Amanda Howe is Professor of Primary Care at the University of East Anglia in Norwich - one of the newer medical schools in the U.K. She is also a GP, Vice Chair of Council at the RCGP, and President-Elect of the World Organization of Family Doctors. She writes here in a personal capacity.
When I starting out as a junior researcher, the big fight was to get primary care research into the universities and the big national and charitable funding streams. The first professor of general practice took up post in 1962, and by 1992 when I became a lecturer, most medical schools had a department of general practice (‘family medicine’ in other countries). But all my seniors still talked as if they were fighting an uphill battle – treated as a minority group, outsiders, less powerful, less well funded, and with a tide to turn against the biomedical ‘lab to bedside’ paradigm.
20+ years on, I am not sure whether that victim voice still needs to be heard. There are some amazing big research units now in U.K. – the School of Primary Care’s member departments all punching above their weight, far more applied funding going into primary care and epidemiological work via the National Institute for Health Research, and medical schools being complemented by nursing and allied health units with excellent track records of their own research.
But some medical schools have put their GP teachers into medical education departments, and made their GP researchers a small part of a ‘big’ health services research unit. And others try to establish a research profile and national/international impact with fewer than 2 full-time academic GPs (my own unit). My ‘Primary Care Group’ also contains brilliant bright colleagues from public health, health economics, sociology and ethics – and the university sees this as a good mixture for applied methods research - but it is not much capacity for clinical work, research, teaching, and academic leadership.
I see tensions from the clinical side ...continue reading