Re: Same old, same old

On Apr 3, 1:53 pm, pas...@xxxxxxxxxxxxxxxxx (Peter Ashby) wrote:
Lance <LanceG...@xxxxxxxxx> wrote:
On Apr 2, 2:10 pm, pas...@xxxxxxxxxxxxxxxxx (Peter Ashby) wrote:
Lance <LanceG...@xxxxxxxxx> wrote:
The curious clinician is becoming increasingly rare. Medicine and
science have become so complicated that it is almost impossible for
one person to be an expert at both. Researchers tend to take a
discovery from the lab and apply it to patients; the reverse trip is
more and more uncommon. More often than not, someone makes an
interesting discovery in the lab and then tries to find a clinical
application. There is little chance, much less financing, for the wild
idea that might prove revolutionary.

The world is replete with wild ideas. The author makes no
reccommendations as to how we discern the wild idea likely to lead to
something from the wild idea that seems just as crackpot and indeed is.
This basically harks back to a supposed golden age when heroic
individuals broke the mould. Like Linus Pauling and high dose VitC
perhaps?

This situation is not helped by the incentives we give to young cancer
researchers but not to experienced clinicians who want to test a
hypothesis developed over years of treating patients. It is difficult
indeed to obtain a grant to do research if you haven't spent your
career in the laboratory. As the baby boomer generation of doctors
approaches retirement, we should harness their experience and wild
ideas by offering training in science or partnering them with younger
research colleagues. Otherwise we risk inventing and discovering
without reference to actually helping cancer patients.

And here she finally identifies the problem, medics are not scientists
and are not educated to be and to do science. Except now they are,
increasingly in the UK to attain consultant status a PhD is seen as more
desireable than an MD. All the clinicians doing PhDs I have met have
been doing them for this very reason.

Another aspect of the problem is our peer review system for financing
research. It works well at eliminating poor investments, but it
squelches innovation and fosters the old boy network. Organizations
that give out "innovator" and "pioneer" awards claim to want to
support new ideas but end up giving money to better ways of doing the
same thing. And our academic and research institutions reward projects
with clearly defined objectives that have a good chance of quickly
leading to publications and tenure. If you have a wild idea or a
completely new paradigm, forget about it.

Or gradually aquire sufficient evidence in its favour, instead of just
having the idea and expecting it to be funded. And again how do you
discriminate? funding all the wild ideas would cost a fortune.

And places for wild ideas do exist. The National Institue for Medical
Research in London, run by the MRC is a blue sky thinking place, quite
deliberately. Researchers are given five years of money to what they
want with, after five years their progress is assessed and they are
given a further five years. Some may get warnings and if after 10years
they have not delivered, out they go. It is a wonderful place to have a
bright idea, I know I used to work there.

Cancer of the cervix is one of the few cancers where we have been able
to break the mold. We have moved from the Pap smear, which merely
discovers abnormal cells, to a vaccine that can prevent the resulting
cancer by protecting women against the virus strains that cause it.

Cervical cancer is also one of the few cancers where the a viral cause
has been identified. It is therefore hardly a Nobel prize winning idea
to tackle it with a vaccine. In fact its a simple no brainer.

Yes a no brainer. But pity the poor writer who is trying to urge
people to have new ideas and can only use old ones as examples.

Indeed and bad ones at that. The H. pylori example is also a hoary old
urban myth. The real story is the two clinicians had proved it to their
satisfaction and thought the necessary experiments and controls to
convince other people beneath them. Science whitheld judgement until
they had done the necessary, once they had it was accepted. Now it turns
out that getting rid of H. pylori might not be a good idea. It is more a
case of a beneficial commensal going haywire in some than a malign
invader. We therefore need a better understanding of the true causes of
ulcers as an interaction between H. pylori and the stomach environment
rather than the rather blunt approach of removing H. pylori.

Peter

--
Add my middle initial to email me. It has become attached to a countrywww.the-brights.net

Yes I read that. Thanks for reminding me.

However the point remains that the journalist may be right to call for
more innovation even if he or she is incapable of much imagination or
of discerning genuine innovation.

Lance

.

Relevant Pages

  • Re: Same old, same old
    ... discovery from the lab and apply it to patients; ... There is little chance, much less financing, for the wild ... ideas by offering training in science or partnering them with younger ... All the clinicians doing PhDs I have met have ...
    (uk.philosophy.humanism)
  • Re: Same old, same old
    ... discovery from the lab and apply it to patients; ... The world is replete with wild ideas. ... ideas by offering training in science or partnering them with younger ... cancer by protecting women against the virus strains that cause it. ...
    (uk.philosophy.humanism)
  • Re: Same old, same old
    ... The world is replete with wild ideas. ... ideas by offering training in science or partnering them with younger ... cancer by protecting women against the virus strains that cause it. ... out that getting rid of H. pylori might not be a good idea. ...
    (uk.philosophy.humanism)
  • Re: Same old, same old
    ... There is little chance, much less financing, for the wild ... ideas by offering training in science or partnering them with younger ... All the clinicians doing PhDs I have met have ... out that getting rid of H. pylori might not be a good idea. ...
    (uk.philosophy.humanism)
  • Re: Same old, same old
    ... discovery from the lab and apply it to patients; ... The world is replete with wild ideas. ... ideas by offering training in science or partnering them with younger ... cancer by protecting women against the virus strains that cause it. ...
    (uk.philosophy.humanism)
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