CLINICAL RESEARCH

Contributing Beyond Patient Care

Clinical trial research can provide a worthwhile avenue to expand your horizons, but consider these pros and cons first.

By the staff of New Ophthalmologist

► So you'd like to become involved in clinical research? Or maybe you're just thinking about it. For many physicians, it can be a worthwhile and interesting addition to their standard practice. Here are a few reasons you might want to pursue this area of medicine, along with a few reasons why clinical trials may not be suited for you.

Contribute to Your Field

Clinical research helps set the agenda for the future of patient care. The insights gained from research define which treatments or therapeutic strategies are effective, and, conversely, which are ineffective or even harmful, and create the framework to tailor clinical management based on patient and disease characteristics. Seenu Hariprasad, M.D., director of clinical research, vitreoretinal service, University of Chicago, says, without these studies, we'd have no way to improve health care. In fact, without clinical trials, there would be no evidence-based medicine.

Learn While Doing

Participating in clinical research is an excellent way to keep abreast of new developments in your field. "This experience broadens your professional perspective and provides an opportunity to learn how other physicians approach patient management," says George Williams, MD, chair of ophthalmology at William Beaumont Hospital in Royal Oak, Mich. When faced with a difficult case, the insight gained from direct involvement in research may give you a broader perspective, enabling you to make the correct diagnosis or formulate a better treatment plan.

Build a Reputation

Becoming a clinical investigator can position you as an innovator and pioneer. It also can elevate your standing among colleagues as well as patients, and thus attract new members to your practice. Depending on the type of study, clinical research also may offer your patients access to cutting-edge, state-of-the-art treatments that aren't widely available.

Beyond patient care, in some cases you might have a chance to be credited as an author on a paper. Assembling a body of published work will help build your practice, your reputation and ultimately, your medical career.

Build Your Network

Clinical research attracts trailblazers, and study investigators often are leaders in their field. For a young ophthalmologist just starting out, the opportunity to meet and interact with influential opinion leaders can be an invaluable experience. You may even find a mentor who can advise and support you in your professional development.

Investigator meetings, which the trial sponsor convenes, bring together researchers for updates and analysis and provide an excellent opportunity to engage with opinion leaders and other physicians in an often informal — sometimes social — setting.

Financial Compensation

Participating in clinical trial research will never be a financial windfall, and in some cases, it can become a financial drain. This could be the case if you're taking time away from the care of "paying" patients or if the study requires a large amount of paperwork. Fortunately, most corporate sponsors of clinical trials provide adequate compensation for your time, and some provide a stipend to cover administrative demands on your staff.

Forms, Forms, Forms

In general, clinical trial research is not for those who cringe at paperwork. It's true that some studies have minimal reporting requirements, for example, a 1- or 2-page checklist, but this is the exception rather than the rule. And there are other forms and procedures to consider, such as the need to obtain informed consent from study patients. If you want to become a clinical investigator, be prepared to accept the administrative responsibilities.

How to Begin

If you're interested in pursuing clinical research, how do you get started? There's no single method that will guarantee success. To identify studies for which you might qualify, check professional journals and Web sites, or contact a professional association such as the American Academy of Ophthalmology. You might also contact instructors and attending physcians under whom you trained, because they're often in a good position to know about ongoing or planned research. Or check with the chairman's office at major hospitals and medical centers. They may know about research that's already under way at the institution, and they may be able to link you with a study organizer.

Finding a mentor who's familiar with the ins and outs of clinical research can be very helpful, Dr. Hariprasad notes. Here again you may want to turn to some of the physicians you worked with during your training.

Another idea, according to Peter Kaiser, M.D., director of the Digital OCT Reading Center of the Cole Eye Institute, Cleveland Clinic, is to tap medical industry sales and clinical representatives with whom you interact. If you communicate your interest to them when they happen to be in your office, you'll already be on their radar when their company begins planning a study.

Keep in mind that, even when you find a study that interests you, there's no guarantee you'll be selected to participate. Study organizers weigh many considerations in choosing study sites. You and your practice must be a good fit for the particular research. You may be required to submit information about your clinical focus, patient base and other factors that could affect your ability to recruit patients and meet other requirements of an investigator.

In the Final Analysis

Clinical research can be a rewarding means by which you can contribute to your field. Research also may provide an opportunity for you to meet key opinion leaders in ophthalmology. It may help you build a reputation of your own. But clinical research also can be demanding, even frustrating, and can place administrative burdens on you and your staff. Plus, it can be difficult to get started as an investigator. However, once you do, it will become increasingly easy to find, and be selected for, other studies. In time, being a clinical investigator may open the door to other career opportunities, such as university positions or government medical service (think Food and Drug Administration or the National Institutes of Health), that you may never have considered or qualified for otherwise.

Who knows where an interest in clinical research might take you. Today you may be enrolling 10 patients in a small study, but one day you might be the principal investigator in a clinical trial that has all of your colleagues talking. nMD