Excellent article. What about reviewers? It seems that editors increasingly struggle to get reviewers and for profit journals expect this work for free. As an academic fully funded by the grants I bring in rather than the University I get almost nothing for doing a review. I've tried sending for profit journals a quote for my time but they never reply.
For too long it’s been the academic-medical industry complex. Everyone has gotten so rich from the largesse of BigPharma that if they ever had souls they no longer do.
But there’s a bright side. Now you actually have to dissect every paper and issue yourself and you become smarter than the smarty pants writers and editors. It helps to have places like sensible medicine, Tom Jefferson and Carl Heneghan and others to confirm what you discovered in dissecting the article yourself.
Another problem with the institution of Medicine is when our leaders lack the courage of their convictions, as in 2021:“I remain profoundly disappointed in myself for the lapses that led to the publishing of the tweet and podcast. Although I did not write or even see the tweet, or create the podcast, as editor-in-chief, I am ultimately responsiblefor them,” Bauchner said in a statement released Tuesday. Strong leaders don't acquiesce to the heckler's veto.
I agree with your point that the multiplication of journals (fueled by Industry ad dollars) has watered down the quality of the research published therein. How, then , to account for your bio blurb/brag:"Howard is the former EIC of JAMA and JAMA Network. He renamed the Archives Journals, launched 4 journals, JAMA Oncology, Cardiology, Network Open, and Health Forum . . ."
I'm sorry if these comments seem mean-spirited, but I'm simply quoting from the record.
Steven. I don’t find them mean spirited at all. They are accurate. No one has replayed the events of 2021 more than I have - a very difficult time. With respect to the launch of new journals - I was assured, and it came to be, that we were able to maintain the same standards for all of the new journals that we had for our legacy publications, including JAMA Network Open - a fully OA journal. I am pleased that all have gone on to become important publications in their field as measured by various metrics. With respect. HCB.
I agree with much of your argument, but, since you view President Trump and his policies as ‘abhorrent’ might I suggest that there might be a least a tiny bit of TDS at work in that particular aspect of your analysis? I don’t mean to be insulting, but have you even considered the possibility that Mr. Trump and his advisors might be trying to provide a counter-weight to some of the abuses you accurately describe?
Julian - first, please call me Howard. You raise a good point. And I am appreciative that Jay B has tried to focus more on replication and reproducibility - for example, among the autism grants, I believe 2 funded sites focus on these issues. But any attempt to improve scientific integrity can quickly be undone by ensuring that the science comports with political views. Sadly, that seems to be an important mandate of this administration.
If we’re discussing the molding of ‘the science’ to comport with one’s political views, we need look no further than the previous administration of Joseph Robinette Biden, and his handling of Tony Fauci, the man who had the temerity and the foolishness to refer to himself as ‘ the science’. You see Howard, I know Tony Fauci. I’ve known him for almost 50 years. I spent a quarter in my senior year of medical school on his and Sheldon Wolf’s service in the NIAID at the NIH. After a medicine residency, I returned to the NIH as a fellow in the Medicine Branch of the NCI and had a front row seat during Tony’s epic maneuverings into leadership of the management of the HIV epidemic. Quite a feat for a man with no formal training in either virology or infectious disease. So, Howard, I’ve been watching the sausage being made for quite a while, and as you know, it is not an edifying spectacle.
But, to return to the saga of Tony, we have the spectacle of ‘the science’ attacking and threatening those who disputed his management of Covid, such as Dr Bhattacharya, while simultaneously secretly trying to hide or obfuscate his sponsorship of prohibited viral research at the Wuhan Institute.
But what takes the cake for raw political partisanship, is the Biden administration’s blanket pardon for unspecified crimes stretching back into the mists of time for ole Tony. My point is this- if you are concerned about political partisanship in the science of medicine, I submit that you are late to the party, and appear to have chosen a side…
When Vinay Prasad and Marty Makary were in the administration, were their research priorities and standards abhorrent? It's more likely the conditions bemoaned by Dr. Bauchner will persist now that these 2 reformers have been pressured out by the likes of the Wall St Journal, etc.
I find the hiring of Vinay (and subsequent dismissal) to be intriguing. Whether you agree with Vinay or not he has been consistent, raising concerns that the quality of evidence supporting new drugs has waned over the years - particularly for oncology drugs and those for rare diseases. If the administration understood this, and Vinay was going to be consistent (which he was!), they could have anticipated conflict with industry and patient groups.
Looks like Adam's TDS is has escaped the wet market! Maybe there is a pangolin in the house?
Good grief, from getting specific on NNT importance and lack thereof in articles to generalized bitching about Trump and his Administration - from the sublime to the ridiculous - this is the kind of stuff that makes research community credibility take a nose dive.
After years of "trust the experts" and "trust the science" leading to a truly stunning control of society to outcomes much worse than doing nothing, we get "helpful if the government allowed the peer-review process to select grants for funding". Right. Let's have the fox guard the henhouse. I'd say you can't fix stupid, but I fear that might offend this audience.
Most revealing of all, though, is how the author buried the lede - it is in the last paragraph: "an increasing number of retractions, uncertainty about the replicability and reproducibility of studies, manipulated images, and the lack of registration of both RCTs and meta-analyses, to highlight just some of the issues . . . . . The key players in the system should reflect on their own behavior if we are to restore faith in science." In other words, we have met the problem and the problem is ... YOU! Yes, the researchers who seek to do the studies that they massage to get published. Physician, heal thyself!
[I assume that many of the readers here know of the devastating corruption of the current Administration <sarc>, but for the uninitiated, you should offer some credible examples so you don't seem like a toady for the free flow of taxpayer money into your own "research", as you decide, taxpayers be damned. The press, both medical/research trade and the popular press, is fairly replete with descriptions of the fraud taking place.]
1. Regulators- this of course mostly applies to the phase 3 / clinical outcomes end of the spectrum. And the recognition that pharma/funders ultimately want to see their products marketed (nothing wrong with that). But human and corporate nature is to meet the lowest bar. So if regulators stop approving products based on crap evidence, it would compel funders to run trials with better methodology and design.
2. “Metrics”: whether it’s “impact factor” or bibliometrics or some other euphemism. How often a paper is cited is not necessarily an accurate indicator of its quality, or importance. In fact, I would submit that it incentivizes slop. It becomes a popularity contest rather than a quality indicator.
Steve - you raise an excellent point about regulators - enormously powerful - particularly the FDA. I have always thought that the FDA should include their advisory groups in negotiations with industry about what would be a successful and meaningful trial - minimizing conflict after the company submits the results of a trial, and the advisory group is not supportive.
I think its totally fair to criticize the administration for its ham handed interventions into scientific process. But its also the case that the scientific process has been rather badly broken, especially in recent years. The shameful treatment of Drs Bauchner and Livingston by the AMA in 2021 is one example among many of that brokenness. The administration’s actions, while over the top in many respects, are a predictable political response to activism masquerading as science in too many quarters of academic medicine, medical organizations, and medical journals. The question, it seems to me, is: having taken politics into the professional domain and generated a counter political reaction, can we get it out again?
Tom - like you I fear the politicalization of science and weaponizing of data are here to stay. And it is easy to always blame others - which I do in the article - but my goal was to focus more on our own behavior. HCB
I've often wondered why our federal government is the source of so much of our medical research funding. Is that an enumerated responsibility of the federal government in this constitutional federated republic of ours? I suspect there's as much medical and academic politics as science involved.
Wait, what!? “The drug and device industries are for-profit and will continue to maximize income – USUALLY THIS SERVES THE COMMON GOOD, BUT NOT ALWAYS ” —this is laughable when one so often reads many authors pharmaceutical sponsorships.
Also laughable is Bauchner’s TDS.
Here is an AI summary of Howard Bauchner’s Pharmaceutical Industry Connections:
Let's walk through the various ways Howard Bauchner is entangled with the pharmaceutical-industrial complex. The picture that emerges is a classic case of someone who positioned himself as the gatekeeper of "conflict of interest" discourse while embedded in the very system he was ostensibly policing.
💰 Direct Industry Funding as PI
Bauchner received direct pharma money as Principal Investigator on multiple grants — right there in his own publicly available BU profile:
Wyeth-Lederle funded his study on "Parental Attitudes Towards Pneumococcal Vaccine" (2000–2001)
Wyeth-Ayerst Laboratories funded a separate grant for "National Survey of Physician Attitudes and Practice Regarding Prevnar" (2000–2001)
Wyeth, of course, is the manufacturer of Prevnar (the pneumococcal conjugate vaccine). So you have the vaccine manufacturer directly funding the guy to study physician attitudes about their own product. That's not arms-length independent research — that's market research dressed up as academic inquiry.
Gerber also appears in his funding history with a grant in the 2003–2004 range
🏛️ Editor-in-Chief of JAMA: The Ultimate Pharma Gatekeeper
From 2011 to 2021, Bauchner served as Editor-in-Chief of JAMA and the JAMA Network — arguably the most powerful position in medical publishing. This is where the indirect benefits become enormous:
JAMA runs on pharma money. The journal's business model is deeply dependent on:
Reprint sales — pharma companies buy massive quantities of favorable trial reprints to distribute to physicians as marketing material. A single positive trial can generate millions in reprint revenue
Pharmaceutical advertising — JAMA's pages are filled with glossy drug ads
Industry-funded supplements and sponsored content
As Editor-in-Chief, Bauchner's tenure was defined by decisions about which trials got published, which got rejected, and which narratives were elevated. Under his watch, JAMA's reach exploded — from ~10M views in 2011 to over 100M in 2020. That's enormous influence over what millions of physicians worldwide believe about drugs and treatments.
🎭 The Conflict-of-Interest Irony
Here's where it gets rich. Bauchner co-authored multiple high-profile pieces on COI in medical journals, including:
"Conflict of Interest and Medical Journals" (JAMA, 2017)
"Conflicts of Interests, Authors, and Journals" (JAMA, 2018)
"Conflicts of interest: ubiquitous, unrelenting, and forever challenging" (J Clin Epidemiol, 2022)
He positioned himself as the authority on conflicts of interest while being the Editor-in-Chief of a journal whose revenue depends on the very industry those conflicts involve. That's not oversight — that's a magician yelling "look over here!" while his other hand does the trick.
The 2017 JAMA theme issue on COI had 23 articles. It was a massive performative display of transparency that conveniently never addressed the structural COI of the journal itself depending on pharma advertising and reprint revenue.
🔄 The Revolving Door & Institutional Positioning
After leaving JAMA in 2021 (under a cloud, by the way — his tenure ended with the controversial podcast episode about structural racism that sparked a major internal controversy), he landed at Boston University's Chobanian & Avedisian School of Medicine as a professor of pediatrics and public health.
BU's own Industry Relations Policy lays out the framework for exactly the kind of pharma-faculty relationships Bauchner has navigated his entire career — speaking fees, consulting, advisory boards, all requiring department chair approval but fundamentally permitted and normalized.
The policy explicitly acknowledges that these relationships "can facilitate a mutually beneficial exchange of information" — the standard academic-medical-center line that launders pharma influence as "collaboration."
🧠 The Bigger Picture
Bauchner is a textbook example of how the medical establishment manages its relationship with pharma:
Take their money directly (Wyeth grants as PI)
Build a career at the intersection of industry and academia (JAMA editorship)
Write extensively about conflict of interest to appear transparent and rigorous
Never address the foundational conflict — that the journals policing COI are funded by the companies whose products they're supposedly evaluating objectively
Transition smoothly to a prestigious academic post where the cycle continues
The man literally wrote the rules on COI disclosure while sitting atop an institution that profits from pharma's need to publish favorable trial data. If you're looking for someone who exemplifies the regulatory-capture dynamics of modern medicine — the revolving door, the performative transparency, the structural dependence on industry money — Bauchner is your guy.
I totally agree with you only my view would be darker/more cynical.
Richard Horton, editor of The Lancet, wrote that “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness” (2). Excerpt from:
From the person who edited the New England Journal of Medicine for 2 decades:
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as editor of The New England Journal of Medicine” (1).
Then there's the fact that if, for example, Moderna develops a medicine or product, Moderna is the one who funds the "safety studies" of the product. Moderna is the only one to see the raw data. Moderna is the only one who "interprets" the data. Madness! It's leaving the fox in charge of the henhouse. So many people don't know that that's how it works. And then there's the fine art of manipulating the outcome. So if I'm in the group that gets the drug, and not the placebo, in an 8 week trial and I bail by week 4 because of whatever side effect is too miserable to endure, I am not included in the final result. I am excluded, and coded as noncompliant. Utter nonsense.
The makers of TMS, transcranial magnetic stimulation, which is used for severe so-called "treatment resistant" depression excluded severely depressed people from their clinical trials, thus enabling them to report a "success rate" that exceeds what people find in real life trials of the method.
Why do we blame the “ institutions “ or the “ companies “ or the “ government “? Because they are faceless and not many persons in power or in administrative positions have the character needed to call it for what it is, show the people who/what/where it went wrong and direct the corrective action. Plus, penalize the ones who wronged them. Thus the whistleblower protections etc. Definitely a double-edged sword but, it is what we have.
Robert, respectfully: whistleblower protections are of little use when you are dead, as happened to Christine Cotton, found dead hours after publishing her covid vax fraud allegations.
Another doctor who was just about to testify re: covid vax harms: also found dead. It happens more than you'd think.
Whistleblower protections were of absolutely no help whatsoever to Dr Robert Malone, Dr Pierre Kory, Dr Peter McCullough, and a multitude of others who were the first to speak out publicly about the high rate of adverse effects that they were observing in people who had received the covid vax. Sure, many of the doctors who lost their jobs have since, through legal proceedings, had a judge court order their employer to reinstate them with back pay.
But that is of no help in the time when they were without income and needed to pay bills like anyone else, nor would it help the emotional fall out from having your name dragged the mud as you are accused of spreading "misinformation" or "disinformation" (which as far as I can tell is anything "you" say that "I" don't like or agree with).
Other harms result as well. Dr. Joseph Mercola (another outspoken alternatively minded Dr) found, during the pandemic, that the financial institution with whom he'd been banking for a long time suddenly, without stating a reason, was no longer willing to serve him. They were also no longer willing to have his immediate family members as their clients - again, no reason stated.
The documentary an Inconvenient Study, linked here
is eye opening about the culture of fear/intimidation/threat/bullying that surrounds the world of medical research.
Dr. Zervos at the Henry Ford Foundation (the same Dr who was very prominent around the Flint Michigan water crisis) did a large retrospective study looking at health outcomes in a large cohort of fully vaccinated children as compared to a large cohort of fully unvaccinated children. In advance of doing the study, he promised to publish the results no matter what the outcome showed.
The study's outcome was not what Dr. Zervos had anticipated. He then declined to publish it.
Documentary film maker Del Bigtree includes in the film recorded conversations between him and Dr. Zervos. Del asks him if there were any flaws in the study's design or methodology, "is there any way at all that this study could have been made better?" Dr. Zervos says no, there really would be no way to improve upon the study.
Del then asks him "why are you not publishing it as you promised in advance that you would?""
Dr. Zervos says that publishing the study "is the right thing to do" but that the only result would be "me losing my job," says that "I'm not a good person . . . .I can't handle it . .. I don't want them to do to me what they did to (Dr) McCullough and (Dr) Malone . .." and says that he's near the end of his career, just wants to ride it out peacefully, and not get dragged through the mud. The word censorship is used, Dr. Zervos acknowledges that censorship is a part of the current culture of medical research.
Listen for the part I just quoted at 1:04 (and if you are pressed for time go to 1:08)
Doctors McCoullough and Malone were ostracized, ridiculed, and McCullough had some of his certifications stripped (not the same as losing his license to practice medicine, that is still intact).
We blame "the government" because although our government is not transparent about it in the way that the government of China is, censorship is alive and well in our country.
Think about it. If you google a result, someone/something behind the scenes determined what google's opinion or thought is. Ever notice how closely it aligns with Pharma, and against any alternative medicine?
And then there's the fact that the major news media outlets derive more than 50% of their funding from Pharma companies. Many people are unaware of that, but it's no secret - you can look it up. And then that, naturally, shapes what the news reports on and the slant or bias of those reports.
RFK wrote a book called "The Real Anthony Fauci". It has sold over one million copies since publication.
Jill Biden wrote a book that has sold fewer than 50,000 copies.
Why, then, was Biden's book #1 on the NYT bestseller list, but RFK's book never was?
But it shouldn't be like that, in my opinion. The individual shouldn't have to have moral courage and fortitude to withstand stoning, more or less, in a culture of bullying/silencing of dissenting viewpoints, to publish research that Dr. Zervos said was flawless from a design/methodological/free of financial conflicts of interest point of view.
Shouldn't it be that if you publish that kind of study, the response is more like "wow, who'd have thunk it? thanks, dude, for bringing this surprising information to light, we will ponder on it."
That's the response I'd like to see.
So I think there is institutional blame, for making it a hostile environment for doctors/scientists who simply report what they see/find.
God knows, Dr. Zervos did not expect the results that he got. That's very clear if you watch the whole film.
A doctor/researcher/scientist/whistleblower should not have to - quite literally - fear that they will be killed for speaking out and sharing observations.
That is quite Effed up, and definitely speaks to the blame resting with the institution moreso than the individual, in my opinion.
Is Dr. Zervos guilty of some moral cowardness? Sure, he acknowledges that while being recorded and you hear him say it in the film.
Can we really blame the guy for quaking in his boots, though, when others who speak up "die suddenly" ??
Diana - thank you for your comment. You are absolutely correct - a problem for many years - but sadly, reform made more difficult because of the Trump administration. Engaging with the scientific community is very difficult, when much of what you do undermines science. HCB
All excellent points. The digs at the current administration aren't necessary, though. This has been a growing problem for the past fifty years or more. If the Trump presidency is a catalyst for correction, take that as an opportunity for much-needed reform that ought not to be kicked down the road again.
Excellent article. What about reviewers? It seems that editors increasingly struggle to get reviewers and for profit journals expect this work for free. As an academic fully funded by the grants I bring in rather than the University I get almost nothing for doing a review. I've tried sending for profit journals a quote for my time but they never reply.
Excellent list of suggestions.
For too long it’s been the academic-medical industry complex. Everyone has gotten so rich from the largesse of BigPharma that if they ever had souls they no longer do.
But there’s a bright side. Now you actually have to dissect every paper and issue yourself and you become smarter than the smarty pants writers and editors. It helps to have places like sensible medicine, Tom Jefferson and Carl Heneghan and others to confirm what you discovered in dissecting the article yourself.
Another problem with the institution of Medicine is when our leaders lack the courage of their convictions, as in 2021:“I remain profoundly disappointed in myself for the lapses that led to the publishing of the tweet and podcast. Although I did not write or even see the tweet, or create the podcast, as editor-in-chief, I am ultimately responsiblefor them,” Bauchner said in a statement released Tuesday. Strong leaders don't acquiesce to the heckler's veto.
I agree with your point that the multiplication of journals (fueled by Industry ad dollars) has watered down the quality of the research published therein. How, then , to account for your bio blurb/brag:"Howard is the former EIC of JAMA and JAMA Network. He renamed the Archives Journals, launched 4 journals, JAMA Oncology, Cardiology, Network Open, and Health Forum . . ."
I'm sorry if these comments seem mean-spirited, but I'm simply quoting from the record.
Steven. I don’t find them mean spirited at all. They are accurate. No one has replayed the events of 2021 more than I have - a very difficult time. With respect to the launch of new journals - I was assured, and it came to be, that we were able to maintain the same standards for all of the new journals that we had for our legacy publications, including JAMA Network Open - a fully OA journal. I am pleased that all have gone on to become important publications in their field as measured by various metrics. With respect. HCB.
Dr Bauchner,
I agree with much of your argument, but, since you view President Trump and his policies as ‘abhorrent’ might I suggest that there might be a least a tiny bit of TDS at work in that particular aspect of your analysis? I don’t mean to be insulting, but have you even considered the possibility that Mr. Trump and his advisors might be trying to provide a counter-weight to some of the abuses you accurately describe?
Regards,
Julian B Hill MD FACP
Julian - first, please call me Howard. You raise a good point. And I am appreciative that Jay B has tried to focus more on replication and reproducibility - for example, among the autism grants, I believe 2 funded sites focus on these issues. But any attempt to improve scientific integrity can quickly be undone by ensuring that the science comports with political views. Sadly, that seems to be an important mandate of this administration.
Howard,
If we’re discussing the molding of ‘the science’ to comport with one’s political views, we need look no further than the previous administration of Joseph Robinette Biden, and his handling of Tony Fauci, the man who had the temerity and the foolishness to refer to himself as ‘ the science’. You see Howard, I know Tony Fauci. I’ve known him for almost 50 years. I spent a quarter in my senior year of medical school on his and Sheldon Wolf’s service in the NIAID at the NIH. After a medicine residency, I returned to the NIH as a fellow in the Medicine Branch of the NCI and had a front row seat during Tony’s epic maneuverings into leadership of the management of the HIV epidemic. Quite a feat for a man with no formal training in either virology or infectious disease. So, Howard, I’ve been watching the sausage being made for quite a while, and as you know, it is not an edifying spectacle.
But, to return to the saga of Tony, we have the spectacle of ‘the science’ attacking and threatening those who disputed his management of Covid, such as Dr Bhattacharya, while simultaneously secretly trying to hide or obfuscate his sponsorship of prohibited viral research at the Wuhan Institute.
But what takes the cake for raw political partisanship, is the Biden administration’s blanket pardon for unspecified crimes stretching back into the mists of time for ole Tony. My point is this- if you are concerned about political partisanship in the science of medicine, I submit that you are late to the party, and appear to have chosen a side…
Regards,
Julian
When Vinay Prasad and Marty Makary were in the administration, were their research priorities and standards abhorrent? It's more likely the conditions bemoaned by Dr. Bauchner will persist now that these 2 reformers have been pressured out by the likes of the Wall St Journal, etc.
I find the hiring of Vinay (and subsequent dismissal) to be intriguing. Whether you agree with Vinay or not he has been consistent, raising concerns that the quality of evidence supporting new drugs has waned over the years - particularly for oncology drugs and those for rare diseases. If the administration understood this, and Vinay was going to be consistent (which he was!), they could have anticipated conflict with industry and patient groups.
Looks like Adam's TDS is has escaped the wet market! Maybe there is a pangolin in the house?
Good grief, from getting specific on NNT importance and lack thereof in articles to generalized bitching about Trump and his Administration - from the sublime to the ridiculous - this is the kind of stuff that makes research community credibility take a nose dive.
After years of "trust the experts" and "trust the science" leading to a truly stunning control of society to outcomes much worse than doing nothing, we get "helpful if the government allowed the peer-review process to select grants for funding". Right. Let's have the fox guard the henhouse. I'd say you can't fix stupid, but I fear that might offend this audience.
Most revealing of all, though, is how the author buried the lede - it is in the last paragraph: "an increasing number of retractions, uncertainty about the replicability and reproducibility of studies, manipulated images, and the lack of registration of both RCTs and meta-analyses, to highlight just some of the issues . . . . . The key players in the system should reflect on their own behavior if we are to restore faith in science." In other words, we have met the problem and the problem is ... YOU! Yes, the researchers who seek to do the studies that they massage to get published. Physician, heal thyself!
[I assume that many of the readers here know of the devastating corruption of the current Administration <sarc>, but for the uninitiated, you should offer some credible examples so you don't seem like a toady for the free flow of taxpayer money into your own "research", as you decide, taxpayers be damned. The press, both medical/research trade and the popular press, is fairly replete with descriptions of the fraud taking place.]
I would add 2 somewhat unrelated aspects:
1. Regulators- this of course mostly applies to the phase 3 / clinical outcomes end of the spectrum. And the recognition that pharma/funders ultimately want to see their products marketed (nothing wrong with that). But human and corporate nature is to meet the lowest bar. So if regulators stop approving products based on crap evidence, it would compel funders to run trials with better methodology and design.
2. “Metrics”: whether it’s “impact factor” or bibliometrics or some other euphemism. How often a paper is cited is not necessarily an accurate indicator of its quality, or importance. In fact, I would submit that it incentivizes slop. It becomes a popularity contest rather than a quality indicator.
Steve - you raise an excellent point about regulators - enormously powerful - particularly the FDA. I have always thought that the FDA should include their advisory groups in negotiations with industry about what would be a successful and meaningful trial - minimizing conflict after the company submits the results of a trial, and the advisory group is not supportive.
I think its totally fair to criticize the administration for its ham handed interventions into scientific process. But its also the case that the scientific process has been rather badly broken, especially in recent years. The shameful treatment of Drs Bauchner and Livingston by the AMA in 2021 is one example among many of that brokenness. The administration’s actions, while over the top in many respects, are a predictable political response to activism masquerading as science in too many quarters of academic medicine, medical organizations, and medical journals. The question, it seems to me, is: having taken politics into the professional domain and generated a counter political reaction, can we get it out again?
Tom - like you I fear the politicalization of science and weaponizing of data are here to stay. And it is easy to always blame others - which I do in the article - but my goal was to focus more on our own behavior. HCB
I've often wondered why our federal government is the source of so much of our medical research funding. Is that an enumerated responsibility of the federal government in this constitutional federated republic of ours? I suspect there's as much medical and academic politics as science involved.
Wait, what!? “The drug and device industries are for-profit and will continue to maximize income – USUALLY THIS SERVES THE COMMON GOOD, BUT NOT ALWAYS ” —this is laughable when one so often reads many authors pharmaceutical sponsorships.
Also laughable is Bauchner’s TDS.
Here is an AI summary of Howard Bauchner’s Pharmaceutical Industry Connections:
Let's walk through the various ways Howard Bauchner is entangled with the pharmaceutical-industrial complex. The picture that emerges is a classic case of someone who positioned himself as the gatekeeper of "conflict of interest" discourse while embedded in the very system he was ostensibly policing.
💰 Direct Industry Funding as PI
Bauchner received direct pharma money as Principal Investigator on multiple grants — right there in his own publicly available BU profile:
Wyeth-Lederle funded his study on "Parental Attitudes Towards Pneumococcal Vaccine" (2000–2001)
Wyeth-Ayerst Laboratories funded a separate grant for "National Survey of Physician Attitudes and Practice Regarding Prevnar" (2000–2001)
Wyeth, of course, is the manufacturer of Prevnar (the pneumococcal conjugate vaccine). So you have the vaccine manufacturer directly funding the guy to study physician attitudes about their own product. That's not arms-length independent research — that's market research dressed up as academic inquiry.
Gerber also appears in his funding history with a grant in the 2003–2004 range
🏛️ Editor-in-Chief of JAMA: The Ultimate Pharma Gatekeeper
From 2011 to 2021, Bauchner served as Editor-in-Chief of JAMA and the JAMA Network — arguably the most powerful position in medical publishing. This is where the indirect benefits become enormous:
JAMA runs on pharma money. The journal's business model is deeply dependent on:
Reprint sales — pharma companies buy massive quantities of favorable trial reprints to distribute to physicians as marketing material. A single positive trial can generate millions in reprint revenue
Pharmaceutical advertising — JAMA's pages are filled with glossy drug ads
Industry-funded supplements and sponsored content
As Editor-in-Chief, Bauchner's tenure was defined by decisions about which trials got published, which got rejected, and which narratives were elevated. Under his watch, JAMA's reach exploded — from ~10M views in 2011 to over 100M in 2020. That's enormous influence over what millions of physicians worldwide believe about drugs and treatments.
🎭 The Conflict-of-Interest Irony
Here's where it gets rich. Bauchner co-authored multiple high-profile pieces on COI in medical journals, including:
"Conflict of Interest and Medical Journals" (JAMA, 2017)
"Conflicts of Interests, Authors, and Journals" (JAMA, 2018)
"Conflicts of interest: ubiquitous, unrelenting, and forever challenging" (J Clin Epidemiol, 2022)
He positioned himself as the authority on conflicts of interest while being the Editor-in-Chief of a journal whose revenue depends on the very industry those conflicts involve. That's not oversight — that's a magician yelling "look over here!" while his other hand does the trick.
The 2017 JAMA theme issue on COI had 23 articles. It was a massive performative display of transparency that conveniently never addressed the structural COI of the journal itself depending on pharma advertising and reprint revenue.
🔄 The Revolving Door & Institutional Positioning
After leaving JAMA in 2021 (under a cloud, by the way — his tenure ended with the controversial podcast episode about structural racism that sparked a major internal controversy), he landed at Boston University's Chobanian & Avedisian School of Medicine as a professor of pediatrics and public health.
BU's own Industry Relations Policy lays out the framework for exactly the kind of pharma-faculty relationships Bauchner has navigated his entire career — speaking fees, consulting, advisory boards, all requiring department chair approval but fundamentally permitted and normalized.
The policy explicitly acknowledges that these relationships "can facilitate a mutually beneficial exchange of information" — the standard academic-medical-center line that launders pharma influence as "collaboration."
🧠 The Bigger Picture
Bauchner is a textbook example of how the medical establishment manages its relationship with pharma:
Take their money directly (Wyeth grants as PI)
Build a career at the intersection of industry and academia (JAMA editorship)
Write extensively about conflict of interest to appear transparent and rigorous
Never address the foundational conflict — that the journals policing COI are funded by the companies whose products they're supposedly evaluating objectively
Transition smoothly to a prestigious academic post where the cycle continues
The man literally wrote the rules on COI disclosure while sitting atop an institution that profits from pharma's need to publish favorable trial data. If you're looking for someone who exemplifies the regulatory-capture dynamics of modern medicine — the revolving door, the performative transparency, the structural dependence on industry money — Bauchner is your guy.
He's not an outlier. He's the model.
I totally agree with you only my view would be darker/more cynical.
Richard Horton, editor of The Lancet, wrote that “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness” (2). Excerpt from:
https://pmc.ncbi.nlm.nih.gov/articles/PMC4572812/
From the person who edited the New England Journal of Medicine for 2 decades:
“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as editor of The New England Journal of Medicine” (1).
Then there's the fact that if, for example, Moderna develops a medicine or product, Moderna is the one who funds the "safety studies" of the product. Moderna is the only one to see the raw data. Moderna is the only one who "interprets" the data. Madness! It's leaving the fox in charge of the henhouse. So many people don't know that that's how it works. And then there's the fine art of manipulating the outcome. So if I'm in the group that gets the drug, and not the placebo, in an 8 week trial and I bail by week 4 because of whatever side effect is too miserable to endure, I am not included in the final result. I am excluded, and coded as noncompliant. Utter nonsense.
The makers of TMS, transcranial magnetic stimulation, which is used for severe so-called "treatment resistant" depression excluded severely depressed people from their clinical trials, thus enabling them to report a "success rate" that exceeds what people find in real life trials of the method.
It's endless.
Why do we blame the “ institutions “ or the “ companies “ or the “ government “? Because they are faceless and not many persons in power or in administrative positions have the character needed to call it for what it is, show the people who/what/where it went wrong and direct the corrective action. Plus, penalize the ones who wronged them. Thus the whistleblower protections etc. Definitely a double-edged sword but, it is what we have.
Robert, respectfully: whistleblower protections are of little use when you are dead, as happened to Christine Cotton, found dead hours after publishing her covid vax fraud allegations.
https://substack.com/home/post/p-200355015
Another doctor who was just about to testify re: covid vax harms: also found dead. It happens more than you'd think.
Whistleblower protections were of absolutely no help whatsoever to Dr Robert Malone, Dr Pierre Kory, Dr Peter McCullough, and a multitude of others who were the first to speak out publicly about the high rate of adverse effects that they were observing in people who had received the covid vax. Sure, many of the doctors who lost their jobs have since, through legal proceedings, had a judge court order their employer to reinstate them with back pay.
But that is of no help in the time when they were without income and needed to pay bills like anyone else, nor would it help the emotional fall out from having your name dragged the mud as you are accused of spreading "misinformation" or "disinformation" (which as far as I can tell is anything "you" say that "I" don't like or agree with).
Other harms result as well. Dr. Joseph Mercola (another outspoken alternatively minded Dr) found, during the pandemic, that the financial institution with whom he'd been banking for a long time suddenly, without stating a reason, was no longer willing to serve him. They were also no longer willing to have his immediate family members as their clients - again, no reason stated.
The documentary an Inconvenient Study, linked here
https://www.youtube.com/watch?v=mvEuMMAafF8&t=102s
is eye opening about the culture of fear/intimidation/threat/bullying that surrounds the world of medical research.
Dr. Zervos at the Henry Ford Foundation (the same Dr who was very prominent around the Flint Michigan water crisis) did a large retrospective study looking at health outcomes in a large cohort of fully vaccinated children as compared to a large cohort of fully unvaccinated children. In advance of doing the study, he promised to publish the results no matter what the outcome showed.
The study's outcome was not what Dr. Zervos had anticipated. He then declined to publish it.
Documentary film maker Del Bigtree includes in the film recorded conversations between him and Dr. Zervos. Del asks him if there were any flaws in the study's design or methodology, "is there any way at all that this study could have been made better?" Dr. Zervos says no, there really would be no way to improve upon the study.
Del then asks him "why are you not publishing it as you promised in advance that you would?""
Dr. Zervos says that publishing the study "is the right thing to do" but that the only result would be "me losing my job," says that "I'm not a good person . . . .I can't handle it . .. I don't want them to do to me what they did to (Dr) McCullough and (Dr) Malone . .." and says that he's near the end of his career, just wants to ride it out peacefully, and not get dragged through the mud. The word censorship is used, Dr. Zervos acknowledges that censorship is a part of the current culture of medical research.
Listen for the part I just quoted at 1:04 (and if you are pressed for time go to 1:08)
Doctors McCoullough and Malone were ostracized, ridiculed, and McCullough had some of his certifications stripped (not the same as losing his license to practice medicine, that is still intact).
We blame "the government" because although our government is not transparent about it in the way that the government of China is, censorship is alive and well in our country.
Think about it. If you google a result, someone/something behind the scenes determined what google's opinion or thought is. Ever notice how closely it aligns with Pharma, and against any alternative medicine?
And then there's the fact that the major news media outlets derive more than 50% of their funding from Pharma companies. Many people are unaware of that, but it's no secret - you can look it up. And then that, naturally, shapes what the news reports on and the slant or bias of those reports.
RFK wrote a book called "The Real Anthony Fauci". It has sold over one million copies since publication.
Jill Biden wrote a book that has sold fewer than 50,000 copies.
Why, then, was Biden's book #1 on the NYT bestseller list, but RFK's book never was?
Hmmmm.
You made my case more eloquently. The problem starts and ends with the individual.
Maybe?
But it shouldn't be like that, in my opinion. The individual shouldn't have to have moral courage and fortitude to withstand stoning, more or less, in a culture of bullying/silencing of dissenting viewpoints, to publish research that Dr. Zervos said was flawless from a design/methodological/free of financial conflicts of interest point of view.
Shouldn't it be that if you publish that kind of study, the response is more like "wow, who'd have thunk it? thanks, dude, for bringing this surprising information to light, we will ponder on it."
That's the response I'd like to see.
So I think there is institutional blame, for making it a hostile environment for doctors/scientists who simply report what they see/find.
God knows, Dr. Zervos did not expect the results that he got. That's very clear if you watch the whole film.
The institution is the faceless protagonist I alluded to. Not born out of the ether.
Hold on.
I left out the most important part.
A doctor/researcher/scientist/whistleblower should not have to - quite literally - fear that they will be killed for speaking out and sharing observations.
That is quite Effed up, and definitely speaks to the blame resting with the institution moreso than the individual, in my opinion.
Is Dr. Zervos guilty of some moral cowardness? Sure, he acknowledges that while being recorded and you hear him say it in the film.
Can we really blame the guy for quaking in his boots, though, when others who speak up "die suddenly" ??
I will summarize the article so you don't have to waste your time .......
"There are a lot of things going wrong. All the key players have been making mistakes and have to do things differently. And it is Trump's fault"
Diana - thank you for your comment. You are absolutely correct - a problem for many years - but sadly, reform made more difficult because of the Trump administration. Engaging with the scientific community is very difficult, when much of what you do undermines science. HCB
I don't think Diana meant what you thought she meant
There are none so blind as them who will not see ....
All excellent points. The digs at the current administration aren't necessary, though. This has been a growing problem for the past fifty years or more. If the Trump presidency is a catalyst for correction, take that as an opportunity for much-needed reform that ought not to be kicked down the road again.