Rapid Responses to:
|
|
Rapid Responses: Rapid Responses published:
-
![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Pinball wizard
- William P Johnson (18 June 2004)
-
Re: Pinball wizard
- madhu singh (22 June 2004)
-
Medical research funding: is the bubble due to burst?
- Bruce G Charlton, Peter Andras (30 June 2004)
|
|
|||
|
William P Johnson, emergency medicine registrar London
Send response to journal:
|
The raison d'etre of academic clinical medicine is to discover things and to use the results to change doctors' habits. However these functions have been hijacked by the drug companies (black hats) and NICE (greyish white hats). Therefore is it any wonder that there is no compelling reason to go into an area of medicine where you are the ball in a government/pharmaceutical pinball machine, with patients being the bumpers, and hospitals/universities being the flippers? The only way that academic medicine can survive is if the universities and hospitals have the integrity to say 'no' to soft drug money for dubious clinical research. Competing interests: None declared |
|||
|
|
|||
|
madhu singh, internal medicine resident philadelphia 19106
Send response to journal:
|
I agree with you- money from drug companies is never "free" however this still leaves us with the small problem of how to provide money for clinical research or even basic science research. As money is always in short supply -I guess academic medicine will remain in the same rut that it has in the forseeable future. Competing interests: None declared |
|||
|
|
|||
|
Bruce G Charlton, Editor-in-Chief - Medical Hypotheses University of Newcastle upon Tyne, UK, NE1 7RU, Peter Andras
Send response to journal:
|
Although many continue to expect (or hope-for) a continuation of the long-term expansion of medical research funding [1], a comparison with the fate of physics is a corrective to over-confidence. Physics was once the richest, most-self-confident and most prestigious science. The first half of the twentieth century was the golden age for the actual science of physics; post-WW II was a golden age for funding. But the achievements did not live-up-to the hype, and recent decades have seen a collapse in physics support until fundamental physics research is pursued in only half a dozen UK universities. Adding a time lag of a few decades, the same trajectory may be expected for medical research. The middle of the twentieth century was the golden age for clinical breakthroughs and biological science, and this was followed by massive expansion in research funding. But the rate of major clinical advances has not lived-up-to the spin [2]. The Human Genome Project was the costliest biological venture in history and was hyped as promising major clinical benefits, yet such predictions now recede ever further into the future. A continual enhancement in the internal 'performance indicators' of medical science, such as grant income and refereed publications, has not been matched by the kind of outputs that are valued by people external to the system. Effective new treatments for serious diseases are progressively drying-up [3]; perhaps because of fundamental flaws in the 'basic to applied' model which is the focus of funding [4]. A significant cull of medical research will therefore probably be a good thing - indeed there are some signs of an imminent modernization of European science generally [5]. We predict that, like physics, in a decade or two there will be much less funding of medical research, fundamental medical science will be pursued at a small number of research centres, and most medical schools and universities will concentrate on training doctors and performing 'applied' medical R&D. An explicit separation of clinical practice and medical research systems will probably be more effective and efficient, but the transition will be painful. REFERENCES 1. Kmietowicz, Z Campaign to revitalise academic medicine calls for radical thinking. BMJ 2004;328:1454 2. Horrobin, D.F. Scientific medicine - success or failure? In: Weatherall, D.J.; Ledingham, J.G.G.; Warrell, D.A. (Eds.) Oxford Textbook of Medicine, 2nd Ed. Oxford University Press: Oxford. 1987, pp 2.1-2.3. 3. The Economist. Fixing the drugs pipeline. The Economist - Technology Quarterly. March 11 2004. www.economist.com 4. Rees J. Complex disease and the new clinical science. Science. 2002; 296: 698-701. 5. Andras P, Charlton BG. European science must embrace modernization (Correspondence). Nature. 2004; 429: 699. Competing interests: None declared |
|||