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JAMA Firing Explained

On January 15, 1999, Dr. George D. Lundberg was fired from his post as editor of the Journal of the American Medical Association. He did not go quietly. In February, the doctor and the AMA negotiated a legal settlement of their dispute and issued a statement calling the firing a "parting of the ways." Terms of the settlement were not revealed, and neither party will now discuss the reasons for the firing, or parting, leaving us to infer that mutual non-disclosure was one of the terms of the agreement.

Scientific American has a regular feature called a "profile" in which they review the career and ideas of some well-known scientist. In the May, 1999 issue, Dr. Lundberg is the subject of this feature. The article does discuss the reasons for the firing.

The immediate and obvious focus of the dispute between the editor and the Association was an article, published during the later stages of the Clinton impeachment debate, which indicated that 59 percent of college students surveyed to not think that oral-genital contact constitutes "having sex." The Scientific American article says, "During his 17 years at the helm, Lundberg is universally acknowledged to have turned JAMA from an underappreciated house organ into one of the most widely cited journals in the world, doubling its circulation and establishing numerous foreign editions." In this context, it seems obvious that disagreement over one article would not constitute sufficient reason to fire the editor.

Scientific American explains, "At the time of Lundberg's departure from the journal, he was planning to ‘once again go big time into caring for the uninsured.'" Specifically, he was writing an editorial - never published because he was fired first - calling for the reorganization of the AMA and of American medicine. The article continues, "Lundberg's plan was to reestablish a ‘big tent' for all types of American doctors that would have as its central ethic universal access to basic medical care." There you have it. Editorial freedom is fine until you disagree with the board of the AMA about an important and politically charged policy.

Although the AMA is a wealthy and powerful organization which spent $17 million on political lobbying in 1997, their ability to control events is reaching its limits. In 1960, the AMA represented 84 percent of physicians in the United States. Now, it represents far less than half - approximately 40 percent. Firing Lundberg will not halt the decline of this organization, it will only accelerate it. Lundberg is now editor in chief of Medscape, a World Wide Web site which publishes medical information. He has not been silenced.