Tactics

Editorial Tactics One solid premise of bioscience is that success in research requires money. This is not an unfamiliar premise; money and success are related issues. We all know important research is expensive today. Undeniably, basic medical research has brought about amazing improvements in practical therapeutic medicine, and we expect even greater benefits in the future. Progress through research is wholly necessary to the continued success and prestige of all independent medical specialties, including dermatology. Properly, then, we might direct our managerial attention to the grand total of funds, spent recently, on research in dermatology, and to the achievements paid for with these funds. Can we demonstrate that institutional money is a requirement for success in dermatology research? Are the results well worth the expenditure? Is the best research done in those departments which most regularly receive the very large grants? Are research money and prestige a good index to those institutions which provide the best training in research? Probably, yes. The objective of such crass, even unsettling, questions and answers is to open a realistic and lively discussion of how large sums of money, designated for research, might best be managed so that dermatology would be enhanced. One federal agency, the National Institutes of Health (NIH), will spend over $3 billion in 1980 to stimulate medical research and development. About 60% of those dollars will be spent at colleges and universities to support the most promising research projects and personnel. Almost $20 million will be spent on topics concerned directly with dermatologic diseases, and about $11 million will be spent in dermatology departments. Not surprisingly, NIH is inclined to spend the money where excellence in science is well established. NIH always intends to invest in university research centers and research projects which are exceptionally well planned and managed. Success in science, 0190-9622/811020231 +02$00.20/0 © 1981 Am Acad Derrnatol

year after year, has been rewarded with money; however, today, continued success in research demands better management, most astute scientific foresight, and much more sophisticated political involvement than ever before. If money is to become available in amounts large enough to reward all meritorious research projects, then all advocates of the NIH must improve the relationships with Congress, answer more complex problems, and begin to justify larger appropriations. Success in research involves continuous political justification, which, in modern times, increasingly involves our entire specialty in the careful preparation of data, organization of effort, and a new determination to succeed. Would it help us to know and discuss all the facts? For instance, where is the most successful, the best-funded research carried out? Who are our most productive scientists? How might we more often encourage them or assist them? In discussions in the legislature or at the NIH, might we all seem better informed and more sophisticated if we understood our outstanding historical successes in dermatologic research? Should we speak fluently, but precisely, about the benefits of recent research to the care of our patients? Should we know the characteristics of those research centers which are currently most productive? Undoubtedly so. Furthermore, the impression we make together in the U.S. Congress will be important. With proper preparation and an organized effort, we can not only protect a reasonable share of existing funds, but we may also be able to justify substantial increases. A reasonable, if ambitious, plan might aim to double the total funds spent for research in dermatology over the next 10 to 12 years. A lesser goal, I suggest, would tend to imply too little effort, and over the long term would allow our specialty to be embarrassingly' 'outplanned, outmanaged, and outargued. " The first step is to begin an

231

232

Journal of the American Academy of Dermatology

Anderson

Table I. Source of funds, purpose of funds, and grantee Several methods of ranking are customary according to success in obtaining research funding from federal authorities. The simplest is by total funds, as shown here. The total beneficial and scholarly environment at a university favoring innovative science may be reflected in the "total federal $$, all life sciences by university" (column 1), but a more sensitive index to innovativeness at the regional or state medical meetings would be "aU NIH $$ biomedicine by state" (column 2). The likely mood of the chairman of dermatology at budget time in regard to research is shown as "all NIH $$ biomedicine by departments of dermatology" (column 3) . All rankings are in decreasing order according to dollar amounts, and the figures are for both 1978 and 1979 fiscal years , by primary citation only, and reflecting money allocated but not spent.

ss,

Tota l federal all life sciences by university I

Rank:

ss

All NIH $$ biomedicine by state"

All NIH biomedicine by dep artments of dermatology'

I 2

University of Washington Johns Hopkins Univ ersi ty

New York Californ ia

Yale University University of California-

3

Uni versity of CaliforniaSF Harvard University University of Minnesota University of Wisconsin

Massachusetts

Temple University

Pennsylvania Texas

Columbia University Stanford University

Illinois Maryland North Carolina

Johns Hopkins University Duke University University of Miami

Connecticut Washington

New York University Harvard University

Ohio Missouri

University of Oregon Washington University (MO)

SF 4

5 6

9 10

Yale University University of Pennsylvania Stanford University University of California-

11 12

Columbia University New York University

7 8

LA

I. Academic Scie nce, Research and Development Funds, Fiscal Year 1978. Detailed Statistical Tables- NSF Publication 79-320 (a statistical listing of universitie s with federal support for life sciences).

2. Research Awards Index , Fiscal Year t979. U.S. Department of Health , Education, and Welfare. Public Health Service, NIH, Division of Research Grants , Bethesda. MD 20205 . NIH Publicat ion 80·200. 3. This selection was made by computer review using index terms of the " Computer Retrieval Information About Science Projects" (CRISP) System of the Division of Research Grants, NIH. Final selection was made in the Arthritis-Musculoskeletal and Skin Diseases Program of NIAMDD.

outspoken candid discussion, a constru ctive comparative study, a more realistic analysis of our research enterprises than we have before. Some of this analysis could appear in the pages of the JOURNAL. As a gentle opening gesture I include Table I, which shows three possible rank-

ings of states, universities, and our dermatology departments in order, according to federal financial support to research. May we begin? Philip C. Anderson, M.D. Columbia, MO