Clinical medicine is increasingly influenced by systematic scientific approaches, working along mechanistic concepts of genes, gene expression or signalling pathways rather than along symptoms or organs. How much scientific knowledge does a modern physician therefore need to possess? Does exposure to science make a better general practitioner?
The progress of medical research needs the contribution of: (i) the scientist pursuing fundamental mechanisms and guided by the quest of knowledge, as well as (ii) the clinician, who is mainly driven by the desire to help his patients. The clinician is capable of recognizing the clinical potential of new ideas, and has access to patients or patient material for validation of laboratory results, while the scientist has the training and the time to delve deep into complex experimental models and techniques.
It is clear that these two worlds must meet for medicine to substantially move forward. The obvious and classical model to achieve this is to amalgamate the scientist and the clinician in one person, the clinician scientist. From a recent survey (unpublished) amongst medical researchers we have learned that clinician scientists, who are in a position to divide their time between laboratory and clinic, are highly satisfied.
However, the worlds of science and medicine appear to drift apart: fewer and fewer doctors take on the double challenge of both research and patient care.
Is it the pressure of profitability of patient care that leaves no room for research? Is it the increasing burden of family obligations or the increasing longing for work-life-balance that makes doctors go home when their clinical shift ends instead of going to the laboratory? Has science become too complex to be mastered successfully with less than a fulltime commitment? Why are there so few Nobel Prizes in Physiology or Medicine held by clinicians?