Primary care research needs extending, not moving

EDITOR—Kernick et al assert that it's time to rattle the cage of academic general practice.1 This is essentially a revisiting of the age old complaint that academics are distanced from practice and hence do not produce “relevant” research. Would the authors really contend that research into the appropriate use of antibiotics for upper respiratory tract infections,2 for example, was irrelevant?

This editorial ignores the contribution of academic practice to developing the methods of measuring change and complexity at the level of the general practitioner—patient interaction. That we can apply complex models, health services research, and qualitative methods is largely due to the growth of multidisciplinary academic primary care based in universities in the United Kingdom.

Kernick et al's biggest mistake is to consider primary care academics as general practitioner academics; this is patently not the case. At the 1999 annual meeting of the Association of University Departments of General Practice one could discover that most of the association's members are not general practitioners (they are a diverse mix of statisticians, epidemiologists, social scientists, nurses, etc). At the meeting the editor of the BMJcommended the discipline for bringing new methods and the health services research agenda into medical research. It is precisely because of the growth of academic primary care that we can now even consider pragmatic approaches to the evaluation of quality in service delivery. Without the academic …