Research Program Helped Me Improve My Community’s Health. Applications Are Open Again

When I first saw the announcement, I didn’t have time to apply. Now, isolating with my own case of COVID, I had a windfall of free time. Pregnant people were dying. It seemed more important than ever to take time to explore questions about how we could improve prenatal care.

FMD RapSDI was an opportunity.

As primary care clinicians working hard to provide day-to-day care for our patients, we might wonder how we can possibly include research in our schedules. Our days are full; we focus on the patient in front of us, and the next and the next. We need time for our families; we are caring for parents, reading to children, exercising. We may need to sustain ourselves with time for other passions. Research, if we are going to do it, needs to fit within the hours we dedicate to our work.

With all of those obligations, we might also ask: Why? 

One element of physician burn-out is desperation: We want to use the hours we have in order to make a difference, but it is hard to get our heads above water to see the difference we are making. 

Research, if it occurs within a team, and if time is cordoned off within our work hours to focus on it, can be a way to make that change. Research need not be hyper-specialized, ivory tower work. If done in the primary care setting, on topics near to our own hearts, it can be a way to make a change in our local communities, for our patients. 

Our particular rural community, far from subspecialists.

Or our urban community, where access to care may be unequally distributed.  

Or our particular ethnic community, with beliefs and practices that inform how individuals interact with the health care system. 

The questions we would like to answer for our own communities and our own patients can be voiced through research if a support structure is present. 

If time is available. 

If we have a team of people who are as invested as we are, who have research expertise and can move the project to its goal.

FMD RapSDI is one model providing that time and support. The program provides each clinician-scholar with a team of experts in research to help structure and complete the project. The program also provides a grant to obtain supplies or reimburse the family physician and clinic staff for their time. For family physicians working within a larger organization, an important element of the program is a commitment from the organization, as a partner in the program, to dedicate a portion of the family physician’s work time to the research.

The project I proposed in August of 2021 was an examination of the use of virtual visits in prenatal care for patients with substance use disorder. Each year, the FMD RapSDI application occurs in two stages. Round one, which is open for the 2025 cycle until Jan. 16, is a proposal of a research question. This is not a full grant proposal, which relatively few of us in primary care have had experience in constructing. Instead, it is the development of a question that is pertinent to your practice, your own patients, your community.  

In round two, four finalists are selected to develop their research questions into a full grant proposal. Mentorship begins here: All four finalists are coached through the process. 

The second-stage application mimicked a grant-writing cycle, and the FMD RapSDI team helped me understand the steps and timelines involved. They helped edit the application itself, to hone it and make it more effective. They provided expertise in constructing a budget. And they helped me learn how to work with a grant-writing team. 

Whether selected as a scholar or not, each of the four finalists came away with important insights into how to develop a project and pursue grants in the future. 

After selection of the two scholars, the FMD RapSDI team continued to coach and support us. I learned to work with a project manager, a statistician, clinic staff and administration. They walked me through the institutional review board application and patient recruitment.

Along the way, I learned to be flexible. For example, we initially planned to recruit patients widely through multiple systems, including our hospital ER, OB triage, and community organizations. This complexity proved challenging. We simplified the plan, recruiting instead among patients who presented to our clinic for care.

Pivoting, re-envisioning, simplifying: These skills would have been difficult to attain without an experienced support team.

Although this support answered the question of how to pursue research, the question remains of how to find the time. A crucial aspect of the program is the commitment from the physician’s organizational administrators that, if selected, the physician scholar will have dedicated time to work on the project. In addition, a portion of the grant funding can be utilized not only to pay for the scholar’s time as principal investigator, but also to pay clinic support staff for their time and interaction with patients to further the study. Though the grant is small, it provides an important model for how a working primary care clinic can do research that promotes patients’ health.

In the end, my own prenatal care study accomplished its goal: It provided specific information about our clinic and our community that can now impact how we deliver prenatal care to our patients. We learned about the importance of clinic staffing. We learned about how strongly our patients felt about their rapport with their prenatal physicians. We learned about how and when to use virtual visits in prenatal care. And we learned that small research projects that make a difference are possible within our primary care setting. 

The FMD RapSDI program itself is accomplishing a much larger goal: inspiring family medicine physicians. As family doctors, we have our hearts in primary care, and we want to seek answers to improve health in our own communities. Our questions, our knowledge and our voices can make a difference. FMD RapSDI is leading the way.