Why Clinical Research?
We work at non-academic community medical centers, where clinical researchers are uncommon. We’re often asked by our peers why we’ve added research onto clinical careers that are already full and satisfying. Many reasons motivate us. Here are a few:
We are insatiably curious and want to figure out how healthcare works and how we can make it better.
We love the creative challenge of filling in knowledge gaps (and there are many) that we encounter in our practices.
We value the close collaboration and collective learning that research requires: friendships and education are delightful byproducts.
We enjoy putting our non-clinical skills to constructive work, like understanding the literature, designing the right study, securing a grant, analyzing the data (providing us many Eureka moments), composing a manuscript (and getting it accepted), and teaching what we have discovered.
We are thrilled and humbled to think that our publications might improve the care of patients whom we’ll never meet.
Why Do Clinical Research at Kaiser Permanente?
Once our curious colleagues grasp what drives our research endeavors, their next question is understandable: "Then why aren’t you working at an academic facility?” That answer is easy. We have all the resources we need right here. Our medical group is allied to one of the country’s largest research divisions outside the university and government setting. This affords us access to partner with methodologically-savvy research scientists and programmer/analysts. They know their way around the large clinical and administrative databases and have the statistical know-how to make sense of the data. While our portfolio of funders includes National Institutes of Health, and foundations, much of our funding has come from internal sources, which testifies to the commitment of the medical group and its affiliates to advancing the science of medicine in practice. In this unique setting, we have an abundance of detailed patient data not readily available to most clinical researchers at academic facilities. Our integrated healthcare system is comprised of 21 medical centers and scores of outpatient medical offices. Together we care for over 4 million healthplan members. Our emergency departments received over 1.3 million visits last year. Our comprehensive patient electronic health records (EHR) include diagnostic and treatment history across all inpatient and outpatient settings (including medications, lab results, imaging, etc.) over a long history of electronic records use. These EHR systems serve not only as a source of data for research, but as a tool for efficient translation of research findings in real-time clinical practice.
Not Publish or Perish
Another benefit of researching outside academia is that we are free from the pressures that can accompany a “publish or perish” model. Our compensation and standing in the medical group are independent of our research productivity. Not having to meet a required quota of publications doesn’t lessen our ambition and determination. It just means that we get to set our own objectives and timelines. We appreciate that luxury.
Team Science: The Benefits of Collaboration
True, it hasn’t all been a walk in the park. Getting a network of community emergency medicine researchers off the ground required a little sweat equity. And still does. But working hard with good friends for something you value has greatly lightened the load. The motives we mentioned and the ensuing rewards have more than compensated for the additional time and effort that research requires.
So Why Do We Do Research in This Community Setting?
Because we couldn’t imagine doing anything else anywhere else. :)
David R Vinson, MD
Co-chair, CREST Network
On behalf of the entire team