Honorary authorship

This issue of Archives of Physical Medicine and Rehabilitation includes an article by Rajasekaran et al that addresses the persistent, difficult, and unsettled issue of unwarranted authorship as it applies to physical medicine and rehabilitation. The findings that it exists and that its frequency is similar to the 25% to 50% rates reported in other medical specialties are discouraging but, unfortunately, not surprising. They do, however, warrant discussion. This commentary attempts to do so and begins with a review of Rajasekaran's findings. It then proceeds to compare them with other work in the literature and concludes with a discussion of (1) why unwarranted authorship matters; (2) if it matters, why does it matter; and (3) what we as authors, editors, and the publishing world can do about it. Our goal is to give us all an improved understanding of the situation as well a little more backbone when dealing with the pressures associated with both overt and covert suggestions for the inclusion of authors that we may believe are unwarranted.