Having shown compelling evidence that clinical research by GPs in their own practices is now virtually extinct, Professor John Campbell Murdoch attributes this to journal policy, and asks for a new category, midway between ‘what is now regarded as a rigorous research paper and the pseudo-intellectual chatterings that occupy the “Back Pages”’.1
This imminent extinction is real, and deserves more thought than Murdoch seems to have given it. I have no doubt that if good clinical research by GPs in their own practices were submitted, the Editor would be delighted to publish it, but where is Murdoch's evidence that such research is being done? Production, not publication, is the problem, and reducing standards of rigour won't solve it.
He overlooks two huge obstacles to research of this kind, both of which could and should be eliminated. To do this will be demanding, but so is good research.
First, research by primary care and within primary care has no systematic funding. It's still regarded as a sort of personal hobby for unusual people which, like stamp collecting, should normally be unpaid. Modern GPs rightly work in groups, but with our present structure of business partnerships, these can only include real research (not pseudo-research promoted by pharmaceutical companies) at their own shared expense. Partners who want to devote substantial professional time to research, and probably to work more obsessively and self-critically than their colleagues, have therefore to earn less for their partners as well as for themselves. Murdoch cites William Pickles of Aysgarth. What did his partner, Dean Dunbar, think of Pickles' devotion to research? By all local contemporary accounts, he cursed it. This does not necessarily reflect badly on Dunbar, there was …