Monday, April 26, 2010

Do physician investigators treat patients AND conduct medical research?

What do physician investigators/physician scientists/clinical researchers/etc. do?

Do physician investigators treat patients AND conduct medical research?
Medical research has several different arms, and physicians can be involved in all of them. Some physicians do treat patients while conducting research, and some focus only on research. Unless you are familiar with the medical research world, the differences can be somewhat confusing.





A physician can be involved in the area of basic medical research, or biomedical research, and would fit the term "physician scientist". It is not uncommon for physicians that work in this field to also have a Ph.D. This research is conducted in laboratories, in academic or industrial settings. In both settings they are usually in charge of a laboratory with staff, with the goal to answer unresolved questions regarding disease and the way how the human body works. More than likely, if a university has a medical school, and an affiliated hospital, you will find some physicians that treat patients with research labs.





Translational research is all about taking a treatment or discovery from "the laboratory bench to the patient bedside". This can also encompass pre-clinical (work performed on animals) research. This is the work that is done before a drug/method is deemed suitable for clinical research trials in humans. In this area as well, physicians can be found.





If a drug/ method of treatment shows enough promise, it will go to clinical research trials. The approval process is somewhat complicated, and too involved to explain in depth here. There are three main phases of clinical research before a drug is put before the FDA for approval, and patient trials generally start either in phase I or II. Often, drug companies outsource these pre-approval studies either directly to a CRO (contract research organization) or indirectly through their drug reps. This shows a lack of biasness on the drug company's behalf. "In house" studies are performed for very close patient monitoring, are usually performed by a CRO, and are conducted under the supervision of a physician at a specific location. If an "in house" study is not needed, the CRO or drug rep will enroll physicians from a targeted demographic (like all pediatric oncologists in the United States) that treat applicable patients as a principal investigator in the clinical research trial. In this way physicians can be investigators. These doctors then recruit patients that meet criteria to use the experimental drug. Evaluations and testing are performed. This recruitment method is also used for safety monitoring, or phase IV clinical research, after a drug has FDA approval.





A clinical researcher is not the same as a physician, as nurses, physical therapists, etc., can be involved in clinical research, and could be considered clinical researchers. The most uncomplicated way to think of the term "clinical", in regard to research, is that it generally focuses on patient outcomes. A clinical researcher is really anyone that has direct or indirect contact with patients and is working with/ looking at a novel treatment or idea, including those in research laboratories.





I hope this answers your questions clearly enough.=)
Reply:Physician investigators treat patients and conduct medical research usually involving clinical trials of new therapies/drugs. Clinical researchers hold PhD's and conduct the vast majority of medical/pharmacological research. I'm not sure about physician scientists. If they are different from the physician investigators, the difference would be that they are involved in basic, medical investigations (not clinical trials) and often hold both and MD and PhD degree.
Reply:They have to get the consent first.


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