{"id":7075,"date":"2010-08-26T05:00:55","date_gmt":"2010-08-26T10:00:55","guid":{"rendered":"http:\/\/pmedicine.org\/epatients\/?p=7075"},"modified":"2010-08-26T07:50:39","modified_gmt":"2010-08-26T12:50:39","slug":"a-troubled-trifecta-peer-review-academia-tenure","status":"publish","type":"post","link":"https:\/\/participatorymedicine.org\/epatients\/2010\/08\/a-troubled-trifecta-peer-review-academia-tenure.html","title":{"rendered":"A Troubled Trifecta: Peer Review, Academia & Tenure"},"content":{"rendered":"

We welcome Peter Frishauf as an author on our blog. Peter is on the Editorial Board [brief bio<\/a>] of our Society’s Journal of Participatory Medicine, and as described below, has already authored some important material on this subject. His first post here is triggered by an article in Tuesday’s New York Times that generated much discussion on a vital subject: how we reality-check what we think we know, as a basis for science, and especially for medical advice. – e-Patient Dave
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\n\"\"<\/a>It\u2019s a recitation of the obvious: without reliable, high-quality peer-review, medical\u00a0information and patient care suffer.<\/p>\n

Sadly, academia and broken peer review are also linked to our tenure system. We\u00a0need to fix that.<\/p>\n

I hate to condemn with a broad brush: many academics care deeply about better patient care and believe \u2013 genuinely \u2013 that tenure is a good thing. As Wikipedia describes it today, tenure \u201cprotects teachers and researchers when they dissent from prevailing opinion, openly disagree with authorities of any sort, or spend time on unfashionable topics.\u201d But sadly, the vast majority of academics acknowledge that an even more powerful benefit of tenure is pretty damn good job security. Tenure has much more to do with money (lifetime job security) than academic freedom.*<\/a><\/a><\/p>\n

Tenure and traditional peer review are joined in a pernicious union that should be smashed if universities are to be trusted to promote the public interest through good, published science and medicine. In the \u201cpublish or perish\u201d environment of academic medicine, candidates for tenure are generally ranked not on how much information they create (by research or invention) or how well they teach (which counts for just about nothing), but by the prestige of the journal where they publish. It\u2019s a system that might have made sense when a journal\u2019s reputation was regarded as a proxy for an author\u2019s scientific rigor and integrity. No more.<\/p>\n

With the Internet, information is distributed efficiently and effortlessly. Reputations are created \u2013 and destroyed \u2013 quickly. Crowdsourcing experts review articles to improve their quality. Articles themselves aren\u2019t published and forgotten, but continually curated over time. The old publishing and peer review model is obsolete in this environment.<\/p>\n

In an excellent article<\/a> this week in The New York Times<\/em>, journalist Patricia Cohen describes a number of experiments to improve peer review:<\/p>\n