In the previous essay I introduced the topic of peer review, presenting in abbreviated form its history, its enduring virtues, its problematic considerations presently and some implications for its future given the impact of electronic information flows and the consequent emergence of e-journals.

Now I have two objectives: (1) a discussion of proposed changes to the dynamics of the peer review process and (2) to expose some of the tyrannies that continue to infect peer reviews. For this I will try to relate how to recognize institutionalized dishonesties and how perhaps to change them.

Let us begin by considering a newly initiated policy established by one journal with which I am familiar and which may be followed in other publications today. That is the editorial practice of asking the authors to suggest possible reviewers for their manuscripts [1].

Now upon first becoming aware of such a notion, I was taken aback. My immediate reaction was positive. I could identify individuals who would know my work. I could then direct the editor to the small subset of fellow radiologists who could understand that generally my offerings are multidisciplinary. Those I thought to be suitable for such a review were also apt to appreciate contributions to the journal that bridge differing subjects and thereby will be congenial to my presentations. Moreover, I thought that my recommendations would be of acquaintances or friends of mine who would be able by content and experience to recognize that I was the author of the accompanying manuscript that they would be chosen to review. As a relationship between me and each of them had been established beforehand based upon our professional interactions, I presumed at first that they would be predisposed to regard my contributions affirmatively. So I was in like Flynn, so to speak.

But then reservations set in. I was only to make suggestions to the editor, not to direct the appointment of reviewers. I would not know if my recommendations would be heeded. Also my circle of acquaintances vastly exceeds my circle of true-blue, bosom buddies. How could I come to conclude that none of those acquaintances harbored a secret animus towards me that he or she wanted to discharge through a devastating review?