This short essay considers preferential publication and impact factor as stimuli, instrumentally conditioning medical researchers. The author postulates that publication houses emphasising publication of the highest levels of evidence (ie, meta-analyses) at the detriment of other levels of evidence, is inadvertently guiding researchers to overlook necessary research for more individualised care. The author recommends preferential publication and impact factor should be openly discussed by medical educators to ensure we are training researchers to conduct meaningful, high quality, innovative research.