The future of health services research in academic medicine
Health Services Research
Health services research is cross cutting in several dimensions. It spans many methodological disciplines beyond clinical medicine, including epidemiology, economics, sociology, psychology, and biostatistics, and is applicable to the entire spectrum of clinical medicine. Basic biomedical science helps us understand why a therapy or test should work. Clinical trials help us understand whether or not they do work. Health services research, however, is needed to generate new knowledge about how these treatments are delivered in real-world settings and how organization and financing influence the quality and accessibility of care. Not every clinical department can be strong in health services research, but more of these departments should identify means and relationships that will nurture junior faculty, postdoctoral trainees, and students who have these interests. Given the multiple challenges that the health care system faces with respect to the quality and costs of care, the academic medical community must become as serious about consolidating and increasing funding for health services research as it is for basic biomedical research. Success in health services research should be regarded as an equally valid measure of accomplishment as research in the basic sciences. To this end there should be a concerted effort by the academic medical community to expand opportunities for training in health services research for clinicians, to support health services research infrastructures within academic medical centers, to urge the NIH to earmark funds from each institute to health services research and cross cutting questions, and to create mechanisms for more stable funding streams including more competitive renewals.