Physician Opportunity Costs for Performing Practice-Based Research
An inverse association has been documented between the magnitude of patient care responsibilities (health maintenance organization penetration) and the amount of clinical research produced by academic medical centers. The output of academic family practice research is affected by this calculus. This article presents evidence that current marketplace demands to increase patient care services may have an even greater impact on nonacademic family practice clinician researchers involved in practice-based research (PBR).
Conclusions
I believe that much social good can result from efforts to bring together practicing clinician researchers, their patients, and the traditional medical research establishment to address important unanswered (and sometimes unasked) questions about disease etiology, management, and health care delivery. Such collaborations should include: (1) basic and social scientists who, in my experience, are willing and eager to collaborate on projects of mutual interest; (2) medical group practices that need incentives to support intramural research; and (3) government funding sources who are increasingly interested in supporting PBR infrastructure. Engaging in PBR has considerable opportunity costs for the physician directly and also indirectly for the physician’s system of care. Unless these costs are recognized and accounted for, it will be difficult or impossible to motivate widespread and sustainable participation in future PBR enterprises.
