Eating the Seed Corn in the Health Research World

[n2doc]

By Keith Humphreys

Michael White’s essay on the dismal state of the National Institutes of Health is a must-read for anyone who cares about progress in medical and public health research. The positive impact of the 1998 bipartisan initiative in Congress to double the NIH budget has been completely wiped out.


Of all the bad news in White’s article, this is particular discouraging:

The tighter competition for funding has put the squeeze on younger scientists with fledgling labs; the proportion of young scientists with NIH grants is half of what was in 1998, while the proportion of funded scientists over 65 has doubled. Because scientific training typically takes over 10 years, students who decided to enter graduate school in the boom days of the mid-Aughts are now entering a job market that looks nothing like what they expected.

On the ground in my daily work in both a university medical school and a public hospital, it’s a rare month that some bright young person doesn’t tell me they are quitting science because it’s too hard to get funded. These are usually not reversible decisions. Even a well-trained young physician who leaves research for 5 years to treat patients full-time is very hard to tempt back into science if the funding picture improves (and is even harder to bring back up to speed on the cutting-edge scientific questions and methods of the day).

There is no question that we have some enormously talented and productive senior citizen scientists. But a decade or two from now, when an antibiotic resistant bacteria or new strain of bird flu is ravaging the planet, that generation will no longer be around to lead the scientific charge on humanity’s behalf. That’s why we constantly need a new stream of young people committing to health science careers. That seed corn is currently being consumed at an alarming rate, and if we don’t act immediately to rectify the situation we will suffer for many years to come from the loss of a generation of health researchers.



http://www.washingtonmonthly.com/ten-miles-square/2013/12/eating_the_seed_corn_in_the_he048061.php#

[Vox Moi]

1. Health Research spending is a bit like Defense spending. Sometimes all you get is spending.

Health Research can be needlessly expensive and poorly managed affair in which the goal is often more the pursuit of grant money than it is the pursuit of science. I have been working in this field for decades in Teaching Hospitals and HMOs and I was witness to waste, mismanagement and fraud. Sometimes, there was even some actual scientific research.
In one project I saw $50 million flitted away on meetings, travel, new hiring, web sites and administration in a project funded under HHS that produced virtually nothing of value. When the grant came up for renewal, they lied and won renewal.
A grant belongs to an investigator with little or no supervision and little or no oversight as to the management of an enterprise that the grant is funding. There is little coordination between various research projects and the infrastructure of research: software, research data resources and so on is created again and again by the instigators who are more interested in ownership of the process than what the process might produce.
You can't buy science by the pound and you can't expect novel ideas and solutions to arise from a system that is built to defend individual status and power. Pumping in more money won't fix a thing.
One Senior Research Scientist put it to me this way: "Research is all Politics".
The Director of a Health Research Center in a major HMO put it to me another way: "The business of this Center is to get as much grant money as possible."
I say that the business at hand is science. The grant money should be the means, not the end.