Family Physicians Have Minimal Funding, Influence At NIH, According To Study, USA

Main Category: Primary Care / General Practice
Article Date: 11 Nov 2008 - 2:00 PDT

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Funding to departments of family medicine and family physicians is minimal at the National Institutes of Health (NIH), according to a new study in the Annals of Internal Medicine. The study is the most comprehensive examination of family medicine's interaction with the NIH. It finds that family medicine's role in NIH-funded research is negligible at a time of growing emphasis on the role of primary-care research to translate the latest science into clinical practice and improve public health in the United States.

The study from Robert Wood Johnson Foundation Clinical Scholar Dr. Sean C. Lucan and colleagues examined NIH grant awards from 2002-2006, as well as family medicine's membership on NIH advisory committees, which review research and set research agendas for NIH's institutes and centers.

Researchers found that despite marginal and diminishing increases from 2002 through 2006, the levels of NIH funding to departments of family medicine are essentially unchanged from well-documented historical lows. The $187 million total in grants that family medicine received in 2006 represents just 0.20 percent of the $95.3 billion in total NIH awards during that year. More than half of all family medicine departments received no grants from NIH. And almost 75 percent of family medicine grants came from just six of NIH's 24 grant-funding institutes and centers.

Researchers also found that family medicine has minimal representation on NIH advisory committees. Of the 5,464 members of NIH's 295 committees and subcommittees, only 21 members were from departments of family medicine. Of these, only nine were family physicians. Departments of family medicine had members on just 6.4 percent of all committees and subcommittees, making up less than 0.38 percent of all advisory committee members at the NIH.

"Our study shows that when it comes to influence at the NIH, family medicine doesn't really have a seat at the table," Lucan said. "Lack of family medicine involvement in the planning and performance of NIH-funded research represents a missed opportunity that has implications for biomedical research in this country, its relevance to patient care, and the greater good of public health in this country."

The researchers call for:

- Practicing family physicians to serve in public seats on NIH advisory committees;

- NIH and family medicine to strengthen partnerships for advanced degrees and research training;

- Experienced family-medicine researchers to share research lessons with the larger family medicine community to foster participation in practice-based investigations and quality-improvement initiatives; and

- Family physicians in community practices to develop greater collaboration with practice-based research networks and academic health centers to help inform research, carry out clinical trials and develop new ideas for research.

"Through greater research training, collaborations, and self-advocacy, family medicine might foster a better relationship with the NIH, to the benefit of both," the researchers conclude.

Robert Wood Johnson Foundation Scholars Program