Research Phobia in Family Medicine

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Research Phobiain Family Medicine

• Dr Franco Del Zotti- Italy
• National Representative of
• EGPRW
• The European General Practice Research Workshop

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Topics

• Historical reasons
• Myths feeding the phobia
• Cognitive Reframing of the myths
• Behavioral therapy of research phobia

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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

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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

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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

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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

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No Time Myth

• Simple Research using Database or Qualitative
  Research take only 2-4 hours for each
  participant and 10-12 hours for the coordinator

• We have a lot of work
• Research is time-consuming

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The too theoric Myth

• We are practical

• We use sophisticated and complex theories e.g.
  decision making, biopsycosocial method
• Research is also apractice and is used in
  industry (operative research)

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The Too much Statistics Myth

• We are just doctors working with people and
  really far from arid and complex statistics

• Qualitative research (e.g focus group) is
  conducted without complex statistics
• Powerful descriptive studies in FM do not often
  need complex calculations

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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

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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

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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! )

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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

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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

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..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

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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)

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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

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..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

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Final Hope

• Research Institutions must promote any effort
  for a better osmosis with a hidden scientific
  capital the experience and curiosity of family
  doctors