When you hear about new medical breakthroughs in the news, you will only hear about peer reviewed research. Peer reviewed means that it passed some sort of basic standards for quality. It is the gold standard of research.
But is it real gold, or fool’s gold?
Medical research seems especially mystical and awe inspiring to the average person. The basic concepts of medicine, which aren’t really difficult to understand, are deliberately cloaked in Latin terminology and other confusing jargon, making medical knowledge and theory seem out of reach to the common person.
After all, every profession needs to make you think you need their services. Lawyers make the legal system so complex and confusing that the average person is completely helpless without legal assistance. Accountants help the IRS tweak the tax code to make it virtually impossible for the average person to know it all, understand it all, or follow all the changes constantly being made. Doctors have made it so you cannot request medical tests or take drugs without their prescription. You name a profession, and you can see ways it perpetuates itself by disempowering the public.
What about the medical research profession?
One of the most important things to know about medical research is that, above all else, it is a profession. Researchers make their money usually from both salaries and grants. The job of the researcher is to find a sponsor for their special type of research. The more research projects and publications they get, the more sponsors they have, and the higher their income. And if a researcher comes up with a patentable device or drug, there are intellectual property rights to throw into the compensation package.
This means that researchers do not work for free. They are mercenary. There may be very interesting and, by social standards, very important research that needs to be done that they could do. But unless, and until, they are paid to do it, the work does not get done.
This means that the funding sources of research, be it the government or private sources, determine what research is actually done. Most of the money for medical research comes from the private sector, usually drug companies, which is why drugs dominate modern medicine. Government funding is little different, since it comes from agencies that are highly lobbied by drug companies, and are run by doctors trained and paid by drug companies. Medicine is a public-private partnership, giving the pharmaceutical industry government-like power over the culture and its healthcare research.
Research into non-drug alternatives are rarely done for this reason. It is also why medicine claims it knows very little about the causes of most diseases of our time. They care much more about the treatment than the cause, since treatment is profitable for the research sponsors, while knowing the cause can lead to prevention, which translates in medical terminology into “unbillable”.
Of course, this is a pretty big scam to pull off. Consider its scope. The public is taxed and begged for donations to pay for medical research that goes into discovering drug treatments that the public will later have to pay incredibly high prices to obtain, and only after paying the doctor for an office visit to get a prescription. And if the drug gives nasty side effects it only leads to more calls for more money to find newer drugs with different side effects.
Is the public getting a good deal here? How do you know the research is scientifically valid? Where is the quality control?
Since most people have been conditioned into believing that they cannot judge medical research unless they have a Ph.D., M.D., N.D., or other license, the research is evaluated for you by other scientists in the field. This is called peer review.
Scientists doing research, as with all professions, belong to a club of like-minded researchers in the same business, promoting their services and products. They belong to the same kinds of industries, such as universities or large multinational drug corporations. They have the same education, which means they all think alike. The purpose of their organization is to provide standards of practice that are supposed to assure quality. Any research must first be somehow reviewed by the peers of this club to make sure the quality guidelines are met, before the research can be published.
Yet, despite this assurance of quality, the fact is that most of what is considered true today will be discarded as false in the future. “Ninety percent of what you learn in medical school will be out of date and considered obsolete in ten years,” we were told by the dean of students when I began medical school. This means that most of what doctors learn is wrong. It also means that the new information which will come in 10 years to replace and update current misconceptions and errors will also be considered obsolete in another ten years’ time. This is a powerful indictment of medical research, which seems to produce little more than temporary information.
It also means that the peer review process does not assure truth. It only means that current standards of practice are followed. Currently, this allows conflicts of interest, since most drug research is paid for by the companies that produce and profit from those same drugs. Even research testing drug side effect hazards is paid for by the companies standing to lose, big time, if their drugs are proven unsafe. Since drug companies have their bottom line, and not unselfish service to mankind, as their reason for existing, it is extremely unwise to trust them with research into their own products. Researchers take no oaths of honesty or integrity. They work for whoever pays them, and they are not above fudging the results to get the desired outcome.
This is not good science, of course. But it is science as practiced in a culture that has professionalized research into a profit-making enterprise. It is not, as people fantasize, the sacred trust needed for helping the sick and injured with unselfish devotion. Medical research is about making money coming up with newly patented drugs to replace the ones that have just gone off-patent and are being sold too cheaply by generic drug competitors.
Peer review does not stop the conflict of interest. Medical journals accept conflict of interest, knowing that it is the way medical research is done. Knowing what research is coming down the pike allows these insiders to get a whiff of new drug developments before the public knows, so they can change their investment portfolio mix for anticipated stock price adjustments.
Peer review also keeps out alternative theories and ways of doing research. All innovation threatens the status quo, and those who control the peer review process, like Supreme Court Justices, can decide on which cases to hear and which to ignore. They are gatekeepers of the status quo, which keeps the current powers that be in power. Since the medical peer review boards are the culture’s final authority on quality, there is no way to challenge their decisions. The quality of the research may in fact be poor, which is evident when you see how many research articles criticize other, peer reviewed research as being flawed in some way. Any researcher will tell you that lots of bad research is done that gets published. However, it’s a publish or perish world. Since researchers and their peers are all caught in this same publish or perish demand, and review one another’s work, they subtly collude to get as much research as they can funded and published. You scratch my back and I’ll scratch yours. They argue among themselves in the journals as to the quality of their work, and for sure there is some competition among scientists as they solicit grants from the same sources to do pretty much the same thing. But there is overall an understanding that, as peers, united they stand and divided they fall.
Of course, this means that peer review is nothing more than a political arrangement for research workers, like a guild or union. It’s goal is to keep control over their field, suppress the competition, and assure continued cash flow. It has nothing to do with science, the systematic search for truth, which must not be tainted by financial motives or tempted by personal gain.
So the next time you hear a news story about some new wonder drug, look for the union label. If it is peer reviewed, there’s a ninety percent change it’s wrong.