Challenges for the Biomedical Research Enterprise

Research in the not-so-recent past was free from the burden of “expected results and potential pitfalls” because those were usually unknown. It was thus conducted in an unbiased way, and often led to objective, reproducible results. Photo Credit: Wellcome Library

The word “enterprise” typically invokes images of lyrical montages, stupendous victories, collaborative venturing into the unknown—thanks to history and pop-culture. For such reasons, whenever we think of biomedical research, the word enterprise does not enter our consciousness easily. It takes some floundering about, reading and reflecting, before one stumbles upon the veritable fact that in its earliest incarnation, biomedical research was very much an enterprise.

And for good reason. Before the invention of the microscope, our research into the science of life was limited to anatomical study of organisms visible to naked eye. Some behavioral and physiological studies were performed, which despite being crude were insightful and allowed for some observations that could be built into theories. There was no precedent, no sophisticated tools, and certainly no “scientific method.” It took considerable enterprise on the part of the scientists of the day to slowly and sedulously establish the building blocks on which our discipline rests today. It involved educated risk-taking and imaginative thinking. It was usually only intellectually rewarding and was not for the faint of the heart as much drudgery was involved and failure was abundant. And it also did not always fulfill a public health need. Sometimes it was only for the advancement of human knowledge.

As we progressed into the industrial revolution, much of that changed. The instruments for scientific research improved vastly, allowing scientists to ask all sorts of questions, which hitherto had been beyond human understanding. There were dire public health and national security problems that required intensive collaborative and cross-disciplinary research, and there was significant financial incentive Indeed, the innovations that were born out of those immediate pre and post-war years have significantly transformed humanity. However as it is today, there is very little enterprise left in biomedical research.

While I have no desire to romanticize the “old ways” for they certainly had their faults, there is one important takeaway here. Research in the not-so-recent past was free from the burden of “expected results and potential pitfalls” because those were usually unknown. It was thus conducted in an unbiased way, and often led to objective, reproducible results. Today, scientific research is liberally mired in chaos. There is very little room for research for the sake of knowledge, let alone serendipitous discoveries. We think in terms of specific aims, rather than bigger pictures. There are scattered bits of knowledge that often clash and do not come together as a cohesive whole. Compounding the problem is the fact that very few laboratories enjoy continued financial support to thoroughly investigate all aspects of their research question. Incomplete, competing or incorrect models fill our scientific journals. Consequently, the time taken to make the next big leap in our understanding of any biological phenomenon has increased.

Several factors are to blame, not the least of which being a significant reduction in funds that is propelling everything towards “safe” research. Different people point to different factors that led up to this, but the fact remains that there is disproportionate expectation of deliverables from the allocation of funds. Projects that are incremental to the current body of knowledge and are founded in precedent of success are the ones that get funded. Therefore, these projects are likely to contribute incremental knowledge, and breakthroughs tend to be rare. Yet the expectation of breakthroughs remains. The tendency to support projects that hinge on the unknown, that are truly at the frontier and can be innovative, is very low. Grant reviewers have to now select projects with guaranteed returns. The problem is further complicated by the fact that it is considerably more difficult to choose grants that are within the top ten percent than those that are within top thirty percent, which used to be the cutoff until less than a decade ago. Stuck between those two, the state of the biomedical research enterprise is that of suffocation, a shrinking knowledge base, and an even more mad dash for “big data” and large drug screens.

The true measure of a scientist’s creative thinking in today’s research climate is to conduct the best possible experiment with the least amount of money, rather than to conduct the best possible experiment to answer the question at hand. With this sort of a model, the priority shifts to staying afloat rather than breaking new ground. And the scientist cannot be blamed for feeding into the model. In order to continue doing any research, they have to accept the status quo. They are without breathing room and constantly out of breath. The only silver lining here may well be that this problem has become so pervasive and vast that it has seeped out of small, science-related news outlets to renowned mainstream media platforms.

Earlier this year, National Public Radio (NPR) profiled several scientists who have quit their jobs in the last five years or so. Their grievances with biomedical research can be summarized into a sentence: no one wants to fund risky, cutting-edge science anymore, more so if there isn’t a clear connection to therapeutics. The New York Times carried a lengthy editorial about the obvious but rejected need to publish negative data in order to redirect biomedical research to its focus on innovation and enterprise, and to retain talented scientists who are being forced to exit the field. Just because research does not prove your hypothesis, does not mean that it is not valuable or informative. These are only two examples out of many. The problem of restricted and constrained scientific research, and it toll it takes has finally caught on.

However, the biggest problem of all in this current scenario is not that we are unaware and apathetic. The biggest problem is that we are helpless. The current state of biomedical research cannot be fixed by us, at least not directly. The road map for most research at universities and non-profit institutions is laid down by the government, since this research is financed through federal funds. While it is only appropriate taxpayer money to be budgeted by the government, the officials making these decisions are not required to have a scientific background. Scientific advisors are often included in discussions but the ultimate decision of how we invest in biomedical research as a nation is made by the Congress. The state of our biomedical research enterprise directly reflects the choices and values of those we have elected. Revamping biomedical research will require changes at the very top, where our national leaders, policymakers and budgeteers sit.

While editorials and opinions in prominent publications help in making our struggles noticeable to our lawmakers, they are not sufficient for action. Congress isn’t exactly full of scientists. For things to change, a two-pronged approach is necessary and requires significant involvement on our part. Since we face the direct consequences of a stifled research program, we must also take the responsibility. On one hand, we need to increase our efforts to reach government officials. This can be considered more short-term where the results of our efforts can be seen as early as the next fiscal year. On the other hand, we more of us need to step up and make the transition into Congress. This is a more long-term solution that will take several years before a greater percentage of scientists can occupy seats in the Congress.

For scientists, a career in politics is not a natural second choice. That’s partly because of the traditional separation between those disciplines. Scientists and politicians have different expertise; they think and act differently. Very few scientists have been able to bridge this gap and fulfill both roles. To even contemplate it can be intimidating and seem as a significant career risk. Another major hurdle is the way we view ourselves as scientists. We view ourselves as one-dimensional entities with excellent critical and analytical capabilities that can be applied to testable ideas and research problems. Often, we do not independently realize just how transferrable those skills are, and that a scientist is not just someone who conducts scientific research. Someone who ensures continued federal support of the biomedical research enterprise is very much a scientist as well.

These ideas have prompted several professional societies to become involved in training scientists in public policy and lobbying. American Association for the Advancement of Science (AAAS), the Lasker Foundation, and even ASCB are among several organizations that offer graduate students and post-docs support with transitioning into science policy positions. Most of these resources are either free or carry a modest fee. This is a great asset to both scientists-in-training and established scientists because the necessary resources have already been compiled for you. The next step is for universities to dedicate some resources towards training their scientists in matters of lobbying for continued support of biomedical research. As of now, established faculty can most easily accomplish this, as they have the easiest access to administration. Discuss the research enterprise with your mentor and get their views. What do they think is our role to play?

Considering all of the above factors, this is a good time to begin our efforts towards changing the future of our beloved research enterprise. All you need to get started is motivation, lots of patience and supportive colleagues. The challenge is not where to begin. The challenge is to find the will to do so, and to keep going despite failure. But research has already taught us how to do that, hasn’t it?

This essay won first prize in COMPASS’s 2014 Writing Contest.