With the booming economy of predatory publishing in medicine, it is time to rethink what constitutes peer review and how peers are being standardized.

Perhaps with the absence of standardization for anonymous peers, manuscripts should undergo a pre-publication trial solely by editors (judges) rather than awaiting trial by peers (juries) unless the recruitment of editors is not standardized as well.

By suggesting peer reviewers at the time of manuscript submissions, authors might be conducting voir dire, thus mimicking the jury selection process found in adversarial legal systems, as opposed to the inquisitorial legal system led by judges (editors).

Pre-publication trial processes might presume that what’s good for peers (juries) is also good for editors (judges).

Just like expert opinions in legal systems, the answer may lie in expert reviews, which could have more evidentiary value during the pre-publication trial of submitted manuscripts.

At the time of manuscript submission itself, authors may need to be charged fees to reimburse the experts reviewing their submitted manuscripts, similar to how experts are reimbursed for their opinions in legal systems.

Reimbursed expert reviewers might need to fully disclose their names as well as their conflicts of interest for both accepted and rejected manuscripts if authors agree to being charged at premium rates. This may not be unlike defendants reimbursing experts for their testimonies at premium rates, unless editors, like plaintiffs and prosecutors, agree to bear the costs of expert reviewers.

Publishers could bid for expert reviewers based on the cost-effectiveness of their expertise, similar to professional football player recruitment during the National Football League Draft. This may resemble MediBid, where empowered patients seeking self-funded health care select cost-effective bids made by physicians and health care facilities. This model has the potential to inspire physician recruiters to pioneer exemplary auctions for drafting, picking, transferring, and trading salaried physicians with no-trade clauses in their contracts rather than the currently restrictive non-compete clauses, which the Federal Trade Commission has recently proposed to ban.

To ensure accountable publishing and counteract predatory publishing, experts acting as independent contractors may need to incorporate professional limited liability companies for performing independent curation of peer-reviewed publications in cases where traditional publishing fails to include experts for responsibly reviewing submitted manuscripts during the pre-publication trial stage.

The above-mentioned adaptations, aimed at upgrading evidence-based medicine, might make it redundant and irrelevant to outright criminalize evidence-generating disinformation, which can continue under the distinctive guise of freedom to preach and reach, not unlike World Wrestling Entertainment as opposed to Olympic wrestling.

In conclusion, while medical publishers contemplate bidding for expert reviewers to evaluate submitted manuscripts during pre-publication trials, professional experts independently curating peer-reviewed publications may upgrade evidence-based medicine with post-market surveillance (phase IV) to counteract evidence-generating disinformation, which may consequently be downgraded, even if not downsized, as numerous entities strive to reach as many people as possible to preach.

Deepak Gupta is an anesthesiologist. Amit Jain is an anesthesiology resident. Shushovan Chakrabortty is a pain physician.