My own take is that those proposed solutions go at the symptoms (the incentives) rather than the underlying disease: inadequate time and resourcing. I’ll use my own experience as an example. The UK MRC Health Services Research Collaboration ran for around a decade, covering most of the noughties. I worked in it (and as part of the group it comprised after its formal closure) from 2001-2009. What was refreshing was the culture – no pressure for short-term benefits. I had annual trips funded to Sydney to go work with Jordan Louviere on developing best-worst scaling. I produced nothing of substance for 6 years on a methodology that came to define my early to mid career. My citations in my first post-doc positions were, frankly, crap compared to my peers and many postdocs today – theirs go up linearly, mine were atrocious.
Then an interesting thing happened: whilst theirs continued to go up linearly mine went exponential; now my citations and bibliometric indices beat those of many professors of health economics nationally and internationally. Furthermore compared to many of my peers a relatively large proportion of my papers contribute to my h-index, something that is less and less true the more senior you become (unless you are an Einstein and every paper is paradigm-shifting).
I spoke to senior members of the UK Department of Health about BWS in the early noughties. The working paper that became my seminal 2007 publication was specifically cited in a call for proposals by the UK HTA NIHR for work to develop a social care instrument. I was then the methodological leader in the team that got the successful bid.
Suffice to say I’ve had a large impact with my work – both in research and policy. I’m not the sharpest knife in the drawer – I stand on the shoulders of giants like Tony Marley and Jordan. However, I had a lot of time to develop the research. I wonder if we had things right in the “good old days” when academics had far fewer of the time and resourcing constraints they have today? Yes I know it’s almost certainly a lost cause I’m espousing given the current way government is funded (i.e. incorrectly).