“Louie, I think this is the beginning of a beautiful friendship.” This single sentence, Humphrey Bogart’s famously delivered last line in “Casablanca,” signifies both the culmination of the classic film’s story and the start of a mutually productive partnership between Bogart’s hard-bitten but heroic character, Rick, and the pragmatic police captain, Louie Renault.
In a scenario perhaps less entertaining but more germane to neurosurgery, when I hear the excitement in the voice of a young investigator who is the new recipient of a Neurosurgery Research and Education Foundation research fellowship, I am reminded of Rick’s enduring words. Such a moment does indeed mark the beginning of a beautiful friendship: In such a moment, a productive partnership between NREF and an awardee ignites, propelling forward a meritorious research project, adding to the body of scientific knowledge, and ultimately helping to heal countless people with neurological disorders. Such a moment simultaneously marks the culmination of a complex process that involves numerous individuals and countless hours spent reviewing research proposals to ensure their worthiness for investment, and-crucially-raising the dollars that will fund the research.
Who Funds Neurological Research?
Both public and private entities actively fund scientific research. However, the most prominent public supporter, the National Institutes of Health, does not have a funding category for technical or surgical innovations, which is how most neurosurgical research is classified. Therefore, this type of research is conducted almost wholly in the private sector.
“Most of the research that neurosurgeons conduct is not directly fundable by more traditional, government sources,” acknowledged William T. Couldwell, MD, a past NREF Research Fellowship awardee and current NREF Executive Council member. “Neurosurgeons used to support their research out of clinical income, but over the years that funding source has diminished.”
Even so, in 2003 528 neurosurgeons and other individual donors demonstrated their support of neurological research through gifts totaling nearly $379,000.
Corporate Partnerships Are Essential
The bulk of support for technical or surgical innovations falls on industry’s shoulders. According to Julian T. “Buz” Hoff, MD, chair of the NREF Executive Council, support of NREF is a worthwhile investment for corporations, “affording them the opportunity to supply research and development funds to their constituents-neurosurgeons in training and in practice-that potentially will
lead to both scientific advances and corporate profits.”
For corporations, the return on their investment is having the opportunity to play a key role in the future of neurosurgery while also achieving growth in their neurological areas of interest.
“These companies have a reciprocal obligation to the profession that uses their product,” said Dr. Hoff. “The well-being and corporate success of some corporations is primarily dependent on neurosurgeons.”
For its role in this “beautiful friendship” with the corporate world, the return on investment for NREF is increased funding for important basic science and cutting edge clinical research projects that allows innovations and new discoveries in neurosurgical medicine to take shape.
In recognition of the value inherent in supporting NREF research projects, companies including DePuy Spine, a Johnson and Johnson Company; Medtronic Neurological; and Kyphon Inc. have made this type of support a company priority in 2004.
NREF: As Time Has Gone By
“Historically, corporations were reluctant to support NREF because the majority of the grants involved basic science research, with little direct benefit to corporate donors,” observed Dr. Hoff.
Despite this fact, many companies supported the foundation from its inception in 1981, regardless of what project their gifts supported. Corporate support of NREF peaked in the late 1990s, and since then funding has steadily declined. The reason for the decline is the same for pharmaceutical, medical device and instrumentation companies as it is for any other corporation: tighter budgets and spending limits imposed in response to declining profits.
NREF is has been able to increase the absolute number of grants awarded each year, despite a declining level of corporate support. However, for NREF to continue to increase funding for its research grants, an increase in the amount of corporate support will be needed. To help identify potential revenue sources, James T. Rutka, MD, is leading an NREF subcommittee whose sole mission is to cultivate “beautiful friendships” with corporate supporters.
“We need to continue to educate our corporate representatives as to the importance of their support, and this will mean person-to-person contact between neurosurgeons and industry sponsors,” said Dr. Rutka. The subcommittee members currently are working to identify, cultivate and solicit much needed grant support. Only time will tell how fruitful their efforts will be.
Michele S. Gregory is AANS director of development.