title: Integrating conflicting professional roles: physician participation in randomized clinical trials.
abstract: The traditional identification of physicians as either clinician or researcher is challenged by the emergence of randomized clinical trials (RCTs) where research and clinical care are performed simultaneously. A mail survey using a self-administered questionnaire, the Physician Orientation Profile, was conducted of 101 physicians from the Collaborative Ocular Melanoma Study (COMS), a set of trials which compares surgical removal of the eye with radiation in the treatment of medium sized eye cancers. A 95% response rate was obtained; follow-up telephone interviews were conducted with 87% of respondents. Key findings suggest that RCTs challenge traditional definitions of physician's 'core task,' because they participate in a social process that requires them to integrate the formerly disparate and sometimes competing roles of researcher and clinician. Three implications of this integration are discussed: amending the expert reward system, altering customary clinical practice and redefining reference groups for professional interaction.
authors.affiliation: Centre for Health Studies, York University, Ontario, Canada.
authors.forename: K M
authors.initials: KM
authors.lastname: Taylor
mesh_terms: D000328:Adult; D035843:Biomedical Research; D003220:Conflict, Psychological; D005134:Eye Neoplasms / Q000628:therapy; D005194:Family Practice; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008545:Melanoma / Q000628:therapy; D008875:Middle Aged; D018579:Patient Selection; D010819:Physician's Role; D016032:Randomized Controlled Trials as Topic; D012106:Research; D035842:Research Subjects; D035844:Researcher-Subject Relations; D012923:Social Class; D012935:Social Justice; D011795:Surveys and Questionnaires; D036302:Therapeutic Human Experimentation; D035501:Uncertainty