Table 1.

Thematic Summary of Practice-Based Research Network (PBRN) Clinician Motivation Emphasizing Personal Satisfaction

Primary ThemeMain Types of SatisfactionSDT Component*Quote
Enjoyment of research without the restrictions of academic work/lifeIntellectual stimulation around medicineAutonomy, Competence, Relatedness“I think I have the best of both worlds. In terms of clinical practice, I think that medicine is more enjoyable in a nonacademic setting, away from all the politics that are part of academia.”“
They are the farm teams of research, growing investigators from the large field of doctors interested enough to participate, but not so much so as to quit their day jobs and go into academia. That is me. I may be growing slowly, but at least I’m growing.”
Sparking diverse interests and creating an opportunity to form a PBR community identity with other practitioner-researchersStimulation and connectivity with learning environments generated through PBRRelatedness“This experience [a network study within residency programs] has been especially poignant for me in that it hopefully will create a learning community among residencies.”
Opportunities to create positive behavior change among patients and other practitionersCompetence“I have enjoyed attending the convocation, meeting like minds, and have been encouraged to pursue the study of the Review of Systems. This has become a project of the Residency Branch with collaborators in several states. I have also enjoyed thinking about how to engage current residents in the scholarly activity of family medicine.”
Creates new opportunities for leadership and role modelsRelatedness“Participating in practice-based research encourages critical thinking skills and develops the necessary mindset to question basic assumptions, accept new and better solutions, and work towards increasing the value of the health care—this has to come from within the profession.”
“I wanted to be involved in showing other practitioners that attention to this teaching (physical activity, healthy eating and energy balance) really does make an impact on patients.”
“The path continued to wind across the United States as I was able to find mentors to teach me and I was asked in turn to advise others new to the moves of the network arts. We all became learners and teachers simultaneously; taken up with the excitement of this new challenge.”
Reward in creating a primary care evidence base that reflects diversity of real-world office settings and diverse populationsRewarding to have non-academic clinical experiences increase the relevance of academic research effortsAutonomy, Competence“I felt my private practice experience and input were valued and applied during discussions about which avenues research should take. I was also able to bring back simple cost effective low tech solutions to major data management problems in my private practice.”
Rewarding to improve patient care by increasing the relevance of research findings through PBRAutonomy, Competence, Relatedness“[Learning about a seminal PBRN study] illustrated to me the value of doing research grounded in clinical practice, the power of PBR to rigorously challenge the conventional ‘ivory tower’ wisdom, and the ability of a network of practicing clinicians to make an important contribution to the practice of medicine.”
Satisfying to have interventions to support patients’ real needsRelatedness“The work I have done in my exam room and in front of my computer has been published, read, and cited—it is now influencing the direction of future research.”
Provided answers for practice to questions from practice”Research has allowed me to see another side of my patients—I was pleasantly surprised to learn that one of my patients is considered the leader and cheerleader for his group (within a diabetes self-management group visit intervention).”
“After getting settled into clinical practice and the birth of my first daughter I continued participation in network studies, including the headache and influenza studies. Within 1 year I become more interested in the network studies and meetings. I identified a mentor and chose the primary care management of type 2 diabetes as my primary area of research interest.”
“The research network provided an opportunity to participate in the discussion of research concerns, the opportunity to collect data that in my office would be only anecdotal and in a network meaningful, and the opportunity to meet primary care physicians from around the country. I ‘live’ in 3 exam rooms and infrequently see my associates during the day and rarely talk about patients, and even less about systems problems. The research network and convocation give me an opportunity to meet friends and explore questions that do not have priority during the patient care hours.”
“Since before completing medical school I have been plagued with local clinical questions such as ‘What is the evidence to support this diagnosis/treatment? Treating my patients as populations makes me feel like I am being more thoughtful and scientific when I am assessing the quality of my services. If we can pool the results of common questions from regular practices, the medical literature may have more credibility when it comes to motivation for changes in practice patterns.”
“When I first approached the University about doing some research on spider bites it seems to have been dismissed by the urban academic community as something of little clinical significance. It was only when working with the research network director that it was clear we could put together a huge number of cases in a short period by linking rural practices together. This is probably a good example of the disconnect between urban academia and the practical problems faced by ‘field doctors’ and the critical shortage of research in many areas of medicine less glamorous than critical care.”
Engagement with others in clinical thinking improves clinical skills and creates meaningful connections that compensate for practice isolation or long work hourEngagement in PBR is a satisfying way to enhance clinical skillsCompetence“I believe that active participation in PBRN has improved my critical-thinking skills and my patient care, kept me at the forefront of contemporary primary care practice, and served as a source of (and stimulus to) continuing medical education.”
Rewarding connections with others are energizingAutonomy, Relatedness“Conducting research keeps my mind sharp, enhances by critical thinking skills, and encourages me to keep up with the latest treatment advances.”
“Feeling the need for continuing research to keep abreast of changes, keep skills up. And being curious, I heard about the research network for those nonacademics who represented private practice. I’ve been hooked ever since.”
“The connections keep me going. The meetings are in the evenings after a long day in the office, but I always feel energized after a meeting and have a fresh perspective.”
“I think practice-based research networks are a good tool for physicians because they allow physicians to network and improve not only how we practice medicine but also improve patient care. It also allows private practice physicians not to feel isolated, but to be involved in practice enhancement programs.”
“To help my loneliness I started reading articles and biographies of famous family physicians: William Budd, William Pickles, James McKenzie, Fred Banting, and, ironically, Curtis Hames. I did not live far from Curtis Hames and he invited me to come to his home and spend time with him. He asked me if I was interested in doing any research and I said I was but I didn’t know how to get started.”
  • * Three components of self-determination theory (SDT) are (1) competence, (2) autonomy, and (3) relatedness.

  • PBR, practice-based research.