The model of the “cowboy” researcher has its roots in the world of basic As Atul Gawande writes: Gawande A. Cowboys and pit crews. “The invitation to give this lecture was a chance for me to think about systems improvement in historical terms,” said Atul A. Gawande, MD, MPH, FACS, who. GAWANDE: We have trained, hired and rewarded people to be cowboys. But it’s pit crews that we need, pit crews for patients. There’s evidence.
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The word pioneer conjures many images, ayul that of the first to discover something. It implies aloneness, if not loneliness. In research—especially family medicine research—nothing could be further from the truth.
Atul Gawande: Medicine Has Become A Team Sport — So How Do We Treat It Like One? : NPR
As with clinical practice itself, successful research requires pit crews, not cowboys. Teamwork is a theme in the work of all 20 pioneers, but in some cases this theme is more explicit. The earliest pioneers of practice-based research like James Mackenzie, William Pickles, and John Fry in the United Kingdom, Frans Huygen in the Netherlands, and Curtis Hames in the United States did work largely alone, but the work of almost all of the 20 named pioneers would have been impossible without important and close collaboration with others.
Similarly, Dr Rick Birtwhistle was recognized for leadership in establishing and driving the Canadian Primary Care Sentinel Surveillance Network, a repository of patient data from electronic medical records from 11 primary care practice-based research networks in 7 provinces and the Northwest Territories.
Anonymized data are collected from almost providers at clinics for almost 1 million patients, 6 giving family medicine researchers unprecedented power to understand the type and complexity of health problems seen in primary care and the capacity to improve care and outcomes for patients and communities. Interestingly, a team and all its members were recognized among the pioneers—the Thames Valley Family Practice Research Unit.
Pioneers and pit crews
Although it might not always be as evident as in these examples, there is no doubt that the work of other recognized pioneers such as Drs Rick Glazier, 7 Gail Webber, 8 and Janet Smylie 9 is highly dependent on teamwork.
The problems of making health care work are large. The complexities are overwhelming governments, economies, and societies around the gawznde.
We have every indication, however, that gawandd people in medicine combine their talents and efforts to design organized service to patients and local communities, extraordinary change can result. This applies as much to the research enterprise as to clinical care, as family medicine and primary care grapple with delivering cost-effective, high-quality care in an era of chronic disease and an aging population.
National Center for Biotechnology InformationU.
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Open in a separate window. College of Family Physicians of Canada; Accessed Sep Cowboys and pit crews.
A personal account of the discovery of the structure of DNA. Green LA, Hickner J. A short history of primary care practice-based research networks: J Am Board Fam Pract. Rosser WW, Green L. Density, destinations or both?
Pioneers and pit crews