Agile, intuitive, creative and cost effective solutions must also be tested to objectively demonstrate that they work. However seasoned medical innovators recognise that most research grant applications will fail. It has also been demonstrated that many funded medical research projects fail to deliver anything of real value or to solve the problem they set out to address. While no reasonable person would expect every attempt at problem solving to succeed, it’s clear that winning a grant is no guarantee that you’ve got a winning idea on your hands. Far from it.
The anatomy of a grant application is a pyramidal structure. At the base is months of preparation, team building, strategising and review of what has already been done in that field. Conservatively grant writing takes twelve to eighteen months. Applicants consider who might be reviewing the application. Not only what organisation, but what individuals might be involved. Their likes, dislikes and prejudices. This is no different from any commercial business venture, the pitch has to take account of the competition and the people who make decisions about the future of the idea in order to have the best chance of succeeding.
What is thought to be appropriate might be based on what the grant committee is familiar with. No point proposing to demonstrate that stomach ulcers are caused by bacteria when a committee knows that they are caused by stress. When distributing limited resources risk must be reduced. In these circumstances it feels safer not to encourage innovation. Paradoxically a system that should foster innovation often ends up backing what’s already established.
Once funded, the project must be completed. Most timelines from funding to completion are between eighteen months and three years. Often at this stage the team is smaller to comply with the budget constraints from the funder. The team will produce a report and draft papers for publication in peer reviewed journals.
The publication process involves negotiating another committee. The goal is to enlighten and inform people who may think they already know the answer to the question you are addressing. What’s more, there is a significant risk that if you say things that are unfamiliar, or propose an idea that goes against the conventional wisdom you may be asked to tone it down, or discover that the journal ‘receives far more papers than they are able to publish’. Successful publication can take a year or even longer.
The grant based research model is not designed to produce agile, intuitive, creative and cost effective solutions. I’m sure that this isn’t unique to medicine.
How do you generate and then demonstrate the validity of solutions in your field?
Which ideas would never have seen the light of day if innovators were not tenacious and inspired leaders?
What problems have you identified and how have you negotiated with people who think they already know the solution, or those who feel they might somehow lose from your ideas?
Is it possible to be innovative in a world where convention and process trumps problem solving and agility?
And in a world of shrinking budgets isn’t it time that we reviewed the opportunity cost of this process?