disclaimer: I'm a university professor, though in a european country and not in health-rrlated area<p>The article is excessively negative in tone, and very dramatic and aggressive. I have found many people adjacent to academia, drop outs, or even some inside, very disenchanted and angry at how it works. And it's true, the sets of incentives, structures and political organisation in academia don't relate at all to academic excellence, and are something we have to "suffer". I wish we could come up with a better set of incentives, but it's very hard to do in a mostly vocational and passion-based activity. So what people have come up is structure the incentives along the chores (eg teaching) and easily measurable results (eg publications). And whenever you come up with an incentive structure, some people will game it. And the current state of publication stress (publish or perish) is extreme and counterproductive. But please note that these measurement requirements and incentives are imposed from outside academia. Of course, I'm not saying leave us to our devices, academia is nepotistic and political enough. But the system sure could use some overhaul. Suggestions welcome.<p>On the other hand, this "fraud" is incentive fraud, but not "truth" fraud. The way science Truth works is by accumulation of imperfect, even erroneous results, leading to an ever more refined understanding of the world. Scientists don't just blindly trust others, even if they cite each other (nowadays, citations are a political and incentive-gaming tool more than actual references). So these massive scale frauds don't bother us so much because they don't make understanding necessarily go backwards. Of course the payer feels it's a waste of money, but in academia we see money as support for research, which is mostly failed anyways because you only make discoveries by failing and failing again.<p>And progress in knowledge is nowadays still going on, even in the medical fields. And academia still works, much as healthcare and compulsory education, becausemany people feel a calling to do these professions properly, even if it doesn't seem so from outside. So let's be optimistic, even while trying to come up with improvements to the current model.<p>PS: So sorry for the wall of text