I’ve been dreaming a lot lately about a fictional world where the academic biomedical center and the biotechnology-pharmaceutical complex are one and the same. In this world, there are no more tenured professors or grant applications or surrendering your principles to predatory publishers. Instead, there are just clinicians and immunologists and cell biologists and biomedical engineers and data scientists --- all working together to develop new drugs and treatments.
I imagine an early career instructor, unburdened from the stress of a system that seemingly values money more than ideas, starting their own research lab. They get their research package from smaller biotech industries. These companies, using dollars they would have otherwise paid to expensive consultants, are eager to try these young minds out - for high risk/high reward work (in the companies’ area of interest of course). Without the pressures of showing the money (to everyone they know), these instructors are left with time to teach the next generation – improving the workforce for industry. If things don’t work out for our early career scientist on the creative front (not everything works, even in this fantasy world), they have the option to pursue more process-oriented and more established niches: translational work bringing late-stage discoveries into the clinic, navigating regulatory hurdles, performing immune correlative studies for clinical trials. The (increasingly benefit-less) tenure system is replaced here by a placement system of sorts. You get to try your luck in the crazy ideas department or you get to settle your discipline and meticulousness in the process development department.
I imagine these clinical trials being more unified, with standards followed academia/industry-wide. No more DIY potency assays, or coming up with definitions of “response” to maximize publication. (No endless panel discussions too, that aim to foster dialogue between the two spheres --- there is just one sector). Clinical trials are streamlined and guided by experienced hands; they are infused with ideas and monitored by eager young minds. There are no internal murmurs of how people simply spun a story to get published. The story is there for all to see.
I imagine no false divisions between related professionals. Work-life balance is happily, wonderfully the same for everyone. No more surveys come out of Nature highlighting the stark contrast in job satisfaction between people who work in industry and people who slave away in academia.
In this world, funding for research is centralized. The government still subsidizes research, but it is happy to do so because it gets less expensive drugs in return. This is in contrast to the current model, where government funding for academic research leads to novel biologics that are then manufactured by industry in a more expensive way, increasing prices for patients. Indeed, David Mitchell, Saad Kenderian and S. Vincent Rajkumar argue in STAT News that letting academic medical centers make cell therapy products (CAR T) for example, would end up saving billions, which can be passed on to consumers. A white paper by the World Medical Innovation Forum highlight the already important role academic medical centers play in several stages of the drug pipeline.
In this world, journal clubs still exist, but are not simply limited to ivory tower discussions, but extend to practical considerations of profit margins and quarterly earnings reports. In this world, there is no factory for unnecessarily churning out advanced degrees to get access to less expensive labor. Knowledge and skills and expertise are available to all, well-paid, employees.
In this world, the academic who prefers creating a world of ideas is not outshone by savvier colleagues that are able to sell someone else’s ideas. That’s because there’s a place for each of them, as each perform a critical role in the enterprise.
There is one major downside: There may be less room in this world for the high priced middlemen, though – we all know who they are. The ones with the titles that don’t communicate what they do, the ones who only communicate through buzzwords bereft of science (or industry, for that matter). I’m not too worried – I suspect there are more than a million other places that need these anyway.
When academia and industry work as one, who knows what that will provide the rest of us? We can go from researching cures to figuring out how to thrive past a hundred years old more quickly.
I know it won't be easy, but I think it's worth it. We need to find ways to get our best and brightest minds working together, consistently, as one, to solve the problems that matter. We owe it to ourselves and to the future.