In the months since President Donald Trump took office, the science and research community has seemingly been under attack by his administration. There have been massive cuts to research funding, changes to vaccine protocols without the input of the Centers for Disease Control and Prevention, and layoffs of federal employees. And this week, the Health and Human Services Secretary, Robert F. Kennedy Jr., was on the Ultimate Human Podcast and said, “We’re probably going to stop publishing in The Lancet, New England Journal of Medicine, JAMA, and those other journals because they’re all corrupt”.
Secretary Kennedy went on to suggest his own agency could bypass the journals and publish research directly. Independent medical journals have long been peer-reviewed publications that platform research and provide knowledge to the medical community worldwide.
Dr. Eric J. Rubin the editor-in-chief of the New England Journal of Medicine, a tuberculosis researcher, and an infectious disease physician, joined GBH’s All Things Considered host Arun Rath to discuss what this could mean to the medical community. What follows is a lightly edited transcript.
Arun Rath: I want to give you a chance to respond to Secretary Kennedy’s charges. We heard an excerpt in the introduction. And for additional context, I should say Secretary Kennedy did not get more specific beyond using the word corruption. Later in his comments, he suggested that medical journals were in some way beholden to pharmaceutical companies, again, without any specific evidence cited. So having said that, I’ll let you respond.
Dr. Eric J. Rubin: Medical journals like ours are all about trying to publish the most important information that has the biggest impact on the health of Americans in the world. I don’t think we are corrupt. I don’t think that we play with cronyism. We’re all about what’s important out there and how we can best get that information across to the physicians who are going to apply it.
Rath: To give us a sense of what this threat could mean, roughly how much research published in the New England Journal of Medicine and other journals comes from government studies. What does that mean to possibly lose that?
Rubin: I don’t know the percentage, certainly there is a lot of good research that we publish that is either coming from federal scientists or funded by the federal government. It would represent a lot of important studies that we published. And I think that’s the key thing, the threat here is that important information doesn’t get out to people in a way that they can trust.
Rath: And as I mentioned, journals a lot like yours have protocols and standards by which the research gets published. What would it mean for medical research? You could say medicine more broadly if government scientists could no longer publish in journals like yours.
Rubin: Arun, I think I’d go back to your introduction where you said that medical journals are independent voices. I think that’s very important. We independently assess information brought to us by authors and decide, 'is it important?’ So we have a curatorial responsibility. We decide what gets out there? And then we edit, and we edit quite a bit to make the story both correct and understandable.
Rath: The New England Journal of Medicine, along with the Lancet and the Journal of the American Medical Association, started in the 1800s. It’s hard to think of institutions so established and mainstream, but is there still a danger that these attacks could delegitimize them?
Rubin: I think there is a danger to medical journals, but I really want to put it in the context of medical research in general. Certainly, what hurts a journal is not only attacking its reputation directly, but cutting off the important research that we publish. So, I think this is all part and parcel of a threat to the scientific enterprise in general.
Rath: Secretary Kennedy suggested that HHS could publish their own in-house journals for research. And I want to quote what he said. This is on that podcast again. He said they would “become the preeminent journals because if you get NIH funding, it is anointing you as a good, legitimate scientist.” Could I get your reaction to that?
Rubin: Well, I certainly welcome any new journals. There are new journals coming out all the time. And a lot of them are doing experiments that are really interesting. And I’m also happy as a, until recently, NIH-funded investigator to be anointed in such a way. But I do think that different journals have different roles. General medical journals, very prominent general medical journals like ours, have a very different responsibility from specialty journals and scientific journals which are publishing to a research audience. We publish to doctors, and we want to tell stories that are both important to doctors and their patients, and that will really have an effect on the health of Americans, global health as well. And we work hard to get the message right.
Rath: And also, it’s not just general journals that have come under attack. The Washington Post reported in April that the Journal of the American College of Chest Physicians got a letter from the Department of Justice questioning their editorial policies. I’ll quote from that letter that said, it has been brought to my attention that more and more journals like Chest, that’s the journal, are conceding that they are partisans in various scientific debates. I’m actually a little bit familiar with that journal because my father was a pulmonary doctor, and it used to come to our house when I was a kid. I’m not aware of Chest or other specialist journals conceding any partisanship. Have you heard otherwise?
Rubin: Well, we got a letter with very similar language that accused us of conceding partisanship, and I don’t think we’ve conceded anything.
Rath: Any idea what that could be talking about?
Rubin: It’s hard to speculate. I really don’t know what they’re trying to get at.
Rath: Finally, to just understand a bit more about the impact of what we’re talking about with medical journals and specialist journals as well, could you talk about what this means for higher education, the impact this could have on medical schools and medical students?
Rubin: Journals are an important source of information. And as you’re suggesting Arun in your question, they’re important sources of education, starting in medical school and going all the way through training. We want our doctors to stay up on what’s the latest. We want, when we see the doctor, we hope that they’re going to know that the treatment of even common diseases has changed. And that’s where I think journals play a critical part. Without them, we would not be able to keep up with what we should be doing as physicians.
