Nevermind that laypersons think that peer review means that your peers are reviewing your actual data for accuracy and fidelity (they are not, they are reviewing only your manuscript, final analyses, and conclusions), which causes them to be perplexed when revelations of fraudulent data published in top journals are reported. Nevermind that the website Retraction Watch, which began as a small side project now has daily and twice daily postings of retracted papers. Nevermind that some scientists have built entire careers on faked data. Nevermind that the fact that something has been peer reviewed provides very little in the way of assurance that the report contains anything other than rubbish. Nevermind that leading investigators publish the same reviews over and over in different journals with the same figures and sometimes the same text.
The entire process is cumbersome, time consuming, frustrating, and of dubious value as currently practiced.
Last year I was invited by the editors of Chest to write a "contemporary review of ionized calcium in the ICU - should it be measured? should it be treated?" I am not aware of why I was selected for this, but I infer that someone suggested me as the author because of my prior research in medical decision making and because of the monograph we wrote several years back called Laboratory Testing in the ICU which applied principles of rational decision making such as Bayesian methods and back-of-the-envelope cost benefit analyses to make a framework of rational laboratory testing in the ICU. I accepted the invitation, even knowing it would entail a good deal of work for me that would be entirely uncompensated, save for buttressing my fragile ego, he said allegorically.
Now, consider for an instant the extra barriers that I, as a non-academic physician faced in agreeing to do this. As a non-academic physician, I do not have access to a medical library, and of course the Chest editors do not have a way to grant me access. That is, non-academic physicians doing scholarly work such as this are effectively disenfranchised from the infrastructure that they need to do scholarly work. Fortunately for me, my wife was a student at the University of Utah during this time so I was able to access the University library with her help. Whether academic centers and peer-reviewed journals ought to have a monopoly on this information is a matter for debate elsewhere, and not a trivial one.