Can we build the plane while flying? Creative approaches to expand the research community in hospital medicine

Anne S. Linker; Christine D. Jones; Gregory W. Ruhnke

doi:10.1002/jhm.13115

Can we build the plane while flying? Creative approaches to expand the research community in hospital medicine

Anne S. Linker, Christine D. Jones, Gregory W. Ruhnke

Research output: Contribution to journal › Editorial

Original language	English
Pages (from-to)	560-561
Number of pages	2
Journal	Journal of Hospital Medicine
Volume	18
Issue number	6
DOIs	https://doi.org/10.1002/jhm.13115
State	Published - Jun 2023

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10.1002/jhm.13115

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@article{3bbe13091b3a40cab4d706ed3df46eaa,

title = "Can we build the plane while flying? Creative approaches to expand the research community in hospital medicine",

author = "Linker, \{Anne S.\} and Jones, \{Christine D.\} and Ruhnke, \{Gregory W.\}",

note = "Funding Information: Disease-related funding mechanisms favor investigators with a specific clinical focus. Despite a brisk expansion in publications by hospitalists and although total federal funding has doubled, funding remains consolidated in a small subset of institutions. Many institutions report foundation grants, which are typically considered less valuable both for institutions and in the academic promotions process. The Agency for Healthcare Research and Quality is a natural target for research proposals likely to arise from investigators in HM but is less well-funded than the NIH.3 Lessons from Emergency Medicine (EM) may be of value.4 The Office of Emergency Care Research (OECR) was created in 2012 after a 5-year period of formalized discussion between the NIH and EM communities,5 after which reports from the Institute of Medicine detailed the need for an EM research funding mechanism. OECR works with the NIH to match researchers with funding opportunities, encourages collaborative investigation, and has stimulated a dramatic rise in EM funding.6 A similar approach might create funding opportunities in HM related to medical errors, patient safety, and systems-based care. The next critical step is advocacy by SHM, JHM, and collaboratives like the Hospital Medicine Reengineering Network (HOMERuN) to stimulate commitment to HM as a field of investigative inquiry and rigorous implementation science by the National Academies and the NIH. Comparisons with general internal medicine (GIM) may be instructive, but there are notable differences between the current state of HM and GIM's development in the 1980s. In 1979, across GIM units, training grants were the second largest source of income (14\%) and patient care only accounted for 48\% of professional activities.7 Now the competition for training grants is more intense, especially as a new T32 opportunity in HM would require that the NIH “defund” a current program. In the past, clinical revenue often cross-subsidized research—a survey of department chairs demonstrated that 71\% intended to use departmental funds to support research in GIM divisions.8 In HM, clinical work dominates professional activities, yet departmental funding to support research efforts is scarce.",

year = "2023",

month = jun,

doi = "10.1002/jhm.13115",

language = "English",

volume = "18",

pages = "560--561",

journal = "Journal of Hospital Medicine",

issn = "1553-5606",

publisher = "Frontline Medical Communications Inc.",

number = "6",

}

TY - JOUR

T1 - Can we build the plane while flying? Creative approaches to expand the research community in hospital medicine

AU - Linker, Anne S.

AU - Jones, Christine D.

AU - Ruhnke, Gregory W.

N1 - Funding Information: Disease-related funding mechanisms favor investigators with a specific clinical focus. Despite a brisk expansion in publications by hospitalists and although total federal funding has doubled, funding remains consolidated in a small subset of institutions. Many institutions report foundation grants, which are typically considered less valuable both for institutions and in the academic promotions process. The Agency for Healthcare Research and Quality is a natural target for research proposals likely to arise from investigators in HM but is less well-funded than the NIH.3 Lessons from Emergency Medicine (EM) may be of value.4 The Office of Emergency Care Research (OECR) was created in 2012 after a 5-year period of formalized discussion between the NIH and EM communities,5 after which reports from the Institute of Medicine detailed the need for an EM research funding mechanism. OECR works with the NIH to match researchers with funding opportunities, encourages collaborative investigation, and has stimulated a dramatic rise in EM funding.6 A similar approach might create funding opportunities in HM related to medical errors, patient safety, and systems-based care. The next critical step is advocacy by SHM, JHM, and collaboratives like the Hospital Medicine Reengineering Network (HOMERuN) to stimulate commitment to HM as a field of investigative inquiry and rigorous implementation science by the National Academies and the NIH. Comparisons with general internal medicine (GIM) may be instructive, but there are notable differences between the current state of HM and GIM's development in the 1980s. In 1979, across GIM units, training grants were the second largest source of income (14%) and patient care only accounted for 48% of professional activities.7 Now the competition for training grants is more intense, especially as a new T32 opportunity in HM would require that the NIH “defund” a current program. In the past, clinical revenue often cross-subsidized research—a survey of department chairs demonstrated that 71% intended to use departmental funds to support research in GIM divisions.8 In HM, clinical work dominates professional activities, yet departmental funding to support research efforts is scarce.

PY - 2023/6

Y1 - 2023/6

UR - https://www.scopus.com/pages/publications/85158013903

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DO - 10.1002/jhm.13115

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C2 - 37129425

AN - SCOPUS:85158013903

SN - 1553-5606

VL - 18

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JO - Journal of Hospital Medicine

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