It is 27 years since Dr Franz Ingelfinger announced that a manuscript would be rejected by his journal, the New England Journal of Medicine, if it had been published elsewhere. Many other medical journals have since adopted this so-called Ingelfinger rule. The restrictions resulting from the rule have generated enormous controversy in medical journalism, as shown by the first of the two-part article The Ingelfinger rule, embargoes, and journal peer review. Critics say that the rule restricts the free flow of information, whereas proponents claim that information from a paper released early may be Inaccurate because the paper has not been subjected to peer review. Yet peer review itself has also come under scrutiny, with its many limitations rarely being openly discussed.