Despite significant growth in the National Institutes of Health budget, a recent study by the Commonwealth Fund Task Force on Academic Health Centers has found that medical schools and teaching hospitals in highly competitive markets are experiencing difficulty conducting research and securing federal research grants.
The study, "Market Forces and Unsponsored Research in Academic Health Centers," which appeared in the March 24, 1999, issue of The Journal of the American Medical Association, shows that academic health centers (AHCs) in markets with high managed care enrollment have fewer discretionary funds available to support research than those in other markets.
The study's lead author, Joel S. Weissman, Ph.D., of Massachusetts General Hospital, reports that internal funding for research is more than twice as high for AHCs in less competitive markets than for AHCs in more competitive markets. Weissman indicates that this discrepancy is cause for concern, given that many researchers are highly dependent on internal sources of funding for their work.
More than 2,000 medical school faculty were surveyed to assess how many rely on unsponsored funds—financing not provided by the federal government or private industry—to conduct research. Unspon-sored research was defined as research paid for with surplus clinical revenues, funds from group practices, or unexpended grant funds, or research dependent on the uncompensated time of individual researchers.
Unsponsored research plays an important role in the investigative process by developing nascent ideas into more fully developed proposals that can lead to external support for published articles or patented products. Study findings suggest that market pressures created by managed care may be limiting AHCs' ability to continue to fund this public good. The authors conclude by calling for debate on the social desirability of relying on clinical income to perform biomedical research.
Facts and Figures
- In 1996, 72 percent of medical school faculty performed unsponsored re-search. Forty-three percent of faculty relied on institutional funding, such as clinical subsidies, for some of their research, while 55 percent funded their research through their own clinical income or by working extra uncompensated hours.
- Internal funding for research as a proportion of total funding was 6.1 percent for AHCs in less competitive markets, compared with 2.5 percent for those in highly competitive markets-which have fewer institutional funds available to them.
- Nearly four-fifths of faculty surveyed reported that their unsponsored research had led to published articles, while 12 to 13 percent reported that it had led to a patent application.