Writedit at Medical Writing, Editing & Grantsmanship raises concerns about the speed with which the Scientific Management Review Board of the National Institutes of Health decided to create a new translational medicine center. At a meeting last month, both NIH director Francis Collins and Arthur Rubenstein, Translational Medicine and Therapeutics Working Group chair, said that the consequences of creating a new institute would have to be deliberated further, but, as Writedit points out, the very next item on the agenda dealt with how the new center could work with NIH's Clinical Center — indicating that the new institute was essentially a done deal. She goes on to doubt that NIH and the SMRB took a comprehensive look at the options and indicates that discussions over alternatives seem to have been stifled. "If such major changes can be implemented so quickly with such little input beyond 'working' group members, what else might the SMRB do on behalf of NIH directors seeking to push through special initiatives?" she asks.