Here - Surrey and Borders Partnership NHS Foundation Trust

esorting too soon to complex statistical
tests. This is a real issue in research in
psychiatry – how to measure the elusive
concepts we deal with daily. In the rest of
medicine measuring blood sugar or bone
density levels is much more
straightforward, which is why these
branches lend themselves so much more
easily to research.
So one early tip to the young researcher
is to think very carefully before you start
your study about precisely what you are
evaluating and how you are measuring it.
Lean heavily towards using an
instrument, like a questionnaire, that is
widely accepted in the field. Of course,
some of the most gloriously innovative
research in psychiatry involves pioneering
a new measurement device, because the
research community has neglected the
concept you are investigating.
But the problems don’t end there. Let’s say
you dodged the statisticians’ scrutiny and
colleagues’ criticism. Then you may go on
to long friendships being threatened by
disputes over how to write it up. And,
finally who is going to be first author?
After that jockeying for position come the
editors’ letters of rejection. This happens
even to the most published of us. The
record among people I have known is 10
rejecting letters from editors for one
paper and 30 rejections for a book.
So given all these problems – why do
research at all?
I still firmly believe it’s worth it. Much of
what we do as doctors arises because
some researcher somewhere bravely
chose to ask the question – what is the
evidence for this piece of practice? There
is nothing more exciting than pushing
back the frontiers of knowledge and
discovering something new and – the
icing on the ‘cake’ - is that it may alter
clinical practice or improve the outcome
for patients.
Having a research interest keeps us
stimulated and interested in our
professional lives. It assists in engaging
with those of similar interests all around
the world and at a time when doctors
frequently feel neglected or downtrodden
by the NHS; it is great for the self-esteem
and earns the respect of colleagues.
I have been impressed at the clinical
acumen and lively minds we are
privileged to work alongside. I believe
there would be many benefits, including
raising clinical morale, for the Trust to
engage more with a research ethos.
Another advantage for the future is that
rapidly climbing the NHS agenda now
comes the issue of providing, proving and
improving the quality of care we provide
our patients. It would be great for us to
engage in research investigating what the
determinants of high quality care are, in
the eyes of patients as well as clinicians
and scrutinize how to improve this. There
may well be some surprising answers. It’s
entirely possible that what doctors
believe is crucial to treatment outcome is
much more peripheral.
Also while we are encouraged to
constantly keep abreast of the latest
research, its only by having done some
yourself, that you are in the best position
to properly evaluate an academic paper.
This is because you will now be aware of
many crucial issues the authors skate
over, but which you know from hard
experience, might be influencing the data
they present.
Its vital not to get pigeonholed – yes I
have done brain scanning research, but I
also got interested in qualitative research
methods – and used them to sit and
observe what goes on in waiting rooms.
These are spaces where our patients
sometimes spend more time than they do
actually seeing us!
Commercial institutions like Banks had
clearly put a lot of thought into
considering and influencing the mental
state of its customers, while they wait to
see a member of staff. The NHS in
contrast appeared to view the waiting
room as some kind of detainment
compound for undesirables. It was often
at best an afterthought in planning.
Yet by the time any doctor sees a patient
Editorial
Surrey and Borders Online Journal www.sabp.nhs.uk/journal 7