The opposing points of view

Email announcing the resignation of most of the Editorial Advisory Board of the MJA


On 2 May 2015, at 3:53 pm, Chris Del Mar <> wrote:

Dr Brian Owler, President of the AMA;

Mr Richard Allely, Chair of AMPCo

Via eMail to, General Manager, AMPCo, Jae Redden <>


Dear Dr Owler and Mr Alleley,


We are members of the Editorial Advisory Committee of the Medical Journal of Australia.

Last Monday we sent our concerns to the AMPco Board regarding recent changes to running the journal and the appointment of Elsevier. As a Committee, we are concerned about the outsourcing of editorial functions to Elsevier.

Not just this outcome, but also the process of arriving at it, together with past events at the Journal, has every appearance of farce. The Editor-in-Chief has been removed summarily, and the Deputy Editor, approached with a view to becoming the Acting-Editor-in-Chief, has also resigned. We – all of the members of the Editorial Advisory Committee but one — can see no point in continued involvement with this tragedy, particularly as our advice is neither sought nor apparently considered.

The only satisfactory resolution to this untenable situation would be to postpone the decision to proceed with outsourcing editorial functions until a full and transparent discussion had been had with AMA members, and the Editorial Advisory Committee representing clinicians, academic researchers, and educators in Australia. It is clear to us that this is unlikely.

Therefore we regretfully tender our resignations from the Editorial Advisory committee of the Medical Journal of Australia, effective immediately.

Yours faithfully

Caroline de Costa,

Chris Del Mar

Craig Anderson

Craig Mellis

David Ellwood

David Wood

Derek Chew

Elmer Villanueva

Gary Wittert

Haydn Walters

Leon Flicker

Mark Harris

Martin Tattersall

Michael Horowitz

Noel Hayman

Paul Fitzgerald

Ric Day

Tom Kotsimbos


Submission to the AMPCo Board on behalf of the Editor in Chief and the editorial staff

The MJA and the Future

AMPCo Board – February 20th 2015

My overall view of the Elsevier proposal

I have grave concerns that outsourcing the Journal will have deleterious effects on our readers and especially on all those colleagues who willingly donate their time to reviewing articles, focusing our attention on specifically Australian issues (such as Aboriginal ill-health and the problems of delivering health care to remote areas), contributing points of view, writing book reviews, volunteering statistical analyses etc.

While these colleagues can be relied upon to donate their time and effort to a journal in which they feel a sense of ownership, I very much doubt that they would wish to be so generous in assisting a profit-seeking enterprise to improve its shareholders’ dividends.

The Journal has achieved world-wide recognition as the voice of Australian medicine and research. This status can be preserved only if control of the Journal remains solely in Australian hands. Once ownership passes to an international organisation, no matter how prestigious, the MJA would have to fit in with that company’s overall international planning. Indeed, that company could decide, at some time, that the Journal was not sufficiently profitable – and could scrap it.

It would be well-nigh impossible for the AMA to then start a new journal – something which the Elsevier contract might not, in fact, permit.

I cannot overemphasis the importance of keeping the MJA in the hands of AMPCo, and under the overall control of the AMA. Once lost to Elsevier, it could never be regained.

My detailed comments follow in the next few pages.

I urge, with all the emphasis I can muster, AMPCo and the AMA not to take this apparently financially expedient (but seriously poorly documented), irreversible, step.



The MJA has served for 100 years as the major means of formal communication between the Australian Medical Association and its membership. It has done this by reporting research and providing guidance that is grounded in science for clinical practice and the formation of health policy. This was enunciated as its purpose originally and this is what it has done.


Plans for reform

In line with its original purpose, the current editorial team, endorsed in this action by the AMPCo board, has begun to revise and reformat the MJA in the light of informed comment from its Editorial Advisory Committee and a formal inquiry into readers’ opinions and attitudes, likes and dislikes, conducted in 2014. A project planning process has been established and six teams have been formed to explore, discuss and decide on revised format, document processing and more.


What I have been doing

Because the MJA was fractured and traumatized by the events surrounding the dismissal of the previous Editor, I have invested energy in seeking to restore respect and good humour among the group. This has taken me 18 months. I have deliberately brought all members of the editorial team into the review project in part to use their considerable intelligence, qualification, dedication and experience, and in part as an expression of my desire to rebuild a team. There is no distinction made in this process among staff: ideas and critique are judged on their value, not who produced them. For example, many staff members contributed to the new cover design, the format of the revised table of contents and the decision and detail about moving research papers from print onto on-line save for a one-page summary for each paper remaining in print. In other words, the production and editorial staff have worked in an interdependent mode in pursuit of optimal revision.

This may seem odd, but there is nothing inconsistent here with the way that I have worked in previous settings as a cursory glance at my academic or business CVs would show. I favour using all talent available to me and I dislike distinctions and layering within the workplace, especially when working in relatively small teams – which the MJA team is.


Responding to the readers

If we are to preserve the MJA as a journal responsive both to the expectations of the AMA, to the Australian medical community and health policy makers it will be important to maintain our capacity to change and to move relatively quickly.

In the 18 months that I have worked with the MJA I have seen how much effort is required to maintain an active communication network with readers, authors, reviewers and policy makers.

To produce a journal that responds in a timely and reflective approach – to the G20 and climate change and the Martin Place siege to name two – to current events requires coordination and integration of editorial and production actions at a high level.


No other major Association journal is outsourced

I do not believe that it is easy to separate the medical judgement, editorial processes and production of an association-based journal for the reasons just given. The Canadian, American and British Medical Associations believe similarly and have retained integrated in-house editorial and production functions. So has the Massachusetts Medical Society that produces the New England Journal of Medicine.

Journals that have outsourced their production are very different in style to Association-based journals. Specialty journals tend to have small voluntary editorial teams. They manage largely research-related content that is easily reviewed and then sent for publication. Many are now wholly on-line and meet the comparatively narrow needs of specialties, not general medical audiences.

It is easy to see how common templates can be constructed to serve the needs of many of these journals because they are variations on a theme. Those served in this way by Elsevier report high levels of satisfaction, as does the editorial staff at The Lancet, a prestigious journal by any reckoning. However, with its worldwide stable of journals, Elsevier might wish to see the journal focusing on issues which complement its other journals. These might not be what the AMA membership wants.

The Lancet, unlike the MJA, is a premier research journal but with excellent entrepreneurial flair and public profile as well. It is unique. It is owned by Elsevier. It existed long before Elsevier, of course, and was excellent then. The resources it commands, both financial and intellectual, enable it to achieve excellence. However, the MJA is an Australian journal. It has no aspiration to rival The Lancet or to attempt to influence world medical opinion as The Lancet does.  I gather that Elsevier, as one might expect, participate in the selection of the editor-in-chief, and the symbiosis between Elsevier and The Lancet is generally strong and mutually beneficial. It is possible that if the production of the MJA were outsourced to Elsevier a similar relationship could develop with time. However, should termination of the agreement be considered, the proposal as it currently stands does not contain an exit clause. There are no details for how and under what conditions termination could occur.

In brief, prominent international medical association journals that serve the needs of the entire medical profession and not specialties, that provide informed commentary and critique as well as research, are produced in an integrated way in-house. The advantages of interaction of the production team with the editorial side of the team, as we have seen in our redesign process, are substantial.


How much?

Now to my comments about the cost of outsourcing the MJA. The dismissal of the production team, most of whom hold university degrees and many of whom have years of experience (a few have been with the MJA for 20 years), would be a big wrench. The transaction costs of moving to a new and unfamiliar production team, located off site and often overseas would be substantial. It is good to hear it said that Scholar1, our document management system would be able to ‘shake hands’ with the Elsevier system – an image of US and Russian Soyuz spacecraft docking in orbit comes to mind. But my belief is that it would be a managerial nightmare. Maybe I’m wrong.

If AMPCo wishes to consider the Elsevier bid further, I argue that an independent due-diligence audit be conducted of what MJA does at present including unpaid time contributed by the current staff, and of all sources of income and expenditure and these figures be compared with a detailed exposition from Elsevier of exactly what they are offering to do, how long for and at what cost.

So what does the AMA think about outsourcing?

As part of the economy of scale that underpins the Elsevier bid, it is likely that the format of the MJA would change to fit the templates that Elsevier applies to its other journals. Whether readers would appreciate a move toward such uniformity I do not know. Many may not care or notice, but some might and wonder whether ‘their’ journal had been sold off to an international agency as yet another manifestation of economic fundamentalism.

These are not idle thoughts: professional associations such as the AMA (and to my certain knowledge the RACP) face major challenges in retaining the loyalty and interest of the foot-soldiers at the same time as moving more in the direction of corporatization. What do AMA members think about outsourcing? It would be wise (for the sake of the AMA as well as the MJA) to find out. In fact, if the decision of the AMPCo board favours outsourcing I consider it imperative that I meet with the AMA Council or Board to apprise them of this move and its implications.

If the production of the MJA were outsourced, then there would be no point, and no capacity, in pursuing the program of reform that we are half way through. The distraction of negotiating redundancies and the massive amount of transactional activity (vastly underestimated in the Elsevier bid in my opinion) required to switch systems would soak up everyone’s time and energy. I don’t want anyone telling me that I don’t know anything about such changes, as I have overseen the transition from one medical curriculum to another when dean at the University of Sydney – a massive six-year task. I have serious relevant experience.

Economy in the time of DoctorPortal

I fully understand the desire of the AMPCo board to save money, especially with declining revenue from AMA membership, advertising and data bases that have degraded and need urgent repair. As the new digital platform for AMPCo products and services, DoctorPortal is in its early stage of development and will require regular review of its business plan, as well as engaging users for feedback on its relevance and usefulness. The enthusiasm for DoctorPortal will require resources.

What can we do better in-house?

I am aware that the operation of the MJA is not optimally efficient. I can see ways in which we can effect savings. Once the review process is complete I have in mind to work with the whole team to determine where we can make savings and then, over the next two years, make them. This will be done firmly, humanely and visibly.

In discussing this with three senior colleagues at the MJA, proposals for alternative revenue streams were offered. The strongest of these was a suggestion to revive the MJA Open brand. It offers publication of papers for a fee, solely on-line. The business plan would focus on accepting a greater portion of research, case studies and clinical guidelines (of high quality but not suitable for the MJA).

Further, given that most research grants in Australia and elsewhere now include money to pay for publishing, we might choose to charge for research papers published in the MJA. The BMJ charges £3,000.00 per paper, and CMAJ $2,750CMD a paper.

The responsiveness of the MJA to member needs could be improved by better communication with the AMA. This needs rehabilitation: we need to get into discussion with the AMA State Branches as well as Federal AMA.

My course of action from here would be to suggest an independent audit of MJA activities and what Elsevier is proposing. It would be prudent to determine whether there are in fact efficiency savings available to AMPCo without outsourcing and what the key differences between the current operation and Elsevier’s operations are. I would also like to discuss the proposed changes with the AMA Board, being the representative body of the AMA membership, to open the communication lines between Federal AMA, State AMA and the MJA.

In summary, I freely accept that the board is empowered to make a choice. If the Journal production is outsourced then much of its distinctive flavour may go and there will be a complex and expensive period of transition.

If the decision is taken to retain production in-house then we will pursue our program of reform and then go in search of efficiency savings. This is NOT unfamiliar territory to me – I have managed effective budgetary savings in several other organisations in which I have worked while being true to humane values and honouring the purpose of the entity.


Stephen Leeder



Submission to the AMPCo Board from the Editor in Chief and the Editorial staff


 Proposal to Publish and Host


The Medical Journal of Australia
Professor Stephen Leeder AO MD FRACP PhD – Editor in Chief
In consultation with the Editorial Department
The Medical Journal of Australia


The following proposal outlines the continued production of the Medical Journal of Australia by the current team employed by AMPCo.


Staff at the Medical Journal of Australia


The Editor-in-Chief serves the Medical Journal of Australia as the overseer of the day-to-day operations and the director of content and strategic planning of the Journal. Professor Stephen Leeder AO MD FRACP PhD brings over 30 years of business experience to this position. He has worked in roles that include the Chair of the Western Sydney Local Health Network Governing Council (present), immediate past Director of the Menzies Centre for Health Policy, Dean of the Medical Faculty at the University of Sydney between 1996 and 2002, two double terms as national president of the Public Health Association, and one triennium as chair of the Health Advisory Committee of the NHMRC. This is to say nothing of his knowledge of economics, as evidenced in his research and medical career, nor of his extensive professional network that includes senior politicians, health officials and scientists, both domestically and internationally. A full business and academic CV is provided as an attachment to this document.


The MJA Team

The Medical Journal of Australia is lauded as the best Australian medical journal by the industry. It currently employs a team with a vast array of experience. Senior staff members at the Journal, comprising the Senior Deputy Medical Editor, Production Manager and the two Senior Assistant Editors, boast over 85 years of experience in Australian medical publishing between them. They have a proven track record of publishing a high-quality product and have an extended network in the Australian clinical, research and publishing community.



The Product Development Executive and senior staff at the Journal, in consultation with the Editorial Advisory Committee, have formulated the following items as current or potential products we can offer to AMPCo.


AMA Member Subscriptions

For many years, the MJA has relied on AMA member subscriptions as its main source of revenue. In 2015 the MJA expects AMA member subscriptions to earn $2,425,996, with a rapid decline in 2016 to $1,820,000. This, as per advice from the Finance Manager, is due to a decision by the AMA to scale down the income provided to AMPCo from its member subscriptions.


Non-AMA Member Subscriptions

In 2015 the MJA expects non-AMA member subscriptions to earn $440,000. We expect the MJA Audience Engagement Project to counteract the attrition previously suffered in this customer base and therefore increase the revenue of non-AMA member subscriptions in 2016. We predict an increase to $455,000 in 2016. Concerted audience marketing endeavours will be undertaken by relevant employees in AMPCo to ensure this goal is met.



Faced with the rise in requirements by government and peak bodies to provide government-funded research as open access to audiences, many journals are turning to new sources of funding. One of the more popular methods is to charge a service fee for each research article published. As this work is expensed in the current course of business, additional costs would only be incurred in the management of finances. Therefore, the MJA proposes to charge a fee for service on each research article published.

The BMJ sets its price at £3,000 ($5,784 AUD) and CMAJ at $2,750 CAD ($2,822 AUD). We estimate our price to be equivalent to CMAJ (being a similar exchange rate and population size) and have modelled our estimates at $3,000 per research article. Last year the Journal published 95 research articles. We believe this could be enacted as soon as the final quarter of 2015 and earn $71,250 in 2015 and $285,000 in 2016. Further research into the market on price would be required. The Editor-in-Chief would retain the right to waive charges on research without or with limited funding.


Other Journals

The Medical Journal of Australia currently produces the Critical Care and Resuscitation (CCR) journal for the College of Intensive Care Medicine. This currently brings in about $100,000 a year in income and employs a part-time employee who works 3 days a week on CCR. The MJA has room to expand the stable of journals it produces. The expansion of this service would require strategic planning.


Monographs and Supplements

The MJA publishes sponsored monographs and supplements, derived from new and published content. The MJA proposes that the supplement price be amended to capture the cost of producing the supplement, as well as pursuing monographs and education supplements. The MJA requests that each contract include limits on manuscripts within the supplement and that better communication and transparency is ensured when negotiating the contracts.


MJA Open

In 2012, the concept of MJA Open was launched without business or strategic planning. MJA Open was to exist as an online only, open access journal that would publish additional research articles as well as supplements. The MJA currently accepts 20% of all research articles received, rejecting the rest. This is due to the size constraints of the Journal, interest for the general readership and academic rigour of said articles. Of those rejected, a further 20% of research articles stand the test of academic rigour and are ‘good’ papers that could be accepted.

We therefore propose to re-open MJA Open using a model outlined as follows:

  • Create an ISSN and ensure we have met PubMed’s indexing requirements
  • Expand the acceptance rate of research articles to include quality articles not suited for publication in the MJA, such as confirmatory studies, research with small sample sizes and qualitative studies
  • Expand the acceptance of clinical guidelines and case studies
  • Publish all articles open access
  • Charge an equivalent price for all research articles as outlined above
  • Charge a price set by market data for all other articles published in MJA Open

We expect to be able to implement this by the final quarter in 2015, earning roughly $35,625. In 2016 we expect to be able expand service and earn roughly $285,000.



With the launch of MJA Professional Development and the AMA’s own work on its CPD tracker and provision of education services on DoctorPortal, the MJA has potential to become a provider of education content. It is known that there is a market for the provision of third-party education content for other providers, and the AMA is itself currently seeking content such as this. The MJA is in a unique position in the education market. While other businesses must go seeking content, the MJA has content that is able to be repurposed as needed. Pricing on this has yet to be explored in detail and is therefore not included in the net results, but we would predict income of at least $10,000 in its first year.


Other Services to AMPCo

The MJA provides an array of services to AMPCo beyond the production of the MJA that are not currently provided for within the MJA budget. These services include the layout and production of MJA Careers, the layout of MJA Classified and a substantial amount of proofreading of information AMPCo public publishes publically. This incurs the company a service charge of $36,898. If the MJA outsources production, it can be estimated that AMPCo would have to pay roughly $34, 559 in additional services.


Provision of Services in relation to the Production of the MJA

Assistant Editors

The Assistant Editors at the Medical Journal of Australia offer all the services detailed in the proposal set forth by Elsevier. Further to these services, the Assistant Editors of the Medical Journal of Australia offer a higher level of scientific editing, including but not limited to the following list:

  1. Consultation with Deputy Editors and authors on house style and article requirements during review stage of manuscript
  2. Pre-processing manuscripts including checking and correcting author details, checking history of the article to ensure efficient editing, ensuring all manuscript components are present and ensuring references are correct and URLs in references are active
  3. Substantive editing, including restructuring, shortening and presenting information logically
  4. Checking numbers within the manuscript and ensuring calculations are correct
  5. Table, box and figure editing
  6. Fact checking
  7. Writing blurbs for RSS feed, writing intro lines for opinion pieces, choosing pull quotes on articles and preparing PDF coversheets for appendices
  8. Checking and editing MJA media releases
  9. Close consultation with the Deputy Editors in the editing cycle of the manuscript, including providing the Deputy Editor with questions regarding scientific and medical content during a “medical read”
  10. Editing and all associated tasks for the Critical Care and Resuscitation Journal
  11. Checking pictures selected by production for the front cover, table of contents and individual articles
  12. Providing consultation on the improvement of the Medical Journal of Australia in format, substance and workflow efficiencies
  13. Providing consultation in issue planning meetings and brainstorming meetings

A detailed table listing the services offered by the MJA Assistant Editors and Publishing Assistant is included in Appendices 1 and 2. Items with a Y in the first column indicate services offered in the Elsevier proposal.


Scientific Proofreading

The Medical Journal of Australia employs scientific proofreaders who ensure that the Journal maintains the quality expected by editors, authors, reviewers and readers. A detailed table listing the services offered by the proofreaders is provided in Appendix 3 of this document. No details of proofreading services are provided for within the Elsevier proposal. As a measure of success, the Journal publishes 1–2 corrections per quarter, a near negligible number.



The Production Team at the Medical Journal of Australia offer all the services detailed in the proposal set forth by Elsevier. Further, the Production Team at the Medical Journal of Australia also offers an expanded range of production services, including but not limited to the following list:

  1. Source images for every MJA article and also images for MJA InSight (print and resized for web)
  2. Produce web tiles and animated gifs for the web home pages (MJA and InSight and email-outs)
  3. Supply images for social media
  4. In consultation with editors, source/create cover image and design cover for each issue
  5. Discuss MJA requirements with the IT/web department (these can vary from issue to issue)
  6. Produce an imposition with team located onsite, allowing for flexibility according to various requirements (eg, last minute editorials, topical issues, MJA Comments).
  7. Supply embargoed copies of MJA articles for media releases and InSight
  8. Negotiate with Sales about placing last minute advertising (increasing revenue)
  9. Decide on placement of advertising in the MJA (in conjunction with editors/conflict of interest), as there are no specific advert pages, depends on articles)
  10. Generate all classified advertising and layout the pages to suit (each issue is different – often includes late-running adverts)
  11. Generate last-minute in-house filler advertising to suit each issue
  12. Negotiate with outside charities to place their advertising as filler adverts (when space allows)
  13. Discuss with the editors what topics are currently in the news, that may be relevant to articles in the MJA, and follow up leads
  14. Discuss with the editors page layouts for various sections (ie, Letters and News, which often vary)
  15. Produce and change the final proof after deadline as a result of onsite team’s flexibility
  16. Re-create graphs and figures in MJA style for consistency and clarity throughout the publication, both in print and resized for web
  17. Change the content, add or remove articles in the Journal, the day before we go to print allowing flexibility
  18. Layout and produce print and web PDFs of Critical Care and Resuscitation
  19. Provide consultation in issue planning meetings and brainstorming meetings



The Medical Journal of Australia employs a talented Administration team that fulfils a dual role of customer service and administration duties. The Journal often calls upon these staff members to go above and beyond their position descriptions, and they excel at operating in an ever changing environment. Lists of duties include but are not limited to the following:

  1. High-quality customer service
  2. Processing of incoming correspondence via email
  3. Processing of new and revised manuscripts and reviewers comments sent via email and ScholarOne
  4. Uploading of new and revised manuscripts and reviewers’ comments to ScholarOne
  5. Sending reminders to authors about outstanding forms
  6. Process accepted, revised and rejected articles on behalf of Deputy Editors
  7. Process rapid rejects (additional workflow items beyond previous item)
  8. Reply to email correspondence from authors and reviewers, answering enquiries and updating them on the progress of the submission
  9. Handle all incoming phone calls relating to the Editor-in-Chief, Deputy Medical Editors, and administrative and general enquiries for the MJA
  10. Ensure that the general filing system is maintained, accurate and up-to-date
  11. Arrange travel requirements for editors
  12. Manage the Editor-in-Chief’s MJA diary
  13. Persuade busy authors and reviewers to submit commissioned manuscripts and reviewers by the required dates
  14. Monitor flow of all submissions from day of receipt to publication
  15. Ensure that the database on ScholarOne is updated and accurate
  16. Find, register and invite new reviewers to review articles on behalf of all medical editors
  17. Monitor the timely return of manuscripts from reviewers and liaise with authors seeking status reports on their papers
  18. Organise administrative workload according to Journal deadlines and editors’ movements
  19. Arrange teleconferences and meetings, including any documentation required, for the Editorial Advisory Committee
  20. Prepare commission letters and commission on behalf of editors
  21. Process MJA media releases and alerts, ensuring that review and proofing process is completed and media releases are delivered to AMA Federal on due date
  22. Organise teleconferences and meetings on behalf of the medical editors
  23. Organise competitions from receipt of submission, including voting, notifying authors and organising flights, if required, and the presentation of awards
  24. Keeping the issue plans updated and chasing outstanding submissions



The MJA employs a tried and tested workflow of publishing developed over 100 years by its own staff members. The total maximum time taken from the start of editing (post accept) to final proofs being supplied to the printer is 24 working days. This includes copy and substantive editing, author review, layout and typesetting, proofreading, production of final PDFs, approvals and advertising.

Editing and production are carefully dovetailed together to maximise efficiency and flexibility, and we publish an issue of the Journal every 10 to 15 working days, as well as publishing selected finalised articles online every other Monday. This time frame is better than that offered within the Elsevier proposal.



The MJA expects to expense a total of $4,131,816 in 2015 and $3,697,874 in 2016. Full details are provided in the line item budget listed below.


Net Result

The MJA expects there to be a loss of $1,309,233 over the next 2 years. We compare this to the loss under the Elsevier proposal of $1,229,381 over the next 2 years. We believe the price difference between our budget and Elsevier ($79,852) accounts for the quality of service above what Elsevier is offering (as detailed in the MJA Services above). Note that the new revenue lines have growth potential, whereas the outsourcing costs increase each year, thus having the opposite effect on the budget.

Further to the above, we note concerns with the Elsevier budget, as follows:

  • 2015 – Long Service Leave – in 2015 there is a negative cost attributed to long service leave. The Finance Manager has informed us that the figure may be revised to zero.
  • 2015 – Legal Fees – historical data from the Profit and Loss of 2012 shows legal fees of $282,939. This was the year in which the previous Editor was dismissed. While the circumstances of the proposed redundancies are different, we believe estimating the legal costs as low as $17,000 to be a gross underestimate and that these should instead be set at $100,000 as protection to the Journal.
  • 2016 – Editorial Manager – in 2016, the Elsevier budget assumes the transfer of the editorial manager software from ScholarOne to Elsevier’s product. Historical data suggest that a project like this takes roughly one year to complete, as there is still the complicated review and revision system to be set up, transfer of the database, and author, reviewer and staff training. Given the outsourcing of the talent staff pool that helped transfer to ScholarOne from the last system, the requirements of IT resources that are currently deployed to other projects, and the total disruption to business in the transfer of production to Elsevier, it would be advisable to continue with ScholarOne for 2016. We estimate these costs to be approximately $42,225.


Assuming the above items are accepted as corrections, then the expense of the Elsevier budget increases by $162,350. This puts their loss for 2015 and 2016 at $1,391,731 and places their budget $82,498 behind what the MJA can achieve.

Note also that there will be IT requirements in transferring to Elsevier, in particular resource time to translate Elsevier’s metadata and article files to work with our websites. As this is costed in a separate budget, we cannot detail the total expense.



In this document, the MJA has provided for sustainable growth in revenue without cuts to staffing and with minimal cuts to overall expenditure. It has done all of this while maintaining a competitive edge with the Elsevier proposal. Our proposal allows the business to carry on without disruption and without damage to its reputation or morale.

We commend this proposal to the AMPCo Board.

Letter from Prof Leeder , Editor in Chief to Mr Richard Allely Chairman of AMPCo

Dear Richard

Thank you for permitting us to raise questions that might be put to Elsevier concerning their bid to host and produce the MJA.

While preparing these questions for you, we discovered a most disturbing account, summarised on Wikipedia and hence duly referenced, of Elsevier’s activities in recent years in the field of academic publishing in Australia and beyond. I attach the body of the Wikipedia entry for you below. You may wish to make it available to all members of your board.

This is a deeply worrying time – I am concerned greatly for the future of the MJA.

I draw your attention to two major points:

  1. The publication by Elsevier of four journals in Australia that purported to be peer-reviewed and independent but which were sponsored by the pharmaceutical industry and which were subsequently closed down following public sanction. The section from Wikipedia reads as follows:


“In May 2009, Elsevier Health Sciences CEO Hansen released a statement regarding Australia-based sponsored journals, conceding that these were “sponsored article compilation publications, on behalf of pharmaceutical clients, that were made to look like journals and lacked the proper disclosures.”

“The statement acknowledged that this “was an unacceptable practice.”[50] The Scientist reported that, according to an Elsevier spokesperson, six sponsored publications “were put out by their Australia office and bore the Excerpta Medica imprint from 2000 to 2005”, namely the Australasian Journal of Bone and Joint Medicine (Australas. J. Bone Joint Med.), the Australasian Journal of General Practice (Australas. J. Gen. Pract.), the Australasian Journal of Neurology (Australas). J. Neurol.), the Australasian Journal of Cardiology (Australas). J. Cardiol.), the Australasian Journal of Clinical Pharmacy (Australas). J. Clin. Pharm.), and the Australasian Journal of Cardiovascular Medicine (Australas. J. Cardiovasc. Med.).[51]”

Needless to say the opprobrium that Elsevier incurred as a result of this deception was substantial. Were AMA members to be aware of this history they may have serious reservations about engaging Elsevier to produce the MJA.

  1. Heavy-handed relations with providers of content, universities, libraries and readers. Take a look at what went on here, and which is going on in France – nationally – at this moment:


“On January 21, 2012, the mathematician Timothy Gowers publicly announced he would boycott Elsevier, noting that others in the field have been doing so privately. The three reasons for the boycott are high subscription prices for individual journals, bundling subscriptions to journals of different value and importance, and Elsevier’s support for SOPA, PIPA, and the Research Works Act.[60][61][62]

“Following this, a petition advocating non-cooperation with Elsevier (that is, not submitting papers to Elsevier journals, not to engage in refereeing articles in Elsevier journals, and not participating in journal editorial boards), appeared on the site “The Cost of Knowledge”. By February 2012 this petition was signed by over 5,000 academics.[60][61] As of January 2013 it was signed by over 13,000 researchers.[63]

“Elsevier disputed the claims, arguing that their prices are below the industry average, and stating that bundling is only one of several different options available to buy access to Elsevier journals.[60] The company also claimed that its profit margins are “simply a consequence of the firm’s efficient operation”.[62]

“On February 27, 2012, Elsevier issued a statement on its website that declared that it has withdrawn support from the Research Works Act.[64] Although the Cost of Knowledge movement was not mentioned, the statement indicated the hope that the move would “help create a less heated and more productive climate” for ongoing discussions with research funders. Hours after Elsevier’s statement, the sponsors of the bill, Representatives Darrell Issa and Carolyn Maloney, issued a joint statement saying that they would not push the bill in Congress.[65]”

The people who currently contribute to and read the MJA may well not wish to be associated voluntarily with Elsevier. Note also the parent company’s sponsorship of military arms fairs in the UK that led to major outbursts from The Lancet and from Richard Smith, former editor of the BMJ. 3

I have arranged the questions we have for Elsevier under the following two headings:

– Relevance of Elsevier to the journal of the AMA

– Elsevier’s current and future intentions for the MJA


  1. Relevance of Elsevier to the journal of the AMA

1.1 What experience does Elsevier have in producing an association-owned journal in which research is only one fifth of our product? The list of their journals is here:

If their service is so good why do they not have the British Medical Journal, the Canadian Medical Association Journal, the American Association Journal and the New England Medical Journal, in their stable?

1.2 To what extent can Elsevier match our capacity for adapting rapidly to evolving events in Australia? Last minute changes require the copy editors and administrators to be available to progress the articles after hours (including weekends) for no additional pay/overtime.

1.3 Will Elsevier do this for no extra cost? OR will they NOT do this as the contract will stipulate the deadlines that will need to be adhered to? OR will Elsevier provide these rapid “last minute” changes at additional cost (to cover their Sydney “managers” and their offshore copy editor additional overtime hours)? The lengths to which the production team go reflect their pride in the final product. Will the Elsevier production team demonstrate the same dedication?

1.4 How can their production staff located off-shore make the kind of intellectual contribution to the evolution of the journal that has enabled us to reformat it into its present, progressively acceptable format and content?

1.5 Elsevier emphasise a global reach – but this is not really relevant to MJA because the MJA does not aim for a global reach. Did the Elsevier proposal consider what is important for the MJA i.e. relevance to the Australian Medical Association general reader? Why does Elsevier place such extraordinary emphasis on global promotion of an Australian journal publishing largely for the Australian medical community? 4


1.6 Given that Elsevier only produces two Australian medical journals (Heart Lung and Circulation and Science Medicine in Sport), both publications comprised almost entirely of research papers for special societies, how will their experience with these journals inform their approach to the other key sections of the MJA – editorials, reflections, perspectives etc.?

1.7 Throughout their bid they imply a model of governance for the journal that includes the AMA with AMPCo at each step. Is this a mistake? Editorial independence including independence from the AMA is essential to the credibility and reputation of the MJA.

1.8 Elsevier provides examples of being able to increase the Impact Factor. On page 7 of their proposal they state that they can “assist the editors with their goal to attract the highest-quality internationally relevant original research and reviews for publication”. Where did Elsevier obtain this goal? They did not speak with MJA staff. And this is not our goal. The MJA‘s primary aim is not to attract international research, but to publish high-quality Australian research and material, in line with its 100 year-old charter, to inform health policy decisions in Australia.


  1. Elsevier’s current and future intentions for the MJA


2.1 Why did Elsevier prepare a brief for hosting the MJA if that was not part of their intention? Jae Redden’s comment at the recent board meeting that it was a ‘mistake’ raises questions about her involvement with the bid and suggests a clear conflict of interest. It is inappropriate for her to defend the Elsevier bid. The question stands.

2.2 How will Elsevier attract and retain peer reviewers who are currently part of an elaborate network of several hundred medical practitioners who by virtue of their commitment to the MJA give of their time and energy voluntarily to this task? They are unlikely to be so motivated when they learn they are reviewing for a commercial company operating aggressively for the profit of its shareholders, and may also be negatively influenced by the “Cost of Knowledge” petition, signed by nearly 15,000 researchers who have pledged to boycott Elsevier. 5


2.3 What leads to a journal being called an ‘Elsevier Journal’ and its editor being identified as one of a band of Elsevier editors? The editor may not wish to be so labelled.

2.4. Who sets subscription fees once the MJA becomes an Elsevier journal?

2.5 How can Elsevier claim to be able to match the quality of our team when they have not inspected what we do or spoken to us and provided no detailed financial information? Our view as expressed in our document is that the quality of what they offer through off-shore services in Mumbai, Madras and Manila, does not come up to what we deliver face-to-face in Sydney.

2.6 The Elsevier proposal did not list the specific tasks of the production personnel (as we did in our proposal) so it makes comparison difficult. In detail, what are the services they propose to provide? The Elsevier proposal is a generic document into which they inserted “MJA” and a few MJA-specific paragraphs.

2.7 Does the workflow proposed by Elsevier allow for editors seeing copy after offshore level-2 copyediting and before approval by authors for publication?

2.8 How does the Elsevier process contend with authors supplying images of insufficient quality for publication?

2.9 How will Elsevier ensure the confidentiality of names, addresses and other information of authors and reviewers so as to avoid the illegality over which they have previously faced court by on-selling names and addresses to a third party without permission?

2.10 What provisions will be made in the contract to allow for assessment of performance and, if necessary, severance? In other words, what will constitute grounds for ‘divorce’ and how will this be handled so as not to provoke an expensive legal battle? Were divorce to occur, the MJA would be left with many of its senior staff gone.



Background information on Elsevier (ethics and practices) – from Wikipedia (references not downloaded)


In recent years the subscription rates charged by the company for its journals have been criticised; some very large journals (those with more than 5000 articles) charge subscription prices as high as $14,000, far above average,[10] and many British universities wind up paying more than a million pounds to Elsevier annually.[11] the company has been criticised not only by advocates of a switch to the open-access publication model, but also by universities whose library budgets make it difficult for them to afford current journal prices. For example, a resolution by Stanford University’s senate singled out Elsevier’s journals as among those which might be “disproportionately expensive compared to their educational and research value” and which librarians should consider dropping, and encouraged its faculty “not to contribute articles or editorial or review efforts to publishers and journals that engage in exploitive or exorbitant pricing”.[12]

Similar guidelines and criticism of Elsevier’s pricing policies have been passed by the University of California, Harvard University and Duke University.[13] The elevated pricing of field journals in economics, most of which are published by Elsevier, was one of the motivations that moved the American Economic Association to launch the American Economic Journal in 2009.[14]

Resignation of editorial boards

In November 1999 the entire editorial board (50 persons) of the Journal of Logic Programming (founded in 1984 by Alan Robinson) collectively resigned after 16 months of unsuccessful negotiations with Elsevier Press about the price of library subscriptions.[15] The personnel created a new journal, Theory and Practice of Logic Programming, with Cambridge University Press at a much lower price,[15] while Elsevier continued publication with a new editorial board and a slightly different name (the Journal of Logic and Algebraic Programming).

In 2002, dissatisfaction at Elsevier’s pricing policies caused the European Economic Association to terminate an agreement with Elsevier designating Elsevier’s European Economic Review as the official journal of the association. The EEA launched a new journal, the Journal of the European Economic Association.[16] 7


At the end of 2003, the entire editorial board of the Journal of Algorithms resigned to start ACM Transactions on Algorithms with a different, lower priced publisher,[17] at the suggestion of Journal of Algorithms founder Donald Knuth.[18] The Journal of Algorithms continued under Elsevier with a new editorial board until October 2009, when it was discontinued.[19] The ACM Transactions on Algorithms is still in circulation.

The same happened in 2005 to the International Journal of Solids and Structures, whose editors resigned to start the Journal of Mechanics of Materials and Structures. However, a new editorial board was quickly established and the journal continues in apparently unaltered form with editors D.A. Hills (Oxford University) and Stelios Kyriakides (University of Texas at Austin).[20][21]

On August 10, 2006, the entire editorial board of the distinguished mathematical journal Topology handed in their resignation, again because of stalled negotiations with Elsevier to lower the subscription price.[22] This board has now launched the new Journal of Topology at a far lower price, under the auspices of the London Mathematical Society.[23] After this mass resignation, Topology remained in circulation under a new editorial board until 2009, when the last issue was published. The journal was discontinued in 2012.[24][25]

The French École Normale Supérieure has stopped having Elsevier publish the journal Annales Scientifiques de l’École Normale Supérieure[26] (as of 2008).[27]

Parent organisation links to weapons industry

An editorial in the medical journal The Lancet in September 2005 sharply criticized the journal’s owner and publisher, Reed Elsevier, for its participation in the international arms trade.[28] Specifically, Reed Exhibitions organized the Defence Systems and Equipment International Exhibition (DSEi), a large arms fair in the U.K. The authors, appealing to the Hippocratic Oath, called for the publisher to “divest itself of all business interests that threaten human, and especially civilian, health and well-being.”[29]

In the 24 March 2007 issue of the The Lancet, leading medical centres including the UK Royal College of Physicians [30] urged Reed Elsevier to sever weapons ties. Doctors spoke out against Reed’s role in the involvement of the organizing of exhibitions for the arms trade.[31] Reed Elsevier’s chief executive responded in June 2007 with a written statement agreeing to do so,[32] welcomed by authors of the petition[clarification needed],[33] announcing that it would sell the 8


part of the company which handled military trade shows. The sale was completed in May 2008.[34]

Action against academics posting their own articles online

Digimarc, a company representing Elsevier, recently told the University of Calgary to remove articles published by faculty authors on university web pages; although such self-archiving of academic articles may be legal under the fair dealing provisions in Canadian copyright law, the university complied. Harvard University and the University of California, Irvine also received takedown notices for self-archived academic articles, a first for Harvard, according to Peter Suber.[35][36]

Chaos, Solitons & Fractals

There was speculation that the editor-in-chief of Chaos, Solitons & Fractals, Mohamed El Naschie, misused his power to publish his work without appropriate peer review. The journal had published 322 papers with El Naschie as author since 1993. The last issue of December 2008 featured five of his papers.[37]

The controversy was covered extensively in blogs.[38][39] The publisher announced in January 2009 that El Naschie had retired as editor-in-chief.[40] As of November 2011 the co-Editors-in-Chief of the journal were Maurice Courbage and Paolo Grigolini.[41] In June 2011 El Naschie sued the journal Nature for libel, claiming that his reputation had been damaged by their November 2008 article about his retirement, which included statements that Nature had been unable to verify his claimed affiliations with certain international institutions.[42]

The suit came to trial in November 2011 and was dismissed in July 2012, with the judge ruling that the article was “substantially true”, contained “honest comment” and was “the product of responsible journalism”. The judgement noted that El Naschie, who represented himself in court, had failed to provide any documentary evidence that his papers had been peer-reviewed.[43] Judge Victoria Sharp also found “reasonable and serious grounds” for suspecting that El Naschie used a range of false names to defend his editorial practice in communications with Nature, and described this behaviour as “curious” and “bizarre”. [44] 9


Sponsored journals

Australasian Journal of Bone & Joint Medicine

At a 2009 court case in Australia where Merck & Co. was being sued by a user of Vioxx, the plaintiff alleged that Merck had paid Elsevier to publish the Australasian Journal of Bone and Joint Medicine, which had the appearance of being a peer-reviewed academic journal but in fact contained only articles favourable to Merck drugs.[45][46][47][48]

Merck has described the journal as a “complimentary publication”, denied claims that articles within it were ghost written by Merck, and stated that the articles were all reprinted from peer-reviewed medical journals.[49]

In May 2009, Elsevier Health Sciences CEO Hansen released a statement regarding Australia-based sponsored journals, conceding that these were “sponsored article compilation publications, on behalf of pharmaceutical clients, that were made to look like journals and lacked the proper disclosures.”

The statement acknowledged that this “was an unacceptable practice.”[50] The Scientist reported that, according to an Elsevier spokesperson, six sponsored publications “were put out by their Australia office and bore the Excerpta Medica imprint from 2000 to 2005”, namely the Australasian Journal of Bone and Joint Medicine (Australas. J. Bone Joint Med.), the Australasian Journal of General Practice (Australas. J. Gen. Pract.), the Australasian Journal of Neurology (Australas. J. Neurol.), the Australasian Journal of Cardiology (Australas. J. Cardiol.), the Australasian Journal of Clinical Pharmacy (Australas. J. Clin. Pharm.), and the Australasian Journal of Cardiovascular Medicine (Australas. J. Cardiovasc. Med.).[51]

Excerpta Medica was a “strategic medical communications agency” run by Elsevier, according to the imprint’s web page.[52]

On October 7, 2010, Excerpta Medica was acquired by Adelphi Worldwide.[53] 10


Shill review offer

According to the BBC “The firm [Elsevier] offered a $25 Amazon voucher to academics who contributed to the textbook Clinical Psychology if they would go on and Barnes & Noble (a large US books retailer) and give it five stars.” Elsevier said that “encouraging interested parties to post book reviews isn’t outside the norm in scholarly publishing, nor is it wrong to offer to nominally compensate people for their time. But in all instances the request should be unbiased, with no incentives for a positive review, and that’s where this particular e-mail went too far”, and that it was a mistake by a marketing employee.[54]

Who’s Afraid of Peer Review?

One of Elsevier’s journals was caught in the sting set-up by John Bohannon, published in Science, called Who’s Afraid of Peer Review?[55] The journal Drug Invention Today accepted an obviously bogus paper made-up by Bohannon that should have been rejected by any good peer review system.[56] Instead Drug Invention Today was among many open access journals who accepted the fake paper for publication. As of 2014, this journal had been transferred to a different publisher.[57]

“The Cost of Knowledge” boycott

In 2003 various university librarians began coordinating with each other to complain about Elsevier’s “big deal” journal bundling packages, in which the company offered a group of journal subscriptions to libraries at a certain rate but in which librarians claimed that there was no economical option to subscribe to only popular journals at rate comparable to the bundled rate.[58] Librarians continued to discuss among themselves implications of the pricing schemes and felt pressured into buying something without having other options.[59]

On January 21, 2012, the mathematician Timothy Gowers publicly announced he would boycott Elsevier, noting that others in the field have been doing so privately. The three reasons for the boycott are high subscription prices for individual journals, bundling subscriptions to journals of different value and importance, and Elsevier’s support for SOPA, PIPA, and the Research Works Act.[60][61][62] 11


Following this, a petition advocating non-cooperation with Elsevier (that is, not submitting papers to Elsevier journals, not to engage in refereeing articles in Elsevier journals, and not participating in journal editorial boards), appeared on the site “The Cost of Knowledge”. By February 2012 this petition was signed by over 5,000 academics.[60][61] As of January 2013 it was signed by over 13,000 researchers.[63]

Elsevier disputed the claims, arguing that their prices are below the industry average, and stating that bundling is only one of several different options available to buy access to Elsevier journals.[60] The company also claimed that its profit margins are “simply a consequence of the firm’s efficient operation”.[62]

On February 27, 2012, Elsevier issued a statement on its website that declared that it has withdrawn support from the Research Works Act.[64] Although the Cost of Knowledge movement was not mentioned, the statement indicated the hope that the move would “help create a less heated and more productive climate” for ongoing discussions with research funders. Hours after Elsevier’s statement, the sponsors of the bill, Representatives Darrell Issa and Carolyn Maloney, issued a joint statement saying that they would not push the bill in Congress.[65]

Selling open access articles

In 2014 Elsevier was found to sell some articles which should have been open access, but that had been put behind a paywall.[66] A different case occurred in 2015, when Elsevier was charged for downloading an open access article from a journal published by John Wiley & Sons. However, it was not clear whether Elsevier was in violation of the license under which the article was made available on their website[65].

Stephen Leeder


The Medical Journal of Australia

April 4th, 2015



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