Seven Reasons to Do Research
What’s yours?
There are 7 reasons for students, residents, fellows, and faculty to do research. Let me list them; then let’s discuss them
To learn about the world
To improve the lives of patients
To get promoted
To make money from patents/spin offs
Habit/inertia
To kill time
Masochism
Let’s consider them in turn
There are still a few people each year who participate in science for the sake of science. To learn about the universe and how the body works. Godspeed to all those this applies to. I salute you.
There are still many physicians and researchers who believe that their work will improve outcomes for patients and public policy. This was and remains the reason behind most of my papers — which are largely about health policy.
In order to jump to the next rung of the ladder, you’ve gotta do some research. This is a terrible rule, but it is real. Every time you look at someone’s CV (for evaluating trainees) and say that’s impressive, you’re contributing to the problem. I would much rather we reward people for being good doctors. When evaluating CVs — its quality over quantity. Read the underlying papers and quiz the trainee. The person who really understands and justifies what they did is the winner
Modern universities are patent trolls. The amount of money they pour into faculty who can generate lucrative patents/products/spin-offs is astonishing. They want a piece of every startup, and many academics are eager to make a dozen or more. Researchers start out wanting to so good and help people but along the way become disillusioned and see the patent as the destination. Then they care mostly about the exit and not about helping people. You can have a great financial exit for a failed product. Being acquired is the goal.
People who work at universities for a long time, who mostly see patients, occasionally do some side projects. If they’re perfectly honest, a lot of this is just habit and inertia. These projects don’t help anybody and produce no meaningful data. They probably don’t wanna do them anyway. Break the habit.
If you do a seven-year general surgery residency, you have to kill time in years four and five. Enter research. Same is true for most fellowships. Why don’t they let you graduate early instead? They need you for the call pool. You are cheap labor. PS we just launched a new lymphoma fellowship. ;)
There are still some people who are doing research just to torture themselves and not for love of the game or any external benefit. If they are perfectly honest, they are not even chasing knowledge. They like the grind. If this is you, there are other ways to suffer. Consider becoming a primary care physician in a large hospital system with many quality metrics.
I’ve ordered this list from good reasons to do research to bad reasons to do research, but only you know the reason why you’re doing it. Just be honest with yourself.
Importantly, even research done for the right reason may not be true or useful. On Sensible Medicine we evaluate the product and not the motive.


"Consider becoming a primary care physician in a large hospital system with many quality metrics."
Ouch
I did research in the latter part of my career because there are so many gaps in evidence for why we do what we do. One stands out: my patient with decompensating cirrhosis was found to have a gallbladder polyp now measuring 10 mm. Doing his own research and seeing in the surgical literature that there was a higher risk of cancer, he talked a surgeon into operating, despite my pleas to get followup measurements. After bleeding complications left a scarred-in liver, he later died of the inability to do further surgery. This led to a study of 20 years of Kaiser data, showing overall no higher risk of gall bladder cancer with a polyp than without, and that even with growth to 10 mm cancer was exceedingly rare. So much of what we do is habit, clinical questions led to research: why are we doing colonoscopies-endoscopies on asymptomatic premenopausal women with iron deficiency? Do people with hepatitis C have an increased risk of liver flare when they receive chemotherapy? Is there really a high risk of seeding if one biopsies liver cancers? Do those with hepatitis B die in old age of hepatitis B, or of the usual heart disease-cancer causes?
In medicine as in life, “the unexamined life is not worth living”.