Edited by Dominique Foray
Chapter 11: Comments on Nathan Rosenberg’s ‘Critical Episodes in the Progress of Medical Innovation’
11. Comments on Nathan Rosenberg’s ‘Critical episodes in the progress of medical innovation’ Iain M. Cockburn In the past 50 years biomedical research has been both extraordinarily successful in developing our understanding of the fundamental science of living organisms and their diseases, and an extraordinary beneficiary of taxpayer largesse, particularly in the USA. Professor Rosenberg reminds us in chapter 7 – with characteristic grace and insight – of several important aspects of the development of modern biomedical science. First, the historical roots of modern molecular biology lie in the interaction between scientific disciplines, with particularly significant contributions from physics in the form of enabling ideas, technologies, methods and instruments. To paraphrase, no scientific discipline is an island unto itself, and particularly for empirical work, progress is spurred and constrained by the supply of tools and instruments that enable collection and analysis of data. The cases of X-ray crystallography, magnetic resonance imaging (MRI) and fluorescence activated cell sorting discussed by Professor Rosenberg are compelling examples of this phenomenon. Second, institutions matter, and in several significant ways. The physical co-location of individuals in places like the Cavendish Laboratory appears to have been an important factor in a number of critical discoveries. The significance of organizational norms, incentives and governance is also evident in the central role played by US academic medical centers (AMCs) in more recent scientific progress. The distinctive governance, structure and financing of AMCs continues to encourage interdisciplinary inquiry and cross-fertilization of fields, and is enabled by a high degree of flexibility...
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