A third reason may be that journals and publishers are multinational increasingly. In the past, the editor and editorial board of a journal knew both the scientific field it protected and the people working in it, but it’s almost impossible to become sufficiently well linked when both editors and submissions result from worldwide. Having authors suggest the best reviewers may therefore seem like a good idea. In the aftermath of the recent scandals involving fake peer reviewers, many journals are determined to carefully turn off the reviewer-recommendation option on the manuscript-submission systems. But that move might not be enough, as the publisher Hindawi discovered this past spring. Although Hindawi doesn’t let authors recommend reviewers for his or her manuscripts, it made a decision to examine the peer-review records for manuscripts submitted in 2013 and 2014 for possible fraud.There’s the critical care doctor who, unable to identify new info in daily notes, offers begun printing them out and holding two superimposed pages up to the light to observe what’s changed. I possibly could be youthful. Physicians retiring early. Small methods bankrupted by up-front expenses or locked into ineffective systems by the prohibitive cost of switching. Hours consumed by onerous data access unrelated to patient care. Workflow disruptions. And above all, massive intrusions on our individual relationships. These complaints might be dismissed as developing pains, born of resistance to change. But transitional chaos should be distinguished from enduring damage. Even so, the researchers found extraordinary EHR-induced distress. It is quantifiable yet stubbornly not eminently.