Why are clinical trials so expensive? Tales from the beast’s belly(milkyeggs.com)

  Suppose that one tries to push back on inefficiency in generalーsomeone naive but well-intentioned, like myself, who is tired of the Long March of interminable meetings. In fact, I expressed my concerns about the proliferation of unproductive meetings in the clinical department to the C-suite executives (with whom I remain on good terms!) and, together, we carefully planned a series of reforms to company culture designed to reduce meeting burden. We hoped to implement a soft cap on the number of meeting participants and the length of a meeting, to normalize efficient behavior such as leaving meetings midway if you no longer need to participate in the remainder, starting meetings on time without 15 minutes of small talk, and a mandated review of all recurring meetings with the intention of pruning overall meeting load by >50%.

  Ironically, on the morning that we planned on roll out these reforms, we received urgent and vehement protests from a member of middle management who was notorious for obsessively overscheduling meetings with huge participant lists just for the sake of “inclusion” and “engagement.” Because this particular manager was currently playing a crucial role in managing the rollout of several clinical trials at the same time, executive management judged that the risk of alienating him was too high, and to this day I believe these reforms remain unimplemented (although I hear he has since left the company, so perhaps my slides will eventually see the light of day).