Chapter II
The Biomedical Frontier
A revolution is in play in the biomedical sciences. The space of the possible is expanding faster than the machinery for delivering it, and that mismatch, not any shortage of discovery, is the defining problem of the coming decades.
Recommendation
Recommendation. Empower physicians to drive discovery and leverage clinical insight into innovation of frontier theranostic technologies. Recognize the physician as uniquely positioned to address the web of structural drivers responsible for the three translational gaps (Gap of Conversion: mechanism understood but never made into anything a clinician can use; Gap of Aggregation: interventions that work for individuals but never become policy that works for populations; Gap of Transfer; innovations that fail to globalize), understanding that as the space of possible theranostics expands, these gaps widen faster still. Make bioethical and regulatory fluency a core competency brought forward to the point of initial design, in the face of bioethically complex interventions with profound implications for humankind. Fund validation as a first-class scientific activity, with careers attached to it.
Sections
- 01New BiologiesTwo things are happening at once in the life sciences, and they compound each other: a deepening of mechanism, as our grasp of how living systems work resolves at ever finer spatiotemporal scale, and a dramatic extension of technical power.Exhibit 2.1
- 02Theranostics: Near-Term to VisionaryAs the space of potential theranostics vastly expands, the clinical translational gap widens even faster. The physician should be positioned to help fill that gap, which requires fluency in what is coming.Exhibit 2.21 definition
- 03Editing Germline, Deciphering Brain, Extending Lifespan, Conquering SpaceFour frontier ambitions warrant separate treatment. Each is transformative, and each is double-edged in a way the others are not.
- 04The Discovery Process: AI as Investigative ToolWhat is being discovered is changing. How biomedical discovery is itself instantiated is changing faster, and the second of the two is the more consequential.
- 05The Translational GapTranslational gaps are one of the great opportunities of the coming decades, and one of the places where the physician's absence costs most.Exhibit 2.3Exhibit 2.41 definitionMoonshots