Clinicians and educators rely on the published medical information. They trust that original research and narrative or systematic reviews are reliable and the authorship is transparent, but this is not always the case. Disclosure of conflicts of interest by authors is required by most journals, disclosure will not detect ghost or guest authorship. Ghosting or guesting is of more than academic interests because it can directly or indirectly affect patient care. Therefore it is important for readers to be aware of this issue, and to be alert to suggestions that particular works may be at increased risk for ghost or guest authors. It is important to take a proactive stance against these practices. Industry, universities, research centers, and professional medical associations should be clear and unequivocal in condeming these practices. Processes need to be in place to investigate and, if need be, deal with violations. Clearly, we must all participate in this endeavor for professional, ethical, and most importantly, best patient care reasons.