Eager to be a researcher — in spite of the cost

University of Cincinnati Dr. Timmy Lee will use a five-year $848,000 National Institutes of Health grant to find ways to predict how veins will react when physicians use them during dialysis. Lee said he plans to stay in research, but he predicts it will be increasingly difficult to retain researchers.

CINCINNATI, Ohio — The rigors of writing grant applications suit Dr. Timmy Lee just fine.

The kidney researcher at the University of Cincinnati will use a five-year $848,000 National Institutes of Health grant to find ways to predict how veins react when physicians use them during dialysis.

The award is a K23, which provides young researchers with funding that gives them more time to focus on research and less time on day-to-day clinical work.

“In academics these days, there’s a big push to generate revenue,” said Lee, 33. “A big part of it is clinical, seeing patients and teaching.

“I foresee myself remaining an academic,” he added. “I’d like to be an investigator with NIH funding and go on to be a national leader in this field.”

Lee is focused on solving arteriovenous fistulas — abnormal connection between an artery and a vein that narrow and eventually fail at a high rate. The NIH grant, announced this week, will examine blood and tissue markers that could predict why fistulas don’t develop properly in patients with end-stage kidney disease, and which veins and patients have a greater risk for problems.

Up to half of fistulas fail after about six months, and many develop clots before they can even be used for dialysis, Lee said. There’s no way to predict which are more likely to fail compared to others, and no way to prevent those failures.

“As a resident and and a fellow, I saw these patients in the hospital all the time,” Lee said. “There are a lot of questions and no real answers.”

Lee is a Louisiana native who went to medical school at Louisiana State University Health Sciences Center in Shreveport, and then researched and continued studying primarily at the University of Alabama in Birmingham. He moved two years ago to the University of Cincinnati, where he’s now an assistant professor of medicine in the division of nephrology and hypertension.

In order to win the NIH grant, Lee reviewed with university staff four or five previous successful grant applications. He had written four similar grants before winning his NIH award.

“I’ve pretty much learned to submit grants at least two times if not more,” Lee said. “People are looking for cutting-edge, innovative research and multidisciplinary teams.”

On his latest grant, he’ll be working with a bio-statistics team, a professor of transplant surgery and someone from his school’s department of environmental health, among others.

“In order to write a solid grant these days you need a number of disciplines involved,” he said.

Lee said he plans to stay in research, but he predicts it will be increasingly difficult for academic institutions to retain researchers.

Medical industry benefits – in speakers’ fees or other incentives — help supplement researcher salaries that are lower than most clinical jobs. For instance, Lee said he makes $136,000 annually for a position that’s a mix of research and patient work. Some of his peers make $150,000 by doing purely clinical work, and others make $90,000 annually as researchers.

The problem is, these industry benefits are being challenged as conflicts of interest more and more. While Lee wholeheartedly endorses many of the conflict-of –interest policies that put an end to these old types of benefits, he sees how their extinction will limit pay for researchers.

“I think the American people now demand the strictest ethical standards,” Lee said, but added: “These days it’s hard to get academics, and once they’re in academics, it’s hard to get them to stay. There has to be some kind benefit be able to make some sort of money on the side that’s along the same interest as the research.”