Research Advocate: Through the Looking Glass to the Future

Making the Vision a Reality

Implementing the next-generation tools described above has the potential to improve patient care and advance medical practice significantly. These improvements, however, will require changes on many levels. The new complexity inherent in clinical and research practice will demand equally complex education and training for physicians and translational scientists: Physicians will learn more of the basic research sciences, with special concentration on medical genetics, and scientists will be exposed to a greater range of clinical issues and disease pathobiology. Simulation and computational modeling are expected to receive greater emphasis. The new and expanded roles of bioethics and HIPAA regulations necessitated by the overarching role of clinical genomics will add a new level of complexity to clinical research.

As translational research comes of age, its infrastructure needs will change, expand, and become more complex: Biomedical research has begun a transition to multidisciplinary teams that may include physicians of several specialties, bench scientists, bioengineers, ethicists, pharmacologists, geneticists, computer programmers, and others to develop, test, and plan implementation for new tools and techniques. An important step in this direction has been taken by the NIH with its decision to replace the General Clinical Research Centers (GCRCs) with the highly sought-after Clinical and Translational Science Institutes (CTSIs). In the current economic climate, however, it would be surprising if federal research funding is increased by any significant amount to permit accelerated funding of the CTSIs and clinical research. Industry-sponsored research, therefore, may become a more important source of support.

A final product of all these changes may not be completely welcome to everyone: Otolaryngology and other surgical specialties can anticipate that as more nonsurgical treatment options are developed and become widely available, the practice profiles of those specialties will change. Already, for example, the use of stereotactic radiosurgery to treat vestibular schwannomas and other intracranial conditions is reducing the necessity for craniotomies.

Osler was correct: The future is today, and each today will bring a bright future and a new age of medicine closer.

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