NIH Funding in Family Medicine: An Analysis of 2003 Awards

Abstract

PURPOSE We wanted to analyze National Institutes of Health (NIH) awards to departments of family medicine. METHODSWe obtained the list of NIH awards to departments of family medicine in 2003, and collected additional information from the Internet regarding each principal investigator (PI), including whether he or she worked primarily in a core (central) organizational component within a family medicine department. RESULTSOne hundred forty-nine NIH awards were granted to 45 departments of family medicine, for a total of $60,085,000. Of 146 awards with a designated PI, approximately two thirds of awards (89, 61%) and awarded dollars ($39,850,000, 70%) went to PIs who were either not full-time family medicine faculty primarily working in family medicine departments, or they were not working in core family medicine organizational components. Few awards to physician PIs in these noncore areas were to family physicians (4 of 37, 11%), whereas most awards to physician PIs in core family medicine areas went to family physicians (40 of 45, 89%). In contrast, most K awards (research career programs) went to PIs in core areas (19 of 23, 83%), and most to family physicians (17 of 23, 74%). Nationally, only 17 R01 awards (research project, traditional) went to family physicians.CONCLUSIONS Most NIH awards to family medicine departments went to PIs in noncore organizational components, where most physician PIs were not family physicians. Family medicine departments interested in increasing NIH funding may want to consider 4 models that appear to exist: individual faculty in core departmental components, K awards, core faculty also working in university-wide organizational components that provide research infrastructure, and integrating noncore administrative components into the department.

Off the Roadmap? Family Medicine's Grant Funding and Committee Representation at NIH

“…1,6,13 Levels of funding for family medicine were reported most recently by Rabinowitz et al, 21 but only for a single year (2003) and with no estimates of change through time. Trends in funding were assessed by Campos-Outcalt et al for the years 1984 to 1997.…”

“…1,6 Through membership, family medicine can participate in research review and help set priorities for national research spending. As a baseline, we were unable to identify any reports quantifying family medicine's membership on NIH advisory committees in the published literature.Increasing funding from NIH is also a goal of family medicine leaders.1,6,13 Levels of funding for family medicine were reported most recently by Rabinowitz et al, 21 but only for a single year (2003) and with no estimates of change through time. Trends in funding were assessed by Campos-Outcalt et al for the years 1984 to 1997.…”

“…1,7,13 Burgeoning junior investigators could look to veteran grantees-preferably in family medicine but also in other disciplines-for mentoring through career development programs (ie, K awards). 1,6,13,21 Encouragingly, with disproportionate percentages of new awards and K awards going to family medicine during the last 5 years, partnering with mentors and existing research infrastructure may already be occurring.Our study has notable strengths. Analyses of awards over the last 5 years allowed us to appreciate that there has been little substantive change in funding to family medicine since previous analyses, specifically in relation to the doubling of the NIH budget.…”

How Can Practice-based Research Contribute to the Elimination of Health Disparities?

“…17 Conducting research in these settings generates more unique challenges than in the academic environment and requires different resources, staffing, and skill sets. 18 Unfortunately, most NIH-funded research is not conducted by primary care generalists, 19 and most quality improvement interventions are not specifically designed for high-disparity populations. In a recent systematic review of quality improvement intervention trials that included mostly ethnic minority patients, researchers found that most interventions did not specifically target the needs of minority patients, and the studies did not address which strategies are most effective in reducing disparities between minority and white patients.…”

In This Issue: Capacity for Caring and Generating New Knowledge

“…Rabinowitz and colleagues analyze NIH funding to US family medicine departments in 2003, fi nding some interesting patterns. 13 The 17 investigator-initiated (R01) awards to family physicians represent only 0.055 % of the 30,886 R01 grants awarded in that year. 14 Katerndahl and Crabtree study the 10-year outcomes of a methodological think tank held at a national primary care research meeting.…”