Taylor K M
Centre for Health Studies, York University, Ontario, Canada.
Soc Sci Med. 1992 Jul;35(2):217-24. doi: 10.1016/0277-9536(92)90169-q.
The traditional identification of physicians as either clinician or researcher is challenged by the emergence of randomized clinical trials (RCTs) where research and clinical care are performed simultaneously. A mail survey using a self-administered questionnaire, the Physician Orientation Profile, was conducted of 101 physicians from the Collaborative Ocular Melanoma Study (COMS), a set of trials which compares surgical removal of the eye with radiation in the treatment of medium sized eye cancers. A 95% response rate was obtained; follow-up telephone interviews were conducted with 87% of respondents. Key findings suggest that RCTs challenge traditional definitions of physician's 'core task,' because they participate in a social process that requires them to integrate the formerly disparate and sometimes competing roles of researcher and clinician. Three implications of this integration are discussed: amending the expert reward system, altering customary clinical practice and redefining reference groups for professional interaction.
随机临床试验（RCT）的出现对传统上将医生分为临床医生或研究人员的分类提出了挑战，在随机临床试验中，研究和临床护理是同时进行的。对来自协作性眼黑色素瘤研究（COMS）的101名医生进行了一项邮件调查，该研究是一组将中型眼癌治疗中眼球手术切除与放射治疗进行比较的试验，使用的是自我管理问卷《医生取向概况》。获得了95%的回复率；对87%的受访者进行了后续电话访谈。主要研究结果表明，随机临床试验对医生“核心任务”的传统定义提出了挑战，因为他们参与了一个社会过程，这要求他们整合研究人员和临床医生以前截然不同且有时相互竞争的角色。讨论了这种整合的三个影响：修改专家奖励系统、改变习惯的临床实践以及重新定义专业互动的参照群体。
