Family medicine, the NIH, and the medical-research roadmap: Perspectives from inside the NIH

Background and Objectives: Family medicine has had little engagement with the National Institutes of Health (NIH), and it is unclear what NIH officials think about this. Methods: Purposive sampling identified 13 key informants at NIH for open-ended, semi-structured interviews. Evaluation was by content analysis. Results: NIH officials expressed the perception that family physicians have strong relationships with patients and communities and focus on interdisciplinary collaboration but that they do limited research and have weak research infrastructure. They also indicated that NIH has repackaged its stated focus, to include areas of research that might be applicable to family medicine, but whether this represents real change is questionable; NIH still emphasizes basic science and exclusionary trials. While NIH officials suggested that family physicians still have no obvious NIH home, they also suggest that family physicians are well-poised to recruit patients and inform questions, if not lead research. Family physicians have opportunity with Clinical and Translational Science Awards (CTSAs) but need areas of expertise and additional formal research training to succeed with greater research participation. Conclusions: NIH key informants generally appreciated family medicine clinically but viewed family medicine research as underdeveloped. Some identified opportunities for family medicine to lead, particularly CTSAs. Greater self-advocacy, research training, and developing areas of expertise may improve family medicine's engagement with NIH.