2016 Radcliffe Lecture - Academic primary health care: still the poor cousin of hospital-based research?
The 2016 Radcliffe Lecture "Academic primary health care: still the poor cousin of hospital-based research?" will be given by Professor Trish Greenhalgh at 6pm on 16 November 2016 in St Luke's Chapel, Radcliffe Observatory Quarter.
Abstract - In 1999, Richard Horton, the editor of the Lancet, accused academic primary health care of being self-absorbed, managerialised and “one of the most intellectually underdeveloped disciplines in medicine”. Only a handful of randomised trials had produced answers that were directly relevant to primary care decision-making. And in relation to the grey zones of primary care practice for which randomised trials were never going to provide the answers, primary care academics had not even begun to develop appropriate methodologies. Furthermore (claimed Horton), too much research effort was being spent on “administrative” questions. What has happened since? This lecture will review progress in primary health care as an academic discipline from the appointment of Oxford’s first academic post in General Practice (a Readership held by Godfrey Fowler) in 1977 to the present day. Expect a quick overview of the standard territory (randomised trials are certainly alive and well in GP land) followed by a guided tour of lesser-known research methods in the swampy lowlands of general practice from geospatial mapping to linguistic ethnography. Horton’s allegation that primary care spends too much time researching “administration” will be critically examined with reference to the pressing policy priorities of GP commissioning, effective gatekeeping and reduction of health inequalities. BOOK HERE
Trish Greenhalgh is Professor of Primary Care Health Sciences at Oxford. She is triple qualified, having gained a BA in Social and Political Sciences from the University of Cambridge in 1980, a medical degree from Oxford in 1983 and an MBA from University College London in 2015. She is Director of the Interdisciplinary Research in Health Sciences (IRIHS )centre.
The lecture will be followed by a reception in the Dept. for Primary Care Health Sciences. Admission is by pre-booked ticket - BOOK HERE
Her early career was in hospital medicine, specialising in diabetes and endocrinology – in which (after a short break to start a family) she gained an MD in 1995. Her initial focus as an academic diabetologist had been the laboratory-based study of insulin pharmacokinetics during periods of metabolic stress. Her interest later shifted to the patient’s lived experience of diabetes (the ‘illness narrative’), including the family, social and cultural context in which ‘self-management’ occurs, and the organisation and delivery of services for monitoring and preventive care. Diabetes disproportionately affects people from minority ethnic and socio-economically deprived groups, and its prevalence increases with age. Those who are poor, elderly, immigrants and speak limited English are in multiple jeopardy. Improving outcomes for such individuals requires an interdisciplinary approach that incorporates biomedical, psychological, socio-cultural and organisational dimensions, as well as optimising health informatics to support both front-line patient care and secondary uses (audit and research).
Professor Greenhalgh currently leads a programme of research at the interface between medicine, management and the social sciences. Her work seeks to celebrate and retain the traditional and humanistic aspects of medicine while also embracing the unparalleled opportunities of contemporary science and technology to improve health outcomes and relieve suffering. With her team at IRIHS, she addresses such diverse themes as the evaluation and improvement of clinical services at the primary-secondary care interface, particularly the use of narrative methods to illuminate the illness experience in ‘hard to reach’ groups; the challenges of implementing evidence-based practice in clinical practice and healthcare policymaking (including the study of knowledge translation and research impact); the adoption and use of new technologies (including electronic patient records and assisted living technologies) by both clinicians and patients; and the application of philosophy and the arts to clinical practice.
Professor Greenhalgh is an experienced teacher of undergraduates and postgraduates. Many of her higher degree students have gone on to win national awards and establish their own programmes of research, teaching and service development. She is an internationally recognised innovator and researcher in medical education, especially in the field of e-learning.
Her external roles in the UK have included: Deputy Chair, Main Panel A (Medicine) of UK Research Excellence Framework, Wellcome Senior Investigator, NIHR Senior Investigator and Council Member of Royal College of General Practitioners. She also holds a number of government and academic advisory roles internationally, including the World Health Organisation and European Public Health Association. In 2014 she became only the second woman GP ever to be elected to the UK’s prestigious Academy of Medical Sciences.