Annals of family medicine
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Annals of family medicine · May 2004
ReviewFuture of research in family medicine: where to from here?
Desired research outcomes in family medicine vary according to the developmental stage of the discipline and the context of practice. Several milestones in the evolution of family practice research worldwide have been achieved. Now family medicine researchers face the challenge of discovering how evidence-based primary health care can be delivered in a sustainable way to individuals within communities. To advance family medicine research, we must ensure that trainees have a positive research attitude, develop academic clinician-researchers, lobby for primary care research funding, support practitioners who wish to do research in their own practices, sustain practice-based research networks, and study important questions.
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Family medicine has matured as an academic and scientific discipline with its own core concepts, knowledge, skills, and research domains. It has acquired much expertise in studying common illnesses; the integration of medical, psychological, social, and behavioral sciences; patient-centered care; and health services delivery. Many health care challenges in the 21st century will place a great demand on primary care, which can serve its purpose only if it is of high quality and evidence based. ⋯ Family medicine can play a leading role in shifting the paradigm of medical research from the laboratory to the person. The 21st century should be a golden age of family medicine research because the time is right for the discipline, the health care environment is most suitable, and stakeholders are supportive. Family medicine must prepare for it by building up its research track record and capacity.
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To promote the range of interventions for building family/general practice (family medicine) research capacity, we describe successful international examples. Such examples of interventions that build research capacity focus on diseases and illness research, as well as process research; monitor the output of research in family/general practice (family medicine); increase the number of family medicine research journals; encourage and enable research skills acquisition (including making it part of professional training); strengthen the academic base; and promote research networks and collaborations. The responsibility for these interventions lies with the government, colleges and academies, and universities. There are exciting and varied methods of building research capacity in family medicine.
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Annals of family medicine · May 2004
ReviewWhy research in family medicine? A superfluous question.
The ultimate answer to the question, "Why research in family medicine?" is to provide better care for our patients. Through research we want to improve quality of primary care by improving our understanding and practice of it. This research will inevitably be specific for family medicine as family medicine is a specific discipline. ⋯ We propose to map these questions within a framework defined by the 3 dimensions of the Donabedian triangle--structure, process, and outcome-and within each of these dimensions by 5 foci-basic knowledge, diagnostic and therapeutic problem solving, practice implementation, policy context, and education. This framework may help to make the various research questions operational and to point out the gaps in our research. The questions and answers should be relevant to daily practice and comprise all domains of family medicine so that eventually most of our daily actions in practice will be underpinned with medical, contextual, and policy evidence and contribute to the improvement of the quality of care.
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The output of family medicine research in developing countries varies vastly from country to country and also within countries. Most research originates from academic departments of family medicine or from collaborative initiatives with researchers in developed countries. ⋯ Solutions require financial resources and international goodwill. Wonca could play a major role in enhancing research in family medicine in the developing world.