Founded originally as a not-for-profit society to provide education, advocacy, and best practices for those involved in medical publication planning, the International Society for Medical Publication Professionals (ISMPP) has grown in size to over 1300 members throughout the world. As ISMPP approaches its 10th Annual Meeting, significant changes are occurring within the industry, as well as in the organisation's operating structure, including the hiring of a full-time President and Chief Operating Officer to help drive the vision and mission of the organisation and provide a ‘visible’ face to ISMPP. Additional changes include a reassessment of key elements of ISMPP's vision and mission, increased organisational collaborations, and more proactive positions across numerous areas of interest in support of its members. At the same time there are significant concerns across the industry regarding initiatives that undermine the credibility and intrinsic value all publication professionals hold dear, which is transparent and ethical scientific exchange.