Many drug bulletins are part of another organization and do not need a separate legal structure (see also Chapter 13). This can have advantages and risks. One advantage is that the editors and bulletin team can focus on the editing of a bulletin because others are doing a lot of the organizational and administrative work. A larger organization may also provide protection against legal action. In some cases it may increase the credibility of a bulletin, for example, if it is linked with a reputable medical school, a health ministry, a drug information centre or consumer organization. The risk of being part of another organization is loss of independence and vulnerability if others have control over decisions about the existence of the bulletin. If one day the ministry decides to no longer publish the bulletin there is little you can do. This is particularly the case when the bulletin is also financially dependent on the organization under whose umbrella it operates. Another risk is the explicit or implicit censorship and loss of independence to please the ‘mother’ organization.
The relationship between the editors or bulletin team and the other organization may, in some places, be thought of as an ‘agent/principal’ relationship. A disadvantage of this structure is that, under certain circumstances, the actions of the ‘agent’ (the editors) can legally bind the ‘principal’ organization, even though the organization may not have given permission for the ‘agent’ to act. A legal adviser should always be consulted when creating a drug bulletin as part of another organization.
A bulletin that is part of an existing structure does not need to draft a constitution. However, it will need to formulate a mission statement outlining its goals and how the bulletin will try to achieve them. The bulletin will also need to draw up rules for the editorial process to assure information quality and safeguard editorial independence (see Chapters 5 and 7). There needs to be a clear agreement on the working relationship between the two organizations and a set of rules that protect the independence of the bulletin.
Case study: Australian Prescriber
At one time Australian Prescriber was published by Australia's national Department of Health and Ageing. The Department of Health was cooperative and did not interfere in the editorial work of the bulletin. The content of the bulletin was determined by health professionals rather than the Department even though the editorial board was appointed by the Minister of Health. The editorial board was advised by an advisory editorial panel, which consisted of Australia's medical and pharmacy colleges and societies. This arrangement enabled Australian Prescriber to be sent to all doctors, dentists and pharmacists. Readership surveys showed that readers considered the journal to be reliable because it was semiofficial and not promoting a particular product.
However, with this arrangement, there was always a risk of losing the funding. Many years ago this actually happened to Australian Prescriber, but due to protests - and an election - the bulletin was started up again.
One useful thing about being published by the national Department of Health was that it would be very difficult to take legal action against the Government unless something that was published was very wrong or defamatory.
The Department of Health and Ageing later established an organization to promote good prescribing in Australia: the National Prescribing Service has been set up as a private company funded by the Australian Government. As the National Prescribing Service is at 'arm's length' from government it can act independently. Australian Prescriber is now published by the National Prescribing Service under this new corporate structure.
Contributed by John Dowden, Australian Prescriber