When you hear about new medical breakthroughs in the news, you’re only going to hear about peer-reviewed research. Peer reviewed means it passed some kind of basic quality standards. It is the gold standard of research.
But is it real gold or fool’s gold?
Medical research seems especially mystical and inspiring to the average person. The basic concepts of medicine, which are not really difficult to understand, are deliberately wrapped in Latin terminology and other confusing jargon, making medical knowledge and theory seem beyond the reach of the common person.
After all, every profession needs to make you think that 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 modify the tax code to make it virtually impossible for the average person to know everything, understand everything, or follow all the changes that are constantly being made. The doctors have made it so that you cannot request medical tests or take medicine without their prescription. You name a profession and you can see the ways it is perpetuated 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 generally get their money from both salaries and grants. The researcher’s job is to find a sponsor for his or her special type of research. The more research projects and publications they get, the more sponsors they will have and the higher their income will be. And if a researcher comes up with a patentable device or drug, there are intellectual property rights to include in the compensation package.
This means that researchers do not work for free. They are mercenaries. There may be very interesting and, by societal standards, very important research that needs to be done and that they could do. But unless and until they get paid to do it, the job doesn’t get done.
This means that the sources of research funding, be it government or private sources, determine what research is actually done. Most of the money for medical research comes from the private sector, usually pharmaceutical companies, which is why drugs dominate modern medicine. Government funding is a bit different in that it comes from agencies that are heavily lobbied by drug companies and are run by doctors trained and paid by the drug companies. Medicine is a public-private partnership that gives the pharmaceutical industry similar power to the government over culture and its health research.
Research on non-drug alternatives is rarely done for this reason. It is also why medicine claims to know very little about the causes of most of the diseases of our time. They care much more about the treatment than the cause, since treatment is profitable for research funders, whereas knowing the cause can lead to prevention, which translates into medical terminology as “non-billable.”
Of course, this is a pretty big scam to pull off. Consider your reach. The public pay taxes and ask for donations to pay for medical research that goes into discovering drug treatments that the public will then have to pay incredibly high prices to obtain, and only after paying the doctor an office visit to get a prescription. And if the drug produces unpleasant side effects, it just leads to more calls for more money to find new drugs with different side effects.
Is the public getting a good deal here? How do you know that the research is scientifically valid? Where is the quality control?
Since most people have been conditioned to believe that they cannot judge medical research unless they have a PhD, MD, ND, or other license, the research is evaluated for you by other scientists in the field. This is called peer review.
Research scientists, like all professions, belong to a club of like-minded researchers in the same business, promoting their services and products. They belong to the same types of industries, such as universities or large multinational pharmaceutical corporations. They have the same upbringing, which means they all think alike. The purpose of your organization is to provide standards of practice that are supposed to ensure quality. Any research must first be peer reviewed in some way by this club to ensure quality guidelines are met, before the research can be published.
Despite this guarantee of quality, however, the fact remains that most of what is considered true today will be dismissed as false in the future. “Ninety percent of what you learn in med school will be out of date and considered obsolete in ten years,” the dean of students told us when I started med school. This means that most of what doctors learn is wrong. It also means that new information arriving 10 years from now to replace and update current misconceptions and bugs will also be considered out of date another 10 years from now. 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 ensure the truth. It just means that current practice standards are followed. Currently, this allows for conflicts of interest, since most drug research is paid for by the companies that make and profit from those drugs themselves. Even research that proves the dangers of drug side effects is paid for by companies who stand to lose, big time, if their drugs are shown to be unsafe. Since pharmaceutical companies have their bottom line, and not selfless service to humanity, as their reason for existing, it is extremely unwise to trust them with research on their own products. Investigators do not take oaths of honesty or integrity. They work for whoever pays them, and are not above manipulating the results to get the desired result.
This is not good science, of course. But it is science as practiced in a culture that has professionalized research into a lucrative enterprise. It is not, as people fantasize, the sacred trust needed to help the sick and injured with selfless devotion. Medical research is all about making money off newly patented drugs to replace ones that just went off-patent and are being sold at too low a price by generic drug competitors.
Peer review does not stop conflict of interest. Medical journals accept conflict of interest, knowing that it is the way medical research is done. Knowing what research is coming up allows these experts to get a sense of new drug developments before the public knows, so they can change their investment portfolio mix for anticipated stock price adjustments.
Peer review also excludes alternative theories and ways of doing research. Any innovation threatens the status quo, and those who control the peer review process, such as Supreme Court justices, can decide which cases to hear and which to ignore. They are guardians of the status quo, which keeps the current powers in power. Since medical peer review boards are the culture’s final authority on quality, there’s no way to challenge their decisions. In fact, the quality of research can be poor, which is evident when you look at how many research articles criticize other peer-reviewed research for being flawed in some way. Any researcher will tell you that a lot of bad research gets published. However, it is a publish or perish world. Since researchers and their peers are all caught up in this same publish-or-death demand, and reviewing each other’s work, they subtly collide to get as much research as possible funded and published. You scratch my back and I scratch yours. They argue with each other in the journals about the quality of their work, and I’m sure there’s some competition between scientists, as they apply for grants from the same sources to do more or less the same thing. But in general there is an understanding that, as pairs, united they stand and divided they fall.
This of course means that peer review is nothing more than a political arrangement for research workers, such as a guild or union. Your goal is to maintain control over your field, suppress competition, and ensure continuous cash flow. It has nothing to do with science, the systematic search for truth, which should not be tainted by economic motives or tempted by personal gain.
So the next time you hear a story about some new wonder drug, look for the syndicate tag. If it’s peer reviewed, there’s a ninety percent change, it’s wrong.
