Sunday, March 31, 2013

The Hero Scientist...will likely never exist!

Great article and cover story of Time Magazine in Britain (April 1st issue)

I found this article to be very interesting and applies to the situation we are now facing re the approach  which should be undertaken to get at the heart of the question:  What are the long term systemic effects of the MoM hips?

I have been a long time believer that uncovering BIG medical problems like cancer for example, will never be solved by physicians working solo.  This article is about the need for collaboration in facing medical issues which involve  physicians and researchers from other disciplines to address problems.  I believe that to be the case with MoM issues, epically those that are long term and especially those that involve cancer claims.  I see no way in which the orthopedic community will get to the bottom of any of this without a collaborative cross disciplinary team consisting of cancer specialists, metal specialists, pathologists in collaboration with the orthopedic research community.

The highlights below are important to keep in mind for those patients who are advocating for addressing solutions to uncovering the long term  MoM issues.  While this article addresses cancer, I see no reason why all of these concepts shouldn't apply to the quest to understand and clarify the systemic issues with MoM hips or, for that matter, any major medical quest to solve problems.

The medical model as it stands today is outdated and need of complete revision to encourage shorter time lines on "cures and answers to complex medical issues of the day.  Here are some highlights:

1.  The idea of a  hero scientist in a concept of the past..  That paradigm is, for the most part, gone.  "no exalted individual, no victory celebration by a sole researcher."

2.  In the cancer community, leaders are recruiting "special-forces" of sorts to address the disease...dream teams  are being  funded by a group of "investors" from the business community to attack this disease who fund generously, oversee the teams and their progress rigorously and shoot for big payoffs on a tight schedule....[Imagine that in medicine!  this is what we would call, a game changing approach to solving problems and a disruptive one at that vs the old approach in medical research of the lead "alpha dog" researcher who commands a majority of the dollars and attribution.  This approach involves dispelling egos and working as a team where the experts are equal contributors in their respective discipline.]

3.  No more silos..."you no longer do science and medicine differently".... this approach "brings science and medicine together."

4.  So what does it take to transform the way and entire medical ecosystem functions?

  • large funders (corporations)
  • unignorable amounts of money
  • best and most talented people
  • generous funding
  • oversight by Nobel science level committee people to "monitor the progress that can sometimes  make top scientists feel like grad students."  there is a need for oversight by objective onlookers who can change team members if the progress isn't being made.
  • big payoffs for the patients
  • tight schedules...in this case...3 years of initial funding.
5.  What does this mean for investigators that are asked to join these teams?
  • changes in the way careers are developed, data is shared and credit on the team is shared....[I can't tell you how often I have thought having such a team in place to address this medical issue re the MoM hips.]
  • less independent fiefs pursing their own goals
  • more collaborators that can be teamed up to answer common and complex questions
  • building dream teams of cross disciplinary cross institutional research teams.,
  • judgement is rendered by patient outcomes not by the numbers of research papers published.
  • In the cancer arena, the physcians/researchers are judged only by the following:  did you reduce mortality of the population you are studying?...cancer in the case of this article.
6.  How has this approach worked so far since the SU2C initiative began funding in this manner?

 The results have been nothing short of "dazzling scientific  and technological advances"...with drugs being delivered in "lightening speed" by employing these types of teams.

7.  What type of participants are on the teams and leading them?

Players who are all at the top of their game from the top institutions in medical research...Harvard (Dana Farber), MD Anderson, Vanderbilt, Columbia, Sloan- Kettering..

8.  How do the scientist/research physicians view this disruptive model after 3 years?

" The traditional researcher, sitting alone or with a couple of post docs in a lab somewhere working on that eureka moment will always have a nice in the new ecosystem.  'We still need people looking under rocks' says Dr William Nelson, Director of the Johns Hopkins Cancer Center, and a vice Chariman of SU2Cs scientific advisory board, and a successful rock looker underer, having discovered the most common genome alteration in prostate cancer.  But the shift to team science is permanent.  When he first considered SU2C's team structure, Drebin was skeptical. 'My feeling was that this was a naivete on the part of the excutives' he says.  'You can make a movie that way  but not science.  I take that back.'

Its a new script for an old plot and there is still a lot to be written as researchers learn more.......

I do hope there are patients becoming involved in thinking about what type of collaborations need to be forged in order to get answers to important medical questions we all have.  I agree with the the premise of the approach used here....there is no one person who can address this issue.

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