The peer review system has become the standard by which scientific articles are refereed. Unfortunately, even from its beginnings in the mid-1800s it has been fraught with difficulties. Potential reviewers are volunteers who may be inundated with requests to review yet these reviews take considerable time and effort. There is little motivation to complete a review causing significant delays in the publication process. There may be biases unintentionally built into the system between reviewers, authors, editors, and journals. Attempts to overcome these biases by various blinding schemes have been met with limited success. Finally, the recent advent of Artificial Intelligence has the potential to completely upend the system, for good or bad.