Medical innovation: Could the U.S. slip?

The Washington Post's Amar Bakshi writes about the Artemis Medical Foundation, an about-to-open clinical research center in India. It's an interesting piece for two things. The first is its blunt critique of American medical research: Artemis founder Kushagra Katariya (formerly a professor at the U. of Miami) declares, “Opportunities to develop cutting edge [medical practices] are fast disappearing in…the United States."

He says that when it comes to developing a new, improved way to treat patients, he can do it “quicker, develop it better, and have the ingredients to really take it much further" than he could in the same amount of time in the U.S.

Here, he can combine his clinical practice with scientific research and technological development, all at a breakneck pace.

"Clinical research and translational research is down 70% in the U.S.," he tells me, laying out two primary explanations:

First, he blames “the lobbies, restrictions, confidentiality problems, insurance companies regulating what needs to be done, what can be done, what cannot be done…the usual ambulance chasing that occurs." In the U.S. there’s too much red tape.

Second, there’s an “inhibition of intellect coming together.” Because “provisions for funding are few and far between," there is a huge amount of “talent divided among 200 universities" that don't always collaborate.

This, in addition to "super-specialization," creates a "silo-mentality" between and within leading institutions. “Clinical applicators at the bedside” and the “researchers in the lab” are like “two parallel railway tracks that never meet” even though they’re working toward the same goal, improved patient care. In India, he says, ideas are fresh and different sectors are more amenable to being brought together to “beat the disease.”...

This sense that the funding, institutional, and reward structures for scientific research have become too conservative-- not in the political sense, but in the sense of being risk-averse, incrementalist, and overly fond of specialization-- is something I've heard in virtually every workshop I've done with scientists. It's a theme I especially hear with young scientists-- and it's strong enough to now serve as a disincentive for some of them to stay in academia or pure research.

(The article doesn't ask whether that speed is a consequence of patients bearing higher risks. An American-trained doctor working in India comments that while "India could be a cheaper option" for "routine medical procedures... one has to realize that ordinarily no one is held accountable if something goes wrong. So do it at your own risk.")

The second interesting thing in the article is Katariya's perspective on the global movement of talent. Because of low wages, there are still lots of Indian-trained doctors who leave for better-paying jobs in Europe, the Middle East, or North America. But

does Katariya stress keeping doctors in India? “No,” he says. “We want people to get experiences everywhere else that the world has to offer, but at the end of the day…we want to bring it back to India....because the local talent, the local ingredients exist to be able to create that stuff [new treatment methods] over here much faster than at a Hopkins, or Cleveland Clinic, or a Stanford or the big names you hear about in the U.S.”

This assumption that flattening the world of science-- to borrow from Tom Friedman-- will be good for everyone is one that I've heard, with greater or lesser undertones of anxiety, among senior scientists and policy people in Europe and the U.S.

Technorati Tags: science, India, medical tourism, brain circulation

Comments

[Amar C. Bakshi]

Hi Alex,

Really enjoyed reading your take on the article. Many thanks. Keep in touch!

Amar
www.washingtonpost.com/america

[Alex Soojung-Kim Pang]

Amar,

Thanks very much! Always a pleasure to recognize good work like yours. That call center piece was good, too.