Conrad Russell Y. Cruz MD PhD
Senior Editor, Telegraft
Children’s National Hospital, Washington DC
The organizational psychologist Adam Grant writes that critical thinking requires us to: “(1) Be 10% more skeptical of people you agree with—and 10% more charitable to people you disagree with; (2) Look for flaws in ideas you like—and strengths in arguments you dislike; and (3) Learn from sources that engage with competing ideas.”
In light of the potentially momentous shifts in the U.S. biomedical research landscape in 2025 based on new presidential mandates, I decided to avoid simply reciting widely accepted views among scientists (e.g., indirect costs enable institutions to allocate shared resources, support scientific discoveries by providing administrative assistance, and maintain equipment and infrastructure while ensuring regulatory compliance). Nor did I want to delve into debates over perceived negatives (e.g., some institutions negotiating indirect costs well above the 25% average, capping indirects can potentially save money – possibly redirecting it to direct research costs, increased accountability and improved efficiency are needed in research).
Instead, I reflected on how academia might address these challenges constructively while it grapples with how best to ensure that U.S. biomedical research is sufficiently funded.
Addressing Gaps in US Public Perception
Whether institutions are already providing substantial value that goes unnoticed or genuinely need to offer more tangible benefits to their communities, it is evident that public trust in universities and scientists has eroded or has become more outspoken. Historically, universities were revered by the public, and science enjoyed broad bipartisan support. However, as the scientific enterprise has expanded, there is a growing perception (justified or not) that its concrete benefits have not kept pace with its growth. To rebuild trust, scientists must prioritize addressing pressing issues that resonate with the public - problems that impact large segments of society. While not every researcher needs to focus on translational science, those who do should better align their efforts with the unique needs of their communities. Academic success should go beyond publishing papers and securing grants; it should also reflect meaningful engagement with and contributions to society. Paraphrasing our pediatric cancer advocate Gavin Lindberg: Communities want better treatments, not incremental papers. Moreover, research professors must be seen as dedicated intellectuals working in their labs rather than corporate consultants jetting around the world. Public perception matters greatly, especially in light of skyrocketing tuition fees and increasingly opaque admissions criteria that (again, justified or not) appear more focused on personality than merit or potential. Research institutions must also find ways to reduce costs and move away from operating as "luxury brands," where induced scarcity drives up demand-and prices. Increasingly being seen as elite does not help.
Involving Our Communities
The disconnect between elite universities and their surrounding communities (or at least the perception of such a disconnect) has grown over time. Academia need not remain an ivory tower; it can become a town square where ideas are exchanged freely with the public. However, public engagement must go beyond superficial measures like hiring PR teams or sending out self-congratulatory newsletters. True engagement requires listening to community concerns, responding meaningfully, and incorporating public input into institutional work. Initiatives such as community listening tours, regular Q&A sessions with local residents, or educational content (but without overt self-promotion) could bridge this gap. Higher education institutions should also embrace intellectual and cultural diversity within their missions to ensure they resonate with the communities they serve.
Reexamining Financial Flow and Efficiency
A significant portion of university income comes from NIH grants or similar government funding, supplemented by private philanthropy or endowments (for institutions fortunate enough to have them). For those lacking endowments, these seismic shifts should serve as a wake-up call to build strategic financial reserves. Advances in AI offer opportunities to streamline administrative processes and improve efficiency. Additionally, universities could explore more formalized partnerships with industry rather than allowing individual faculty members to act independently as consultants-a practice that benefits only the individual while consuming time meant for institutional research. By channeling such collaborations through the institution itself, universities could ensure they share in the financial rewards while maintaining faculty as full-time, conflict-of-effort-free employees.
To be sure, there are real threats to biomedical research out there --- threats that would require we all work together (harness that much touted team science approach). But it wouldn’t hurt to slowly chip away at what might be contributing factors to decreases in funding.
#CommunityFeature#fromtheeditors#feature4