Physician-Scientists--Endangered and Essential

If the country9s medical research enterprise is to make the contributions it is poised to deliver, the progressive, dangerous decline in the number of physician-scientists must be reversed. This decline--most pronounced among trainees and young investigators--has resulted from: societal pressures toward careers in primary care; economic disincentives, a shift in funding priorities; and the growth of managed care. Because physician-scientists are indispensable participants in the bi-directional flow of information from bedside to laboratory, and because no single agency can correct this problem alone, a major national effort--catalyzed by federal legislation-is recommended: to establish a climate in academia conducive to creating physician-scientists; to set up a network of clinical research units; to enlist the support of foundations, biopharmaceutical companies and managed care entities, as well as government and academia; and to set up a national database of physicians scientists.