To change peer review, make it enforceable so that perpetrators of abuse have no incentive to abuse power. Tell the medical students which specialties have honest peer review, so that they begin to ask questions of their mentors in different specialties all across the country at the same time (now). Once a few specialties have honest peer review it will be easier to demand hones review in each site of practice. This approach amounts to an end run around local power by applying national standards.
To hear false-witness is Kafkaesque. Shunning occurs under the influence of committees controlled by competitors colluding in libel, and who seek 'market share' (in private practice) or power (in government). Some committees are biased by members who are not even physicians, let alone peers. All the above constitutes professional and psychological rape, it rarely reaches public discussion. This lawless situation ruins any profession: As was said to Ben-Hur, "There are no rules in the Arena." The 'games' have already begun; we are losing. For example, William Chace, Ph.D., President of Emory University, has been quoted as saying the Hippocratic Oath no longer obtains because we are employees. Perhaps he is correct for whatever institution he may control. He invites us to accept Enron Medicine, and so far we have done so. As in the Holocaust, those in authority (organized medicine) look the other way.
