Friday, July 31, 2009

Biology, not the next big thing

When I tell people I have a biomedical engineering degree, one of the most common responses is "that is going to be the next big thing." They then either get shrugged off, or a long philosophical ramble depending on my mood. Far from being the next big thing, a lot of the biomedical world is set up for a pretty bad crash.

Biomedical Engineering faces one strong issue. Many of its best inventions, while quite impressive, don't actually provide much benefit to most patients. A great example is the poster child of the field, MRI. Doctors make a fortune off of sending patients to get MRIs. They have large fixed costs, and fairly low variable costs, so when a hospital has one it is in their best interest to keep it running all the time. To do that they often pay doctors well if they send doctors to get a scan. Patients are easily talked into getting them, and often pressure doctors into using them since they sound like the sort of thing that would help convince the doctor that the pain in their back is really some horrible condition that needs immediate surgery. This adds up to a lot of MRIs being done, and a lot of money being sent back to Biomedical Engineers and Medical Physicists. There is only one problem. For most conditions the patients who get MRIs do not do any better than those who don't. This means that whenever hospitals get serious about cutting inflation of medical costs medical imaging will be one of the hardest hit fields. You can save significant money without hurting patients.

The bigger trend for the biomedical field is that the United States spends twice as much on health care as a percentage of GDP than any other country in the world. For this extra money we buy essentially nothing. Most of the money is wasted. Some of this goes to the fact we pay doctors more than any other country. Some of this goes to our over-treating of many conditions like back pain or cancer that we really aren't able to do much for. But whatever the cause of the extra expense it is clear that this country could choose to spend a lot less money on health care and get the same or better outcomes. Whenever the government takes this fact seriously expect a lot less money to be flowing into that part of the economy. When that happens we will find that, actually we need a lot less biomedical engineers and laboratory scientists. It may even go as far as hurting nurses and other professions that interact with patients, but I suspect they are more insulated.

On the research side of the world there are two issues that will cause an increasing squeeze. First, we are producing less and less new drugs. For quite some time now the number of new drugs approved by the FDA has been decreasing. This means that in the long run all those jobs at pharmaceutical companies are unstable. There will still be blockbuster drugs, but as patents run out companies just won't be able to afford as much research and development as they had in the past.

At the same time NIH budgets are huge. Medicine takes up the highest percentage of government research dollars it ever has. Regression to the mean says that it is a pretty good guess that in the long-run this value will drop. Eventually the military, or NASA, or energy research, or some other field will pass up medicine in importance for those in congress. If that happens it won't be pretty for those with professor jobs that require grant money to get any real chance at tenure. To be honest with how things looked before the stimulus plan, I am not sure we haven't hit that point already.

Even if biomedical sciences was the next big thing, that doesn't make it a good field to enter. A lot of demand for a skill set can still result in poor job prospects if supply is greater than demand. In 2008 there were 75,151 bachelors degrees granted in the life sciences. To that number add another 101,810 in "health sciences and related clinical sciences" and another 90,039 in Psychology. That is a lot of competition in this part of the economy. Compare this to the 67,092 in all engineering degrees combined!

Of course doctors will always do just fine, worst case scenario they start taking jobs from nurses. But being in a non-patient oriented part of the biomedical world is a pretty scary prospect right now.


Justus said...

Hmm this is bad news for me.

glmory said...

MD's and MD PhDs have set up absurd barriers to entry. This means the job market is, and always will be, pretty good... Those 35 year old post docs I have met by the dozen though, they are in a rough spot. Trying to make it on just an undergrad degree is even worse though so there will always be more grad students signing up...

But yeah, I am pretty glad to be out of there.