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...]