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Peer review is at the heart of science. Yet, as Richard Smith explains in this talk, there are many problems with peer reviewed research. As Richard argues, peer review is not an evidence-based process, but rather a faith-based process. Is it time for something different? Peer review has two main functions: 1) Quality assurance and 2) Improving what is published. However, with that in mind, there is no evidence of effectiveness of peer review, and lots of evidence of its ineffectiveness. This is along with peer review being slow, expensive, wasteful, inefficient, prone to bias and being largely irrelevant! Richard discusses a few of the main issues as he sees it. For example, studies in large journals are more likely to be wrong when compared to smaller journals. Some argue that the vast majority of research is a waste of time. Similarly, replication is also a major problem, as Richard explains. A huge number of studies cannot be replicated, raising questions about the initial research. What is published in j