Gaul is divided into three parts. History, into two. In the beginning, Marilyn Monroe walked the earth. Movies, medical journals, just about everything was black and white. Advertising was for cars, cigarettes and soap flakes.

Next came the dinosaurs, Raquel Welch and technicolor. Magazines like this one sprang up featuring advertising for drugs and instruments. Soon, even the medical journals began to interrupt their grayness with an occasional color ad.
For today's purposes, the key event in this slightly compressed history was the introduction of marketing and advertising into medicine. Along with it came the need to disclose commercial relationships. This has been an increasingly contentious issue. One ophthalmic subspeciality meeting almost came to blows in the lecture hall over it a few years back.

Not long before that, there was also a dust-up in the letters to the editor pages of a leading peer-reviewed ophthalmic journal. Just as authors in such journals and speakers at meetings are expected to disclose their support from or connection to commercial interests, a physician wrote, so should the "throwaway" publications do the same. (Just in passing, can we not try "disposable" as a friendlier designation?)

I agree with that position entirely. You have a right to know the difference between the ads and the editorial. If time or space has been bought and the message shaped by the buyer, the audience ought to know. That used to be easier.

You can pretty safely assume that a booth speaker in an exhibit hall has been paid and retained to deliver a message. Put that same retained speaker in a lecture hall and it's a little harder to sort out, without the disclosure. The manifestation of that phenomenon in advertising-supported media is sponsored editorial, once described by the confusing and now discredited term "advertorial." It's not an ad, but the sponsor does retain some (varying) degree of influence on the message.

I want to be very clear that there is no explicit or implicit judgment in any of this about the relative quality of any of these messages, whether a booth presentation at a meeting, straight advertisement in a publication, sponsored editorial or "pure" editorial. Even we journalists have to put pure in quotes; everyone knows that such an animal doesn't exist and never did.

As often as not, I find sponsored articles, roundtables and booth sessions to be as valuable as content from any other source. Most physicians who participate in them seem to bend over backward to provide balanced and accurate information. If they didn't, we would have no use for them. But the point here is that we need to clearly disclose the sources and relationships just as you and your colleagues do in journals and at live events. We can always do a better job of that.

For now, our policy, one that's been in place since our inaugural issue: When content is sponsored, you'll find that sponsorship disclosed at the bottom of the page with identification of the sponsor. We also attempt to design sponsored content so that it's clearly distinguishable from the editorial. If there's any question, look at the top of the page. If it carries the Review label, no one's paid us for it.

Second, we do not exchange editorial coverage for advertising. It makes perfect sense for a supplier to want to have an ad appear in an issue in which the editorial content covers its product or its category of product. In fact, we promote our editorial beforehand for just that purpose, as does every other publisher. But neither I and our editorial staff nor our clinical editors have any influence or even knowledge of such ads until well after the articles are written and edited.

When advertising related to an article does come in, we don't place it within that article, out of concern that such placement creates the appearance of a quid pro quo. Near a related article, no problem. In it, no.

—Chris Glenn, Editor in Chief