Saturday, 9 February 2013

Why didn't the medical research bubble burst?


In 2005 I co-wrote a commentary which argued that the medical research bubble was about to burst:

The continual and uninterrupted expansion of medical research funding is generally assumed to be a permanent feature of modern societies, but this expectation may turn-out to be mistaken. Sciences tend to go through boom and bust phases. Twentieth century physics is an example where huge increases in funding followed an era of scientific breakthroughs. Speculative over-expansion led to diminishing returns on investment then a collapse in funding. We predict that medicine will follow the same trajectory. After prolonged over-funding of the ‘basic-to-applied’ model of clinical innovation, and a progressive shift towards Big Science organization, medical research has become increasingly inefficient and ineffective. Although incremental improvements to existing treatment strategies continue, the rate of significant therapeutic breakthroughs has been declining for three decades. Medical science now requires rationalization and modernization. From this perspective, the current level of medical research funding looks like a bubble due to burst.


Well: It didn't happen.

The bubble continues.

Why did I get it so very wrong?


Simple really. I assumed that because medical research has become increasingly inefficient and ineffective and the rate of significant therapeutic breakthroughs has been declining then people would stop wasting money, time and resources on doing it.

I assumed, that is, there was some kind of relationship between being funded to the tune of hundreds of billions of dollars per year and actually achieving something.

How mistaken I was.


The point I missed was that the tenfold expansion in medical research funding and medical research personnel over recent decades meant not that this implied that this vast conglomeration of useless parasites would be cut - but exactly the opposite: that they now form a special interest group so large and so wealthy and so influential that it is impossible to cut them.


Well - ah ken noo... +


+ Reference to traditional Scottish joke - God's response to the tormented sinners in Hell who cried out 'Lord, we didnae ken!' [we didn't know] was: 'Well, ye ken noo'. [you know now...] 



dearieme said...

I imagine this is one of the mechanisms that, applied all over the economy, will return us to a Dark Age - the fakecharities, the fakescientists, the civil servants, the teachers, etc, etc.

It's my boast that having spent most of my career teaching engineering and science in good universities, at least I didn't do much harm. And in the case of one of my bits of software, I saved a company enough money that it would have, in their estimation, more than paid for my whole academic career, teaching, research, the lot. Hell, they even gifted me an unfettered research fund by way of thanks. How many fake medical researchers it would also have paid for, God knows.

Boethius said...

Do you think the death rate plateau is related to diminishing returns in medical research or we are approaching the biological limits of medicine?

Bruce Charlton said...

@d - I have had two or three good ideas/ discoveries in my research career - at least, so I suppose; but as they have had no effect whatsoever I don't really know - and therefore I am certainly myself one of the parasites at least as regards my salary.

(I haven't had a research grant since 1987 - having applied 5 times to get money to look for adrenal cortical nerves in human beings, drawn a blank, and done it anyway without external funding. I never wasted time/ energy/ enthusiasm applying for grants after that.)


@Boethius - Neither of the above. There is a perfect storm of factors reducing innovation overall. But people are not even trying to make real and useful discoveries (that is the title of my latest book, on the corruption of science). People are 'doing research' not trying to solve problems. In fact, in medicine, overall, things are getting worse - with Big Pharma killing off known useful drugs in favour of new actively-harmful agents.

It is a total mess!

dearieme said...

Anent dud medical research.

Bruce Charlton said...

@d article says "As a result, years and billions of dollars have been wasted following false leads, they say."

Why do they say 'wasted' - these grants will have built financially rewarding and prestigious careers for hundreds of pseudo-scientists who might otherwise have been recognized as lying mediocrites...

Anonymous said...

At least here in Sweden there are signs of the commercial side of the bubble* bursting, with several major research facilities closing after essentially producing nothing of value for several decades.