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The Academic Paradigm Is the Problem
  1. Matthew A. Movsesian, MD
  1. From the Cardiology Section, VA Salt Lake City Health Care System; and Departments of Internal Medicine (Cardiology) and Pharmacology, University of Utah, Salt Lake City, UT.
  1. Received December 15, 2008, and in revised form February 4, 2009.
  2. Accepted for publication February 6, 2009.
  3. Supported by the Medical Research Funds from the United States Department of Veterans Affairs and by grants from the American Heart Association and the Leducq Foundation (O6 CVD 02).
  4. Reprints: Matthew Movsesian, MD, Cardiology Section, VA Salt Lake City Health Care System, 500 Foothill Blvd, Salt Lake City, UT 84148. E-mail: matthew.movsesian{at}

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The following is adapted from a talk given by the author, a former member of the National Council of the American Federation for Medical Research, at the Heart Failure Society of America Annual Scientific Meeting, Toronto, Ontario, Canada, on September 23, 2008.

The issue I would like to address has to do with what many of us perceive to be a slow progress in research leading to the development of new therapeutic agents for heart failure. I would argue that our academic paradigm, with its focus on assessing the individual accomplishments of faculty members rather than on facilitating progress by the research community as a whole, is an impediment to progress. I would like to begin my argument using, as an allegorical example, a story about a basketball team.


The owner of a basketball team wanted to devise an incentive plan to improve his team's performance. He reasoned that team performance was the sum of the performances of the individual players, and that the key, therefore, was to maximize the productivity of each individual. He reasoned further that, because basketball games are won by scoring more points than one's opponent, the appropriate incentive plan would be one in which each player would be paid in direct proportion to the number of points he scored.

The plan was put into practice. As predicted, players became proficient at the skills they needed to score points. Shooting was central, and players put a huge amount of effort into this particular aspect of the game. But one had to have the ball and get open before one could shoot, the players also worked on rebounding, stealing the ball, and ball handling. Those with the greatest combination of talent and personal motivation became the highest scorers and were the most highly rewarded. Most people looked …

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