Great review of some of the problems with our current peer review system. This system came into being when such reviews were conducted by mailing around paper copies. Today, we have incredible online tools that provide facile publishing outlets and interactive forums. Peer review needs to move into the public, online space. PeerJ Preprints are an example of this at work, but we really need the heavy hitters—New England Journal of Medicine and JAMA—to get onboard.