The Three New Pressures on Medical Research

The United States has long been known as the place to come to if you want to pursue groundbreaking research and investigatory work in the biomedical sciences. Government funding of smart, inquisitive researchers has led to numerous discoveries that have significantly impacted our improving national health status and drawn researchers from all over the world. Many vaccines, biomedical devices and treatment techniques have been discovered with the help of federal research funding. However, this funding is becoming harder to come by.

Three recent developments are reducing America’s ability to maintain its world leadership in biomedical investigation.

First, fewer research proposals are being funded. You have to be in the top 10 percent, roughly, of your peer group to even be considered for funding. Even top researchers—principle investigators (PIs)—who were funded regularly in the past are now having their proposals rejected. Funding for “advancing scientific knowledge and innovation,” a designated category by the National Institutes of Health (NIH), has continued to drop since 2010 and has not recovered in the projected FY13 budget.

Secondly, budgets are being reduced not just during the award phase (when PIs are told about the resources at their disposal) but also years into a research effort. PIs who have planned out their research effort using awarded funds can be told years into a three- or five-year award that they need to cut their budgets. This sets off the predictable scramble to rebudget and still achieve the promised research aims. Rebudgeting is both difficult and frustrating when spending has been preplanned down to the last penny.

Finally, the NIH had been supporting research faculty with salaries up to $199,700 until the end of last year. This year they reduced the salary that can be charged to grants to a maximum of $179,700.

With many medical specialists earning over $200,000 per year on average, this is a major disincentive for their continuing research activities. If salary support for biomedical investigation is reduced, the research institution or medical school will need to find an additional $20,000, plus fringe benefits, to support that same faculty member doing the same work. This puts additional pressure on medical schools, research institutes and hospitals to provide support to allow these researchers to continue their efforts. Researchers who are physicians may refocus their efforts elsewhere.

Is cutting the generation of new knowledge really the course that the United States really wants to set for itself?

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