Rebuttal: Should medical journals carry pharmaceutical advertising?

Dr Hoey believes advertisements for pharmaceutical products, which, by definition, focus on the advantages of one brand name product to the exclusion of all others, undercut the impartial educational mandate of our journal. I suggest, on the other hand, that our readers know the difference between advertisements and articles and that there is no possible room for confusion.

He suggests that advertisements for pharmaceutical products are not evidence-based. I note that the products advertised in medical journals must first be approved by Health Canada in a process that is lengthy, extraordinarily rigorous, and entirely evidence-based; and that the advertisements for those products must be approved by another set of highly professional reviewers at the Pharmaceutical Advertising Advisory Board.

But then Dr Hoey makes rather a leap of pure faith—from telling us what he thinks to telling us what we think. “Readers,” he writes, “will surely accept my position” as to why “medical associations like [the College of Family Physicians of Canada] accept pharmaceutical advertising.”

Not necessarily. We at Canadian Family Physician (CFP), for example, don’t so much “accept” advertising as do our very best to sell as much of it as we possibly can. Those advertisements that we succeed in persuading advertisers to place with us are welcomed gratefully and enthusiastically, because every page of advertising we print pays for a page of clinical practice or critical appraisal or commentary or family medicine research. There is really nothing “distasteful” or “lesser of evils” or “dismal” about it. When we reach an advertising-sales milestone, we order pizza for the whole journal group to celebrate.

Finally, Dr Hoey advises us that “abandoning the print journal would be a good place to start.” The way I see it, though, the print edition comes to you every month as a surprise package of things you don’t already know, prepared for you by our editors; the electronic media are where you go to look for things when you know what you’re looking for. There is a lot of overlap, of course, but readers should ideally have access to both.

As it happens, CFP did a reader survey this past June and asked a question about usage of the various media in which we provide our journal. A surprising 87% of readers read the print edition, and 53% read only the print edition, while 47% use a combination of print, Web, and digital editions. Abandoning print would mean abandoning most of our readers!

We at CFP certainly don’t want to abandon any readers and we continue to believe that advertisements that meet all of the strict requirements for inclusion in medical journals are quite a reasonable way to help pay for producing the journal.

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