Key points are not available for this paper at this time.
Richard Smith was editor of the BMJ and chief executive of the BMJ Publishing Group for 13 years. In his last year at the journal he retreated to a 15th century palazzo in Venice to write a book. This is a much shortened chapter from the author's book provisionally entitled The Trouble With Medical Journals that the RSM Press will publish in the autumn www.rsmpress.co.uk , and this is the fourth in a series of extracts that will be published in the JRSM.
Richard Smith (Mon,) studied this question.