engineering Journal of Biological Physics
"and Skin Disorders."
Certainly I'd go for that.
Solicitations, this is your email.
Did the publisher send you an unsolicited email?
Direct marketing, okay, if it's no
it suggests, the answers I'm giving
suggest that it's a legitimate journal.
So no, they didn't do that.
Did they promise an unusually short submission
to publication time such as a few weeks or a month?
No, although I can tell you that legitimate journals,
especially legitimate medical journals now
are offering to give you an answer,
especially if it's rejected, within a couple weeks.
That's new because there's so much competition
among the legitimate hard copy medical journals.
Can you easily locate the journal's website?
And like I said, and it doesn't have notations saying,
I think this is an illegitimate journal
especially if you're looking through Google.
Does the website appear professional?
Or did some elementary school student put it together?
Are there advertisements?
If they offer you a view at an issue,
are there advertisements from unrelated sources?
You know, like,
I don't know, underwear models in the,
I don't know, AMA does that, well, who knows.
Does the website contain misleading information?
Or many language errors?
Language errors in emails and on the website
are one of the big, big things.
Remember, these are publishers, these are publishers.
They should have vetted their website really well.
Is there full contact information
or just a place to send your money?
Okay, do they talk about the ownership
and management of the journal?
Illegitimate, no.
Business model, we'll go on to editorial board.
Can you recognize the names of the editorial board?
Are they in your specialty, in your area?
One danger, sometimes they'll put names down
that are well known in the field
just on their editorial board.
Have they asked the people?
No, can you get them off of there?
No, people have filed lawsuits to get their names
off of some of these editorial board lists
and they've been unsuccessful
basically because they can't find them
or they're in countries that don't recognize
US, British, Canadian law.
Okay, can you find the journal's latest papers?
I find that very, very useful.
Go to ResearchGate and or Google or something similar
and look for the name of the journal
if you really think you're not sure
and see if there's some recent articles listed.
Okay, are those articles of good quality?
Okay, do they contain the contact information
for the author, if so, contact the authors and see.
Does the journal have the same authors repeatedly
on their articles?
And all you need is a table of contents for that, okay.
Do they have author instructions
or can you submit anything you want?
Big red flag, do they have an external review process
and do they describe it?
Submission fee, now this is where the rubber meets the road.
Do they tell you about submission fees on their website?
Author instructions, a legitimate gold journal will say
if it's accepted we will charge a fee.
And they can have various fees
and they can have graduated fees, all different things
and they can even say, if you're coming
from a developing country we can waive the fee.
And that's all legit, but they don't say anything
about the fee until they accept your paper the next day
that's a problem, okay.
Here are some sites you can go to and these links,
or actually some of these sites are on your library site.
If you go to your library site you can have access
to some of this information.
Whether they are listed on the do not publish
essentially site or on the legitimate site.
Okay, here's one of the big ones,
Beall's List of Predatory Journals
and Publishers and Updates.
And here's the link and that's the one you guys
have a subscription to?
Yes, okay, it's the simplest way--
-: Cabell's. -: I'm sorry?
Woman: Cabell's, Cabell's, we have Cabell's blacklist.
-: Cabell's, okay, they have a different one.
Okay, but that's the easiest way.
Just go down the list, if it's on the list of do not publish
then you don't and if it's on the good one then go for it.
Copyright and embargo, you want to be able
to use your paper, send it around, post it on wherever,
and you need to be able to do that.
If you publish in some of these illegitimate journals
you're not gonna have access
to your publication for other use.
Again, your P&T committees and potential employers
are not going to recognize it or if they do recognize it
are not gonna think highly of you,
and generally they're not accepted for promotion and tenure.
Now ethical issues in general in open-access publishing.
Promotion and tenure committees are looking
at the article processing charges as a measure
of how important the journal is
and how important your paper was.
It may restrict academic freedom if you don't have the money
especially from poorer countries,
and the hybrid journals which are increasing all the time
where they have subscriptions, print publications,
and then they also charge authors fees for open-access.
It's called double-dipping, they're getting money
from everybody at the same time,
and that poses some ethical dilemmas.
Okay, other fake news.
You never heard of fake news before I know.
You haven't heard of fake news?
Student: No.
-: Well fake news, it comes out in open-access.
The Fox News puts it as a lead and then millions of people
are affected by bad information, ghostwritten research.
Okay, now here's from the Federal Trade Commission,
and this was an official document
published in 2017 about these journals.
They deceptively claim that their journals provide authors
with rigorous peer review and have editorial boards.
In fact they don't.
Editors have not agreed to be affiliated,
and they charge significant fees and do not allow authors
to withdraw their publications once they're sent in.
Who's responsible for guiding you to the right places?
And I've mentioned the librarians multiple times,
but your bioethics committee or your IRBs
should have a role if you go to them.
Colleagues, mentors, other authors in your field,
and your professional organizations.
So everybody has a piece of the pie
to help guide you to the right place, now what?
What are you gonna do?
You have something sitting on your computer.
It's almost ready or it's ready to be sent in.
What are you going to do?
Well, that's up to you and your institution.
They have to help you.
And I hope the resources are there.
Okay, I have no idea, we're stuck, but okay.
Okay, so we'll take questions
and I'm supposed to ask for outsiders to call in
if they would like to.
I promise not to charge you an article processing fee.
(audience applauding)
You're very kind.
One, two, three, okay, yes, sir.
Man: Yeah, so do you think pharmaceutical companies
make high use of these illegitimate journals
to increase profits?
-: Do pharmaceutical companies
use these open-access journals to increase profits?
They have so many other ways to increase profits
and screw the profession and the public,
they don't make a lot of use of it.
They will publish, get their people to publish in some
of these journals just so they can show the clinicians,
the gullible clinicians, see, we had good results
from our sketchy drug,
but they have lots of other ways of doing it.
Have you seen the commercials on television?
Make your patients demand that they get the drug.
That's a lot better, other questions?
Okay, again, we're good?
Good, good, good, good?
Okay, good luck in your careers, thank you very much.
(audience applauding)