Advancing Research & Scholarly Activity for the Internist

Being an academic physician and medical school dean, I have often been asked why physicians should do research, heard the various objections to research, and have had folks ask for inspiration for conducting research. I thought I would try to capture my thoughts and experience here on the topic. I hope it is helpful and inspires folks to do more research and scholarly activity.

There are plenty of great reasons why physicians should conduct research and engage in scholarly activity. The first is good karma. Research has the potential to improve the lives around us and is in alignment with the medical ethical principle of benevolence. Research also has the potential of creating a “Halo Effect” around the person conducting it. Trainees have known this for a long time, and a common motivator for medical students to conduct research is based on the hopes that it will one day enhance their application to residency. Additionally, research can be financially beneficial. For example, I know various physicians who either augment their income with conducting clinical trials or conduct research full time. Lastly, there is an innate academic curiosity in every physician who I have met. The ability to answer questions and advance science is an inherent desire that conducting research can help answer.

I hear a number of objections as to why physicians and/or trainees can’t conduct research. I have taken the top 10 and listed below along with my thoughts as to overcome each:

1. Lack of Time
   Lack of time is the primary reason trainees provide as a barrier to conduct research. While it is an important consideration, there are several opportunities to reduce time commitments. “Many hands make light work,” is a common phrase that rings true with research because collaboration with others can help decrease time burdens. Another thought would be to get your time compensated with clinical trials or in academic environments where you will have dedicated time. Additionally, it may be worthwhile asking your employer for dedicated time to focus on research opportunities that will enhance the organization.
2. No Funding
   Lack of funding is another common reason why folks don’t conduct research. One consideration is to look for available funding, which may range from external grants to institution funding. Here are some examples of incredible research projects that have been conducted with significant impact that required little or no funding: chocolate and blood pressure trial, taking levothyroxine at night, residency work hours and mortality,  driving performance after sleep deprivation, and Wikipedia accuracy for medical conditions.
3. Research Isn’t Fun
   Folks often say that research isn’t fun. However, I would say that it can be quite fun. In fact, if you think about the rock stars in our profession, getting international notoriety, or presenting your research findings at national conferences, there are plenty of fun outcomes associated with research.
4. No Experience
   Sometimes, physicians will say that they don’t have adequate research experience. Sir Osler used to say, “experience is fallacious, and judgment is difficult.” While experience can be helpful, collaboration and innovation can be great ways to overcome lack of experience.
5. No Skills
   I also hear folks citing that they don’t have the prerequisite skills to conduct research. This is the best time ever to quickly acquire skills from research (e.g., brainstorming, submitting publications, writing articles, etc.). Also, there are so many people that want to collaborate on research that already have these skills. I am also impressed with the number of medical students and residents who have incredible research skills that are always looking for attending physicians to collaborate with.
6. Not Clinical Enough
   Most physicians are focused on things that directly affect patient care. As a physician who has conducted research, I couldn’t agree more. In fact, I think the most important thing is research that is clinical-application centered. I would suggest leveraging your skills as a physician to start with clinical observations and look for questions that research can answer.
7. Not Enough Patient Numbers
   Physicians in small practices often cite that they don’t have enough patient numbers to conduct research. This is another area where collaboration with others can make the biggest difference. For folks interested in clinical trials that have low patient numbers, Clinical Research Organizations (CRO), such as Alcanza, can help identify potential patients through partnership opportunities.
8. Not Aligned with my Career Goals
   Some folks have said that research doesn’t align with their career goals. I would like to point out the “halo effect” that can come from research that may positively impact your career even if it isn’t the focus of your career. It may open new doors for you. Also, you may discover that research (such as clinical research practices) may intersect with or open doors to career pathways you actually want to pursue.
9. No Mentor Support
   Physicians as well as trainees often cite lack of mentors to help them with their research. I have found that there are tons of folks with significant research skills that would love to collaborate, if just asked. Your local medical school is one great place to approach to ask for research expertise and collaborators are more abundant than you might think.
10. No Institutional Support
    With most physicians being employed, there is sometimes a perception that there isn’t institutional support for research. Although that may be true in some cases, a well thought out approach that shows institutional benefit could garner more institutional support than you may think. This is one of those situations in life where you will only know the answer if you ask.

I hope these considerations are helpful and they inspire at least one person to consider conducting research that will advance the public good.