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 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 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

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 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

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 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