Research Phobia in Family Medicine Dr Franco Del

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 Ø“We are inferior and very practical Ø“Research is high Theory for academic people” Ø“We have no time”

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

“No Time” Myth • We have a lot • Simple Research using Database or of work Qualitative • Research is Research take only time-consuming 2 -4 hours for each participant and 1012 hours for the coordinator

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 • Qualitative research • We are just doctors working (e. g : focus group) is conducted without with people and complex statistics really far from • Powerful descriptive arid and complex studies in FM do not statistics 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 üA way of limiting the Punishment against the first heroes. . üA 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