They are designed for that orientation. The fans on the outside of GPUs blow down towards the board, not up towards the adjacent cards.
My setup has only about 1.25 to 1.5 inches between cards and I have no heat issues whatsoever.
The exhaust comes out the sides of the assembly, like this:

That was an informative image, thanks.
So how come when you put your hand close to the fan you can feel the hot air blowing out of it, adjacent to the cards rather than from it's sides?