In attorney and medical advocate Gregory Piche's hard-hitting book SHAM PEER REVIEW: The Power of Immunity and The Abuse of Trust, the author highlights several cautionary legal cases stemming from the Peer Review process, more appropriately known amongst medical professionals as The Sham Peer Review. SHAM PEER REVIEW is an illuminating read highlighting professional medical careers held in the balance from unjust and unfair evaluations of personal performance. The book also delves into our judicial system's fragile unwillingness and maze of interpretations in confronting and challenging the hornet's nest created by Sham Peer Reviews. Every hospital as an institution has a power structure among its medical staff. Powerful members of a medical staff are never the subject of Sham Peer Review and rarely the subject of any kind of meaningful Peer Review. Armed with control over the Peer Review process, statutory immunity and other protections, medical staff leaders wield an immense amount of personal power over those on the medical staff that they view as threats, competitors, or of a lesser station.