The researcher development program: how to extend the involvement of Australian general practitioners in research?

CONTEXT: This article reviews the Researcher Development Program (RDP) component of the Australian Government's Primary Health Care Research, Evaluation, and Development (PHC RED) strategy, examining critical aspects of program performance and suggesting strategies that might increase the involvement of rural GPs in research. ISSUE: Primary health care research capacity can only be built by providing sustainable, dedicated funding and a dedicated redistribution of workload from practice to research. The PHC RED funds and program supports only provide incentives to redirect existing capacity within primary health care from patient care to research for the time during which incentives are in place, generally as a part-time funded position for less than one-year's duration. The one-year time constraint is the most serious impediment to the success of the program. There is no formal provision for the continuing status of clinician/researchers. Continuation depends on the capacity of the mentor agencies, academic departments of general practice or university departments of rural health, to continue to support them, and on the time they can make available from their practice. Existing measures of program success, published research and new knowledge incorporated into practice settings, are too ambitious for researchers given a one-year time frame, working part time. Clinician/researchers have a demonstrated willingness to devote time to developing and answering a research question, but often lack the time and administrative support to get through the processes required, including ethics application and writing for publication. LESSONS LEARNED: A better way to capture success of the RDP program might be through a multi-objective composite set of measures of research performance that captures different types of outputs, with weighting factors assigned to different measures of research output. Development of peer-review panels to replace or augment annual reporting to assess the progress of PHC RED programs might also serve both to measure success and to promote collaborative ventures. Small scale research projects are more conducive to practising GPs than randomised controlled trials or large scale observational studies. Smaller projects can still lead to important discoveries and improvements to the healthcare system. Examples include guideline development, descriptive studies, and small-number analytical epidemiological studies. In order to engage the rural primary care community in redirecting clinical time to research, the needs of clinicians must be met, as well as those of funders, academic mentors and collaborators. Structures and systems that can be developed through PHC RED, including research networks, will determine whether efforts to increase research in primary-care settings succeed and are sustainable. Sustainable networks need sustainable funding.