Conducting research in rural primary care medicine: do we need more experimental research or guidance?

Ecological evidence has suggested that health systems with a strong orientation towards primary care achieve lower overall costs, better satisfaction of their populations, and better health. Relevant research is essential to informing best practice in primary care settings, as this may be different to best practice in secondary or tertiary settings. However, several barriers have been described that impede the effort to provide quality evidence in primary care, including clinical leaders’ reluctance to accept the problem, lack of skills for translational research, lack of funding for primary care related research questions, and lack of robust evidence from randomized controlled trials (RCTs) in primary care. It is the latter barrier that this editorial seeks to address. Similar barriers have been reported when rural primary care research is considered, as was discussed the second Rural Health Invitational Conference of the European Association of Remote and Isolated Physicians (EURIPA) forum at Sinaia, Romania in 2011 (http://www.euripaforum2011.eu). These barriers may be compromising clinical decisions in primary care, leading to primary care research being criticized as a lost cause, which may have also had a negative impact on the development of academic rural practice.