Why Is Biomedical Research So Conservative?

How do scientists decide what research to do? One would like to think that they take a suitably scientific approach to this question by thinking about important problems that need to be solved, and asking which of these problems could be solved given the time and money available. But are research projects actually proposed and funded in this way, or are there other forces at work?

Particle physicists and astronomers realized decades ago that they needed to take a coordinated approach to planning so that they had accelerators and telescopes to work on. This “big science” approach involved agreeing on the long-term scientific goals in a given field and then getting the relevant funding agencies in different countries on board. This approach has been remarkably successful, as demonstrated by the recent detections of the Higgs boson and gravitational waves. But it does not always go to plan—if it did, a chemical company called Magnablend would not own the site of the abandoned Superconducting Super Collider in Texas.

But what happens in other areas of research, that tend to be organized from the bottom up rather than from the top down?

In late 2014 four prominent life scientists in the United States published a provocative essay titled “Rescuing U.S. biomedical research from its systemic flaws.”1 The essay described how two long-term trends—an ongoing increase in the number of biomedical researchers in the U.S. and an ongoing decrease in real-terms funding for the National Institutes

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