Norman Levine, M.D., is a private practitioner in Tucson, Ariz. He also is a member of the Dermatology Times Editorial Advisory board and a co-medical editor.
I am a member of a charitable foundation committee that funds research grants to investigators interested in dermatologic scientific questions.
When I first was appointed to serve in this capacity seven years ago, the review of the proposals was relatively straightforward. I understood the hypotheses to be tested and had at least a passing knowledge of the methodology being proposed to answer the scientific questions. Over the ensuing years, either my intellectual capacity has eroded or the sophistication and complexity of the science have dramatically accelerated (or both). Of the 18 research grant proposals that I have just reviewed, I had a major problem understanding at least half of them. I had particular difficulty with proposals involving molecular genetics and signaling pathways, two of the hottest topics in investigative dermatology today.
The explosion of discovery has pushed the understanding of complex problems to new levels. However, many are rapidly being left behind, not only because of lack of interest in keeping current, but also because of a perceived concern about the relevance of the research. It is all too easy for those who fail to grasp the nature of potentially important experimental answers to dismiss those findings as unimportant. This can lead to unintended negative consequences, including a reluctance of the dermatology community to support research efforts and a tendency to turn to simplistic (and often misguided), easy-to-comprehend explanations for natural phenomena, based on less than first-rate investigative efforts.
We are at an important crossroads with our specialty. Some of the most important scientific discoveries are occurring in the laboratories of those interested in skin disease. However, at the clinical level, we as a specialty appear to be drifting away from the scientific method towards medicine by anecdote and hyperbole. How can we reconcile these two contradictory developments and improve our collective knowledge base and, ultimately, the care of our patients? I could personally use one of those "books for dummies" publications, which explain everything from acne to wine to bankruptcy in an understandable and often entertaining manner. If we cannot find a volunteer to author such a book, "Basic Science for Dummies," the next best approach is to somehow organize a Marshall Plan of sorts to bring us up to date. Here are a few ways to accomplish this task:
Dermatologists differentiate themselves from others caring for patients with skin disease by their understanding of the mechanisms of disease and therapy. I fear that this is getting away from us to some extent. Basic scientists can help by educating us in a way that is understandable and relevant.