Why are we doing so little clinical research? Part 2: Why clinical research is neglected.

Family medicine is a clinical discipline. So why are so few family physicians doing clinical research? Certainly there are notable exceptions to that generalization. But if you look at our publication record as a whole, clinical descriptive research is only a small part. Yet it is an important issue, with consequences for our place in medical schools. In this editorial, I want to address this issue and hope to stimulate discussion about how we can raise the profile of this field of research. I will define clinical descriptive research, discuss the four cornerstones on which it is built, suggest some reasons for our neglect, and try to convey the rich opportunities that exist in our day-to-day clinical experiences. Our neglect of clinical research is puzzling. Of all types of research, this area is for clinicians the most fitting, the most practical, and the most enjoyable. We are also heirs to a rich tradition of clinical research in general practice. It is fitting because it can be part and parcel of our clinical practice and need not require blocks of segregated time. Once we have decided which patients to study, it will add only a few minutes to the consulting time for these patients and will add some record keeping. Because our interventions are no different from our usual care, clinical research does not pose ethical problems. Although it does need thought and preparation, it does not call for complicated research designs. Because we do not need research assistants, large grants are not necessar y. Clinical research is enjoyable because we are looking at our own work and our own patients. If you look very closely at a group of your patients over time, I can almost promise that you will find things that are not in the books or that are in the books but are wrong. As a result you will experience the joy of discovery.