After 25 years as an editor, I’ve learnt in my eight years as an ex-editor that it’s mostly miserable being at the author end of a very unequal power relationship. We read a lot about doctors aiming to be patient centered, but whoever heard of editors being author centred? The brutal truth, as a senior editorial colleague told me in my early days as an editor, is that “they, the authors, need us more than we need them.” There are some exceptions, but mostly editors can neglect, exploit, and even abuse authors.

Two recent experiences prompt these reflections. I’m not going to name these journals because we don’t want to fall out with the editors. A senior doctor told me that when he was a young medical academic he was advised that there were two people he should never upset—the ward sister and the editor of the journal of his specialty.

The first journal asked us to write something. There was no question of payment, and, despite Samuel Johnson saying that only a fool would write for any reason apart from money, we accepted. (Of course, if you are an academic—and I’m not (well, not a proper one) but my coauthors are—then money does ultimately flow from publishing in prestigious journals.)

It was a difficult topic in that almost nothing had been published and evidence was hard to find. We scraped around and did the best we could. We even generated some evidence of our own. We eventually submitted the paper—late, I must confess.

After a month or so we got a response that said in effect “We weren’t much impressed, but we might publish your paper if you can respond to our criticisms and the comments of our three reviewers, some of them very critical, and revise the paper. We need a detailed response to all of these comments, and we need you to submit a clean copy and a copy that shows all changes.” Some of my coauthors think we should give up at this stage, but I argue that despite their snooty tone the editors do want to publish the paper; after all, I remind my coauthors, they asked us to write it.

It turns out to be a lot of work to revise the paper, not least to track down references provided by one of the reviewers. I must concede, however, that this is a case where responding to the reviewers’ comments may have improved the paper. Eventually we are able to submit the clean and marked copies of our paper and the long letter responding to all the reviewers’ comments. This all has to be done through the clunky online system that asks lots of questions about all of us. It feels like being positive vetted.

After a couple of weeks we get another response, saying that the journal will publish the paper if we jump through more hoops, including changing the form of all the references. The response also includes comments from another editor saying that this isn’t much of an article and doesn’t have a coherent argument. The editors are, however, willing to publish the paper despite these observations. Whatever pleasure there might have been in this final acceptance is much diminished by these comments. Somehow it has been forgotten that we were asked to write the article on this difficult subject: we are supplicants not benefactors.

Between us we must have spent perhaps 40 hours working on this paper, and I must confess that some blogs that I have written in 30 minutes have given me much more satisfaction than this paper.

In the second case we weren’t commissioned to write the paper but were encouraged by the editors. They even suggested a complex and lengthy structure that demanded much more work than the usual article. It took us a long time to write the paper—partly because a senior author wanted a rewrite late in the day.

We hoped that the paper might be published before a particular event and submitted the paper several months before the event, pointing out the event in a covering letter.

Sadly despite promptings we didn’t get a response until a week or two before the event. The paper was rejected on the recommendation of three reviewers. I exaggerate a little, but reviewer A said “they didn’t mention my work,” reviewer B said “they didn’t pay enough attention to my specialty,” and the comments of reviewer C, although lengthy, were incomprehensible.

We asked if they might consider an appeal, and they said they would. We revised the paper extensively, responding even to the incomprehensible comments as best we could. We resubmitted, but now something went very wrong. We waited months and heard nothing. Eventually we rang, and an assistant said that our paper was with the editor. We waited more months; perhaps we were too patient, but we didn’t want to disturb the great person. (Editors fall into the same category as policemen and customs officers: even if you want to kick them you have to be painfully polite.)

Eventually we rang again, and this time an assistant said that she couldn’t find our paper on the system. She would do so and ring back. She didn’t. This repeated itself three times. Oddly we weren’t mad; just resigned. In the NHS or any bureaucratic system there comes a time when you have to pull the biggest string you possess. We did, and eventually an email arrived saying that our paper was being considered. There for now the story ends—except that I dreamt last night that the paper will be rejected, as it probably will be.

Now it may be that we entered this black hole through not following the correct resubmission procedure. These journals run complex systems—and oblivion awaits those who make mistakes.

Does it have to be like this? Could journals have friendlier systems and be less demanding? Of course, it could be possible, but it probably won’t be as long as “we, the authors, need them, the journals, more than they need us.” Several authors have advocated a scheme whereby they put their papers out to auction and ask the journals to bid. Only the very powerful can do that, but the rise in blogs, social media, and universal open access might shift the power relationship—or it might be that the proliferation of outlets might increase the brand value of the few, allowing them to continue to neglect, exploit, and even abuse authors.

Since finishing this blog I’ve received a terse email from yet another journal reprimanding me for being late with my review of an article. I accepted to do the review just a week ago, and it seems aggressive to chase me so quickly. As I’ll not be paid or credited and will probably have my comments ignored I may tell the editors to stuff it—except that I’m too scared.

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.