Driving Medical Innovation through interdisciplinarity: a role for the Clinician-scientists?

by Annet van Royen-Kerkhof

The domain of health care is rapidly changing. Medicine is going to face more and more complex problems, requiring multidimensional solutions. Examples of these complex problems are: the increase of obesity within the general population, leading to various chronic illnesses, such as diabetes and cardiovascular disease; vaccine refusal and subsequent increase of infectious diseases; end of life discussions in an era with abundant (costly) treatment options. In addition, the impact of climate change on health care is becoming more clear, and needs to be addressed. These problems cannot be solved by doctors or scientists alone, but need the involvement of other disciplines e.g. sociologists, economists, environmentalists and so on.

In the twentieth century, basic science evolved to a large extent inducing a lot of new research insights. This enhancement led to a proliferation of individual disciplines, mostly in silo’s. Beyond discussion, discipline‐specific training is critical for ensuring research excellence within fields. However, we are now in an era in which the need for cross-discipline research is increasing, acknowledging the inherent complexity of  nature and society.

This means an urgent call to start bridging the disciplines and aim at interdisciplinarity. Interdisciplinary research collaboration means integrating insights and producing an interdisciplinary understanding. To be able to do this one must understand the language of another discipline, willing to really listen, ask questions.

Interdisciplinarity has its own set of unique challenges, ranging from communication issues to allocation of credits among a team. These aspects should be addressed and taken into account in the process of interdisciplinary collaboration. In Natures Special on interdisciplinarity (2015) it was noted, that interdisciplinary research takes time to have an impact, thus less attractive for funding agencies. Interdisciplinary work can have broad societal and economic impacts that are not captured by citations, which might be a drawback for young researchers, that in the current system will be judged by the citation index.

Luckily, more and more the high impact of interdisciplinary research is being acknowledged, as well as that for complicated problems interdisciplinary collaboration is required. While this change is taking place, the clinician-scientist can take position, namely clinician-scientists have the capacity to work in or lead interdisciplinary teams, they have already encountered hurdles, that might hamper true interdisciplinary research. The clinician-scientist is used to overcome issues of communication, allocation of credits, since this is part of daily practice, within a university, still with a disciplinary structure.

With this changing perspective, institutions can start to facilitate the training of clinician scientists, e.g. by interdisciplinary projects early in educational programs, so students are used to crossing boundaries and are trained to be open to other perspectives. Funding agencies should take into account the added value of interdisciplinary research for complex problems. Therefore I think, that from what might have been perceived as a difficult position, in the near future the clinician-scientist will be figure head of highly valued interdisciplinary teams, leading to innovative research.

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