Physician-scientists typically engage in both clinical care and basic or clinical research (though not always at the same point in their career). That combination of experience and training allows the physician-scientist to contribute a unique perspective that encompasses both the “bedside-to-bench” and the “bench to bedside” approach. By both seeing patients and performing research, they can translate clinical observations to the laboratory to help identify the mechanisms of disease, as well as applying the finding of basic science to patient care.
It is difficult to obtain accurate numbers about the total size of the physician-scientist workforce because data is not available on the number of physician-scientists whose research is funded by non-NIH sources, or those employed in the pharmaceutical or medical device industries. PSW-WG analyses indicate that there were approximately 9,000 physician-scientists in the NIH-funded workforce during 2008-2012, including 4,192 with an MD, 4,086 with an MD/PhD, 341 nurse-scientists, 253 veterinarian-scientists, and 161 dentist-scientists (Figure 2.1).
Among MDs, most physician-scientists fall into one of two broad categories: those who perform research directly with patients in their practice, and those who conduct laboratory-based research. Despite increasing efforts to educate physicians in research methods, the dramatic advances in molecular and cell biology in the second half of the 20th century accelerated a reductionist approach to basic biomedical research, leading to a language barrier between basic scientists and clinical practitioners.11
Among non-MD physician-scientists, each makes specific contributions to biomedical research:
Dentist-scientists. These physician-scientists, like MD-scientists, are positioned to derive their research questions and concepts from clinical (chairside) observations. The 2000 publication "Oral Health in America: A Report of the Surgeon General," concluded that there is a need to support and maintain a biomedical research infrastructure to enhance knowledge about oral disease and improve the oral and general health of the U.S. population.
Veterinarian-scientists. The National Research Council (NRC)’s Committee on Increasing Veterinary Involvement in Biomedical Research (2004), Committee on the National Needs for Research in Veterinary Medicine (2005), and Committee to Assess the Current and Future Workforce Needs in Veterinary Medicine (2013) described multiple roles for veterinarians in biomedical research, including serving as principal investigators, co-investigators, research scientists, and technical advisors. They noted that these individuals also perform important supportive roles as attending veterinarians at research institutions, where they provide medical care for research animals, serve as federally-mandated members of animal care and use committees, and provide technical instruction and advice on experiments utilizing animals.
Nurse-scientists. As the largest group of clinical practitioners in the U.S. healthcare workforce, nurses are uniquely positioned to make important contributions to improving health and quality of life. Nurse-scientists, many of whom conduct clinically-based, patient-oriented research, develop science that informs clinical practice. While some nurse researchers conduct basic science to uncover the biological mechanisms of disease, the main focus of nursing research is minimizing the impact of disease on individuals, their families and caregivers, and communities.
11 Schafer, ibid.