Why Great Universities With Academic Health Centers Must Be Research Leaders

The importance of basing decisions on research data is evident to everyone in the world today as we continue to confront coronavirus on a global scale. The world is learning that we need discovery if we want meaningful improvements in the health and well-being of society. The importance of research has been demonstrated throughout history. 

In 1827, the predominant method of treating pneumonia was bloodletting with leeches; 33 million leeches were imported to Paris alone for medical treatment. It was the clinical standard of care at the time and 50% of patients who received the treatment for pneumonia survived. But in 1835, Pierre Charles Alexandre Louis upended the practice. Louis, a French physician, clinician and pathologist at l'Hôpital de la Charité (Charity Hospital) in Paris, penned a now-famous clinical treatise about leech use. In his treatise, Louis observed that if bloodletting occurred within one to three days of hospital admission, 50% of the patients survived; if it was delayed four to six days, 65% of the patients survived; and if they didn't get around to bleeding the patients until seven to nine days 85% of them survived. Proven an ineffective treatment method, by 1837 the importation of leeches to Paris dropped to 7,000. 

I am often reminded of a famous but anonymous quote about clinical learning that goes like this, "Half of what I am going to tell you about treating patients will eventually be proven wrong; the problem is I don't know which half." This simple statement underscores the fact that new discoveries are constant. That's the nature and evolution of knowledge. Nothing advances without knowledge, and all knowledge comes from research. 

Research is methodical and it always involves communication. Broadly defined, it is a systematic process of critical inquiry leading to valid propositions and conclusions that are communicated to interested others. There are many ways of arriving at valid propositional knowledge. But while learning can occur at an individual intuitive level, research requires the dissemination and transmission of these understandings in the public domain so that knowledge can be put into action. 

Looking at it from an academic health center perspective, what new information would you teach if you are not committed to discovery through research? Without research there would be no new knowledge to pass on to learners and, sadly, nothing new to offer patients. That's why our nation's greatest universities with academic health centers are dedicated to the generation of new knowledge. And research is an interdisciplinary activity, using concepts and methods from the arts and humanities – like philosophy and sociology – as well as science and quantitative medicine. Top-tier academic health care institutions, like UCSF, have balanced National Institutes of Health (NIH) portfolios that include fundamental science, translational research, broad-based clinical trials, and implementation science. Embracing the concepts of cross-disciplinary critical inquiry and public knowledge dissemination are what take academic health centers from good to great. 

Research grows out of the need to solve problems by questioning conventional wisdom and taken-for-granted assumptions – just like Dr. Louis did in 1835. And health outcomes are improved through scientific study and dissemination of knowledge. The net result is that the entire population has the potential to benefit … even if only half of what we think we know is correct. 

Here's to a new academic year that's rich in scientific discovery.