Tuesday, May 6, 2014

Annals of ineptitude: NIH grant planning edition

Still clearing my desktop.

The April 4th issue of Science has a ten page section up front regarding the current travails of U.S. grant-funded researchers: "Chasing the Money".

The NIH funding situation has been getting progressively worse over the past few years. Meanwhile, over the years, the NIH has kept coming up with new schemes to direct funds to new investigators in order to pump fresh blood into the system.

Now, read the following excerpt from the lead article:

  • The agency makes it easier for new investigators to get funding, for example, but it doesn't know how they fare 5 years out, when their first big grant is up for renewal. "We want to make sure we're not setting them up for failure," says Sally Rockey, NIH's deputy director for extramural research. The agency plans to start tracking these people, to gauge whether they're headed for dire straits.

Now read it again.

Note the words "plans to start." Plans. To. Start. Plans to start. Now? Now?(!) 

Two things: 1) when starting a program, it's good to think through the outcomes beforehand. Especially when your enticing people into a career and investing heavily in them. Especially when their livelihood while pursuing that career is dependent on your organization. Similarly, it's good to try to ascertain results/outcomes in as timely a fashion as possible. 2) Sally Rockey and her colleagues should read "Chasing the Money" in the April 4th edition of Science as well as the many other articles out there about the current funding environment. They might learn something. Why would these new investigators not be headed for dire straits?

File this away under the NIH subsection of government ineptitude. 

Sunday, May 4, 2014

Clearing my desktop part 2. Medicine-the ABIM piles on

Two recent articles of interest concern medicine, and specifically how burdens unrelated to patient care continue to accumulate in a cruel fashion.  I want to highlight one quotation from each article. These quotations perfectly echo my sentiments about one particular new aggravation .

The first article can be found here.  The following quotation is in regard to one new initrusion that I and many, many of my colleagues find outrageous. The American Board of Internal Medicine (ABIM) continues to ratchet up the monetary and time burden of recertification with no evidence that anyone, aside from the ABIM itself, will benefit: 

  • doctors also face board recertification in the various medical specialties that has become time-consuming, expensive, imposing and a convenient method for our specialty societies and boards to make money."

The second article--also dealing with new cruelties inflicted on physicians who would rather just be providing patient care--is here.  And here is the quotation: 

  • Almost comically, the response of medical leadership—their solution— is to call for more physician testing. In fact, the American Board of Internal Medicine (ABIM)—in its own act of hostage-taking—has decided that in addition to being tested every ten years, doctors must comply with new, costly, "two year milestones." For many physicians, if they don't comply be the end of this month, the ABIM will advertise the doctor's "lack of compliance" on their website. 
Physicians would not be up in arms about these dictates from the ABIM if there were any shred of solid evidence that they improved patient outcomes. But there isn't. There is just yet more intrusion on the schedule, budget and sanity of physicians; yet more paperwork.

Clearing my desktop part 1. Science-the broken research funding system.

I have not written here for a while. Some of the key problems with the biomedical research enterprise that I have been thinking about of late have been described by prominent scientists in widely-circulated articles. What I would have written--at least regarding the descriptions of the problems, if not the solutions--would have been redundant.

Here is an example of one of these articles (in the op-ed section of the Wall Street Journal). Regarding the authors' description of the problems with grant review, I can only say "amen."  (The article, unfortunately, may be behind the Journal's paywall.)

Here is another example. Again, regarding the overview provided and the descriptions of the problems with the current system of research funding: "amen."