Marker

You may wonder why doesn't your romantic idea work outside Utopia.

The answer is simple: Have you consider the number of medical school and academic staff around the world ? Even if we consider only the top 100 universities and each has 30 professors in the field of internal medicine (a severe under-estimation), there are 3000 of them. Are there sufficient number of novel treatment for them to put into their annual publication record ?

But there are ways to get around with the difficulty. And the most simple way is: We do not study new treatment - we look for new diagnostic or prognostic tools.

Oh, I'm not saying these kinds of research are not important. They are. But the overwhelming proportion of research in this area serves a different pragmatic purpose. Look, there's a new method of imaging, blood assay, or genetic test - all good and well. There are a number of ways to play around with each: we can compare it between patients with different diseases and controls, see if it helps to make a diagnosis, see if it predicts outcome, see whether it predicts some unexpected secondary outcome (the description is self-contradicting, I know), see if it changes with conventional treatment ... there are many possibilities. You don't really need something novel, and a series of related paper is often guaranteed.

And the administrators satisfied.