Chiropractic research capacity in Canada in 2008.

Abstract

Research is needed in any health care profession to advance knowledge and find more effective and safer ways to help patients. There is no exception for chiropractic. It is necessary to conduct both basic biological research and clinical research to link discoveries with practice.1 For this to occur however, an adequate number of trained and committed researchers is required as is the appropriate infrastructure and funding. Working in collaborative networks may help as well.2 The traditional avenue to become an independent researcher is to undertake postgraduate research training and earn a PhD and for many, to get a postdoctoral fellowship. Combining formal clinical and research training has the advantage of providing one with an overview of both worlds and an in-depth understanding of the needs in a specific area.3 Perhaps one of the greatest challenges in all health professions is developing a sufficient pool of clinician-scientists to meet the research needs of that profession. A clinician-scientist can be defined as an individual with a clinical doctoral degree (such as a DC or MD) who performs research as their primary or major professional activity.1 This is ideally in some combination with professional practice. These clinician-scientists tend to conduct more patient-oriented clinical research than PhDs who tend to conduct more basic science research.4 Professional practice benefits researchers by informing research questions and aiding with result interpretation, something PhD researchers without clinical backgrounds may find more challenging.1,4 Few clinicians are interested in a research career however. Concern over a reduction in physician-scientists has been raised.2,4 In the United States the number of physicians who reported research as their major professional activity has gone from over 23,000 in 1985 (4.5%) to 14,521 (1.8%) in 2003, and this is despite increased funding for biomedical research.2,4 This may be partially explained by an increase in the total number of physicians as well as a decrease in those pursuing a research career.4 Other explanations include the renewed interest in patient care, having to deal with increasing debt loads upon graduation, a lack of a research mentor and lack of exposure to research as students, heavy clinical requirements during medical school, and greater demands for patient care.2 In addition, increased regulation of clinical research and the relative lack of clinical research emphasis in academic health centers have also been deemed detrimental to clinician-scientist numbers.2 Key message «This means that considerably less than 1% of the profession is conducting the majority of the research to provide the evidence required to substantiate what the remaining 99% of the profession does clinically in terms of patient care. To achieve a level of 1% of the profession doing research on a full-time basis would require an additional 40 chiropractors.»