Research Phobia in Family Medicine
Dr Franco Del Zotti- Italy National Representative of EGPRW The European General Practice Research Workshop
Topics
• • • • Historical reasons Myths feeding the phobia Cognitive Reframing of the myths Behavioral therapy of “research phobia “
Historical background
• In the past decades Family doctors (FDs) were involved in manual practice and were really distant from the Ideas and the Theory of Research
But now…
• Frequent Discoveries and Health Authorities are often asking us to change our prescribing behavior • We need to study and to work in group with Research tools :Epidemiology. EBM, Qualitative Research
Myths against Research
• It is necessary to change but FDs still resist hard…
• We often think “We are inferior and very practical “Research is high Theory for academic people” “We have no time”
The Myth of inferiority
• THE MYTH • We are inferior and Research is for specialist doctors and for Universities • REFRAMING • There is a lot of evidence for the renaissance of Family Medicine (see WHO Documents) • The number of Family Medicine (FM) Departments is increasing
“No Time” Myth
• We have a lot • Simple Research using Database or of work Qualitative • Research is Research take time-consuming only 2-4 hours for each participant and 10-12 hours for the coordinator
The “too theoric” Myth
• “We are practical”
• We use sophisticated and complex theories e.g. decision making, biopsycosocial method • Research is also a“practice” and is used in industry (operative research)
The “Too much Statistics” Myth
• Qualitative research • We are just doctors working (e.g : focus group) is conducted without with people and complex statistics really far from • Powerful descriptive arid and complex studies in FM do not statistics often need complex calculations
The Poverty Myth
• WE Have NO Tools for research • Tools are expensive • We normally use PCs with a spreadsheet and another software for clinical records, both very useful for simple statistics and relatively cheap
Behavioral Therapy
• After the cognitive approach to our research phobia, now we are going to introduce some behavioral strategies A way of limiting the Punishment against the first heroes.. A Ladder of small steps towards Research
Avoid punishments !
• Be careful of pursuing High Standards (….Frustrations..) • Mind close contacts with university doctors or research professionals (they are very critical ..) Try to find a real sympathetic friend among “experts” ( in this case you are lucky! )
First small steps…. …The Idea..
Do not be afraid of the white empty page…
Start from the richness of FM :
Informal ideas,problems and feelings connected to daily practice are the real “steam-engine” of Research
First step: Follow this simple flow-chart
Problem or feeling of patient of doctor Research IDEA The place of answer: MEDLINE No Answer ?
Prepare a Sheet, Questionnaire, or search your database
First steps….
• Do a self-audit just for yourself and your practice • Communicate only orally the results to a small number of colleagues • Partecipate “passively” in the research of other family doctors
…..First small steps
• Try to do small qualitative research (with patients, with family doctors) • Enter a small group of collagues even by the Net ( so you are not afraid of local judges..) • Publish small articles on local newsletters
Small steps (advanced)
• Try to learn the use of “queries” for your clinical record database • Try to learn the use of Epidemiological Software “Epi-info” (it is Free!): • For the “English language phobia” : send posters to the congress ( they are less risky than oral communication)
Conclusion..
• Several reasons are pushing Family Medicine Research but there is a spread out hostility or phobia towards Research • New Development in FM (Group practice, PC, Telematics, not expensive software) can facilitate a change
..Conclusions
We have tried to show that a special form of “cognitive-behavioral” therapy can be useful to break “mental walls” still surviving in our open world
Final Hope
Research Institutions must promote any effort for a better osmosis with a hidden scientific capital : the experience and curiosity of family doctors