Over time an evolution has taken place in the nature of medical publishing. From being more-or-less exclusively channels for professional information to clinicians, medical journals have become tools in the process of qualifying researchers. Bringing credits to authors has become one of the main tasks of scientific publishing. This evolution can be described as a shift from a main focus on the reader as the recipient of information (reader-orientation) to greater emphasis on the author, who gets merits for publishing scientific papers (author-orientation). The scientific community does not live up to the international guidelines, which require substantial contributions in order to obtain authorship credits. The result has been author inflation and honorary authorship. The concept of authorship has changed, which may imperil the integrity of the scientific article. Increasing consciousness and changing attitudes are needed among researchers, medical schools and granting agencies. A stricter and more traditional definition of authorship should be established.