In my last post I talked about a major problem I see in scientific research right now: the set of pressures and incentives on scientific researchers that promotes publication and grant funding at the expense of real progress that can meaningfully change health care. In a nod to Clayton Christensen’s sustaining vs. disruptive technology paradigm that explains many of the phenomena we see in products and services (such as health care), I use the terms ‘sustaining research’ and ‘disruptive research’ to distinguish between two fundamentally different approaches to life science discovery.
Disruptive research accomplishes what we would like research to accomplish: to challenge the dominant paradigm, transform the way we perceive, classify, and treat certain diseases, and run against conventional thinking. The net effect of disruptive research is to shift a particular disease along the blue arrow in our familiar diagram: to bring a condition out of the realm of intuitive medicine, into empirical and ultimately precision medicine. Sustaining research, on the other hand, shifts diseases along the red line, adding publication upon publication about a particular topic while leaving the condition squarely in the realm of intuitive medicine and stuck on the red trajectory.
In my opinion, as outlined in my previous post, the current problem with academic science is that disruptive research programs are too perilous for young scientists, at the peak creativity point of their careers, to risk engaging in without fear of failure of losing their grant funding and/or faculty position. This had partly to do with the conservative nature of grant funding, but mostly because (by definition) disruptive science is all about taking risks and accepting a high experimental failure rate. (That’s not really something that can be changed: if you think you’re doing disruptive science, but most of your experiments seem to succeed, then either you’re not really disrupting anything or you’ve been incredibly lucky.) As mentioned before, pursuing a disruptive research program as a junior researcher is like mortgaging your house to play Powerball: you might win, but the odds say you’ll lose. Consequentially, we all turn to sustaining research, and slog through a few decades of trench warfare where we end up with a healthy C.V. full of publications but having made no real impact on health care.
So my question I pose openly to everyone is this: how can we hack life science research to get more disruptive science, and in turn better health care?
To address this question, today I’m only going to think about things that can done within the existing academic structure. I’ll save external disruption (from outside companies, individual entrepreneurs, or other non-traditional sources) for a post another day. If we can’t count on change from the funding agencies or from the journal editors (which is out of the scope of this blog post, and not a very hack-ish solution anyway), what have we got to work with? The next obvious candidates are the universities that foster the actual academic research being done.
One way that university faculties or departments could greatly encourage disruptive research would be to strongly increase accessibility to bridge funding. Traditionally, bridge funding is money that is allocated for a rainy day when a researcher loses their grant funding (if it expires and they fail to secure a renewal, for example) and the lab would have to either shut down or scale down into hibernation mode if no other money can be found. If a department decided to hack a solution to increase disruptive research, one solution might be to allocate a considerable chunk of money to a fund that researchers apply for at the same time as applying for traditional grant funding, which I call ‘visionary funding’. The application rules are as follows: you must use the exact same grant application you submitted for federal funding, but without the preliminary data. You will get funding from this pot if a) your original grant proposal is rejected from the CIHR, NIH or whatever other funding agency, and b) your proposal is strong enough, solely on the basis of its creative ideas and potentially disruptive outcomes, to merit visionary funding. Practically speaking, this won’t be nearly as much money as a funded grant would have been, but it’s better than the situation we have now where researchers (particularly junior researchers) have no choice but to be funded or else risk losing their entire labs.
That sounds nice and all, but of course there’s a catch – all of that visionary funding money has to come from somewhere. My answer, however, would not be popular among department chairs: you have to hire fewer faculty members, and use those savings to promote disruptive research among your existing faculty. You might immediately cry foul: this would be catastrophic for research output of the department! How can we possibly compete with other universities with fewer PhDs on staff? Well, that first statement is true- research output, as measured by publications, would probably decrease. But the effect here will be to decrease sustaining research as you promote disruptive research. You can’t have your cake and eat it too: there’s no point in trying to promote disruptive research if you’re not willing to sacrifice the sustaining stuff that up until now has been the main currency driving your department budget. The end result would be fewer researchers in the department, producing less output on a papers-per-year basis, but whose contributions will be far more disruptive and will ultimately impact health care more. It is up to the department to capitalize on their real, actionable impact on health care in order to secure more money to feed the cycle of disruptive research further.
I think the biggest issue with this approach is it requires some very visible sacrifice on the part of faculty administrations, seriously upending their traditional strategy of ‘get bigger, get funding’ without promising any direct return. So, barring some change in the near future, I can’t see this happening on departments’ own initiative. If this change does occur, it will have to be due to pressure from faculty members who want ways to take chances and do disruptive research- and who want a department that encourages that sort of behaviour. This sort of change could also be promoted by universities, but at a lower level- at the level of graduate and postdoctoral training.
If you want to encourage disruptive research tomorrow, it would be a good idea to look at where it currently takes place today: often at the intersection between two fields that do not typically collaborate. Some of the best disruptive ideas take root when scientists are dropped outside their comfort zone into a completely unfamiliar field, learn the basic landscape, and then realize, ‘Hey- that problem you guys have is very similar to a problem we figured out a few years ago- maybe try looking at it this other way’, or ‘This technology that they have in this field is the perfect tool to address problem X that I’d been working on before’, or even occasionally ‘Wow, there is a direct link between X and Y that somehow no one has noticed before, which completely changes the way I view X’. That’s where the magic happens. So how do you increase the odds of this happening?
With graduate students, this shouldn’t be too difficult. Just add a requirement to every Master’s and PhD program that you must take at least 2 courses completely outside of your field in order to graduate. Outside your field can’t mean ‘well, I study this kind of brain imaging, so I’m going to take a course in this other kind of brain imaging’- that course needs to be something like, kidney disease. Or if you’re studying kidney disease, maybe take a course in addiction psychiatry. Whatever you find interesting. Of course, simply changing grad student requirements isn’t that tough a change to implement, because after all they’re grad students, so you can just tell them to stop complaining and get back to work. If you want to really foster cross-disciplinary collaboration, you have to do something with postdocs.
So, here’s my hack solution to promote disruptive research in the near future. In many labs, postdocs are the true drivers of research in that they’re the ones who do a lot of the actual bench work, actually write the papers, and actually put together a lot of the funding applications (if not the large grants, at least a lot of smaller ones for their own careers). They’re also relatively young, hungry for a faculty position, and looking to get an edge. Imagine if a department came out with the following statement: We are allocating some money for use as postdoc fellowship funding. However, this money will ONLY be given out if your lab hires a postdoc who did their PhD in a unrelated field and who has a completely different background and skillset than anyone currently in your research group. Imagine the consequences of that: faculty members will be happy to take postdocs from different fields if the department pays for them. You’re not going to have a shortage of applicants, because the job market is so bad for PhD graduates right now that you’ll still get your pick of several supremely qualified people. The postdoc, in turn, will have a huge advantage in applying for faculty positions: they’ll be ‘that person who knows about both X (their PhD work) and Y (their postdoc work)’, rather than simply ‘One of those countless people who did both their PhD and postdoc in X and are now competing with everybody else for the same faculty positions’. When these postdocs mature and become faculty members, not only will their experience in cross-disciplinary learning have set them up to do disruptive research, but their relatively unique position as ‘Expert in X and Y’ will put them in a better bargaining position to handle the risks of a disruptive of research program. Those are the kind of researchers who could pressure their department into setting up something like the visionary fund I described earlier.
Admittedly, this approach won’t directly solve the pressures I outlined in my previous post- there would still be the same competition for grants, the same need to publish, and the same forces pushing towards sustaining research trench warfare. But hopefully this strategy might lead towards a more bottom-up solution, where individual researchers are both a bit more motivated and empowered to put forth a disruptive research plan, rather than a top-down approach full of artificial incentives that don’t really make sense. In a future post, I’ll think about some hack solutions for research that are external to the academic research environment- pharma companies, medical device makers, and possibly individual entrepreneurs- and see if anything there might synergize with this approach.