Why research in family medicine? A superfluous question

Abstract

The ultimate answer to the question, "Why research in family medicine?" is to provide better care for our patients. Through research we want to improve quality of primary care by improving our understanding and practice of it. This research will inevitably be specific for family medicine as family medicine is a specific discipline. In this article we first explore what makes family medicine a specific discipline. In a second part we present a framework to grasp the various research questions that must be answered to achieve the complex and multifaceted goal of improving quality of care. Family medicine is a specific discipline for 3 reasons: it has a unique epidemiology, the context of care is important, and it has a strong link and responsibility to the community. Quality of care is a complex and multidimensional concept that raises diverse research questions. We propose to map these questions within a framework defined by the 3 dimensions of the Donabedian triangle--structure, process, and outcome-and within each of these dimensions by 5 foci-basic knowledge, diagnostic and therapeutic problem solving, practice implementation, policy context, and education. This framework may help to make the various research questions operational and to point out the gaps in our research. The questions and answers should be relevant to daily practice and comprise all domains of family medicine so that eventually most of our daily actions in practice will be underpinned with medical, contextual, and policy evidence and contribute to the improvement of the quality of care.

Figure 1.

An operational framework for research in family medicine.

Figure 2.

Application of the framework to research on type 2 diabetes mellitus.