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   Table of Contents      
GUEST EDITORIAL
Year : 2016  |  Volume : 64  |  Issue : 12  |  Page : 871-872

The 21st century doctor: A clinician–scientist?


Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 308433, Singapore

Date of Web Publication23-Jan-2017

Correspondence Address:
Rupesh Agrawal
Department of Ophthalmology, National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 308433
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.198861

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How to cite this article:
Agrawal R. The 21st century doctor: A clinician–scientist?. Indian J Ophthalmol 2016;64:871-2

How to cite this URL:
Agrawal R. The 21st century doctor: A clinician–scientist?. Indian J Ophthalmol [serial online] 2016 [cited 2017 Mar 24];64:871-2. Available from: http://www.ijo.in/text.asp?2016/64/12/871/198861

Evidence-based medicine has become an integral part of our daily practice.[1] As physicians, we have a duty to provide the best treatment for our patients. We have the responsibility to use, on the top of our own clinical expertise and acumen, the most up-to-date, reliable evidence to support our judgment so as to provide appropriate management for our patients. Moreover, we are facing increasing pressure from well-informed and tech-savvy patients who want to hear the various treatment options as backed by studies. As modern-day patients have easy access to medical information, there is a significant rise in demand for more accurate, research-proven solutions for their medical problems. As such, evidence-based medicine has become crucial in enhancing the overall quality of care for our patients.[2]

As a 21st century doctor, our responsibility does not stop at using the available resources but also extends to making a contribution to these resources ourselves. The resultant phenomenon of increased popularity of evidence-based medicine is the move toward grooming doctors into becoming clinician–scientists, such doctors are competent enough to perform some form of clinical or basic science research.[3] This requirement, be it implicit or explicit, aims to generate leading projects that can perhaps save humanity.

However, our initial pure intentions of improving health care through our research findings seem to have developed into our own vested interest. Research requirements have become prevalent in medical field, be it for residency application, career advancement, reputation, or other personal reasons, and this has unknowingly resulted in a fierce competition rather than a friendly contribution where many have become obsessed over quantity rather than quality of research papers. Are we truly driven by passion and good faith in helping patients or are we simply churning out papers after papers for our own interest and greed?

Moreover, there lies the problem of secondary interests of individuals and organizations infiltrating medical practice. With heavy investment of time, effort, resources, or money in health-care industry, it is not uncommon to see commercialization creeping into medical field, thereby affecting the clinical practice of many physicians.[4] Such problem has been recognized in the research field, with declaration of interest required for publications of research work such that readers are aware of any underlying motive or interest behind the research that may skew the findings. However, how many of us remind ourselves to wear a filtering lens when reading sponsored research projects or marketed pharmaceutical drugs? How critical are we when we assess the quality of each research project and its findings? Research papers are plenty, but it is our own ownership to make use of the knowledge provided to us and filter them with our critical mind so as to avoid advising on injudicious investigations and treatment.

All of these ultimately beg the crucial question – who are we doing research for? For our patients or for ourselves? Are we not physicians before scientists? This article may have seemed to undermine all clinician–researchers, but we cannot deny the necessity of research in this modern-day medicine. In fact, medicine has always strived on research, which reports experiences and findings by self or others since the beginning of time. Indeed, intentions of doctors undertaking research may vary; they may be driven by passion to cultivate research skills, curiosities in certain medical fields, or self-serving aspirations for career advancements.[5] However, if we uphold to the ethics of research and ensure that the amount of time and effort put into research truly translate into benefits for our patients, perhaps we should not be ashamed for the intention that we each hold onto. Furthermore, the pure act of cultivating interest in research may even serve as a stepping stone for greater research in the future. As famously quoted, “Allow yourself to be a beginner. No one starts off being excellent.” We may just be at our beginnings of a better future.

Scientific research has become an integral part of modern health-care system where evidence-based medicine is heavily emphasized and practiced upon. Only up-to-date research can maintain on par with this rapidly developing medical field, ultimately allowing us to deliver the best health care for our patients. Our intentions in contributing to this rapidly changing field may vary, and it is our duty to take a step back and reflect whether our intentions have compromised on the safety of our patients, the ethics of research, and our duty as physicians. Only then can we safely pride in ourselves for the work that we have produced.

 
  References Top

1.
Sackett DL. Evidence-based medicine. Semin Perinatol 1997;21:3-5.  Back to cited text no. 1
    
2.
Woolf SH. The meaning of translational research and why it matters. JAMA 2008;299:211-3.  Back to cited text no. 2
    
3.
Lemon TI, Lampard R, Stone BA. Research skills for undergraduates: A must! Perspect Med Educ 2013;2:174-5.  Back to cited text no. 3
    
4.
Brennan TA, Rothman DJ, Blank L, Blumenthal D, Chimonas SC, Cohen JJ, et al. Health industry practices that create conflicts of interest: A policy proposal for academic medical centers. JAMA 2006;295:429-33.  Back to cited text no. 4
    
5.
Abu-Zaid A. Research skills: The neglected competency in tomorrow's 21st-century doctors. Perspect Med Educ 2014;3:63-5.  Back to cited text no. 5
    




 

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