Multidisciplinary Approaches to Biomedical Research

To the Editor: In their Commentary on a new policy framework for the biomedical research enterprise, Drs Federoff and Rubin¹ argued persuasively for reforms that could rid the research enterprise of boom-bust cycles, close funding gaps, and depoliticize interest group–driven funding decisions. The authors called for a coherent and inclusive policy advisory system that would have the support of policy makers and professional societies alike.

However, conspicuously absent from their vision of reform was any mention of the behavioral and social sciences. Anthropologists, economists, psychologists, and sociologists are as vital to a new framework for health research as their colleagues in biology, chemistry, engineering, and medicine. In 1983, Wilson described the pathway to discovery as proceeding through disciplinary consilience, stating that “Only fluency across the boundaries will provide a clear view of the world as it really is.”²

Medicine has a rich and continually developing tradition of interdisciplinary collaboration. In 1977, Engel introduced the biopsychosocial model, advocating for seeing the human body, the processes that determine health and disease, and the research enterprise from multiple scientific perspectives.³ From the early 1990s through the present, excitement over technological advancements in genomics, imaging, and other areas seems to have tempered enthusiasm in some constituencies for the importance of social and behavioral determinants of health. However, the understanding of molecular and genomic processes is incomplete without consideration of social, psychological, behavioral, and economic influences on health and disease.^{4 - 5}

Although strides have likewise been made toward a more translational medicine, key biomedical innovations may be trapped between bench and bedside. Even after innovations reach the clinic, many of the most effective medications may be rendered useless when behavioral and social barriers prevent a patient from using them.

A new policy framework should harness the potential of the full range of scientists working to advance health, rather than confine itself only to the life sciences and physical sciences.