Publish or perish: a proposal.

Because promotion and funding of physicians in academic medicine are closely linked to the number of their publications, investigators feel impelled to publish as frequently as possible. This pressure leads to a number of unfortunate practices in medical publishing, including undertaking trivial studies because they yield rapid results, needlessly reporting the same study in installments, reporting a study more than once, and listing as authors people only marginally involved in the study. It may also be a motivation for fraud. An effective way to reduce these offenses and affirm the supremacy of substance over volume in scientific research would be to place a ceiling on the number of publications that can be considered in evaluating a candidate for promotion or funding. Each publication would then receive commensurately more attention, both from the researcher and from those judging the work.