Medical Research And The Hospital

Press, Volume CII, Issue 30190, 23 July 1963, Page 12

Medical Research And The Hospital

Not long ago the practice of medicine was an art. During the last few decades, however, there has been a tremendous growth in scientific medicine. Scientific knowledge is born of research. We are living in an age of intensive medical research. It is going on everywhere in the world. No longer are men content to accept things without question, to accept without understanding. Yet man is still far from mastering his environment: every step forward seems to bring a fresh challenge.

Even the most learned doctor in the world can never “know” medicine,, he must continue to learn it. Medicine is a life-long study and research is a necessary part of this study. Where does research come into the New Zealand medical scene? Who undertakes it? It can be undertaken only to a very limited extent by the general practitioner, whose arduous job is to keep abreast of progress in practical medicine and to apply

it to the patient in his normal environment —in his home or at his place of work. How then does the general practitioner keep up to date? How does it happen that New Zealand has set such a high standard of medical care? Is this due to the high quality of its general practitioners and to their undergraduate training? Basically this is true: but it would be impossible for the practising doctor to maintain the high standard of his work if he did not have behind him a numerically smaller, but none the less important, band of specialists grouped together at the public hospitals.

Role Of Big Hoapitala The public hospital, particularly those in the main cities of New Zealand, are the centres of medical learning in which teaching and research should go hand in hand. There, physicians and surgeons and others in everincreasing numbers of specialties keep abreast of modern medical knowledge, develop new techniques, exchange ideas and continue to develop those critical faculties that are conducive to clear and honest thinking.

In the four main cities of New Zealand the spirit of criticism and assessment of new ideas reaches its highest development. Here the stimulus that demands the very best from men is greatest. Why? Because the metropolitan hospitals are' so much involved in teaching and research. It is not the intention to discuss teaching, except to say that the teaching of students and young doctors, just like the teaching of young nurses, is a stimulus that a first-class hospital cannot do without. What of research? How necessary is it? It is sometimes said that New Zealand with its small population cannot hope to obtain worthwhile results from research. Our resources, it is said, are limited: why not, therefore leave research to countries abroad? N.Z. Contributions

This is a short-sighted view. To begin with, the result of research is not necessarily determined by the size or financial resources of a particular country. Valuable contributions to medical knowledge have already been made by New Zealand workers in the fields of goitre, bloodpressure. cancer and diseases of the blood. Such work has received world-wide acclaim, and it has been done in, our metropolitan hospitals. Thousands of research projects are undertaken through, out the world and each'project may help to solve some small problem and help in a small way to forge a link in the chain of our knowledge. Perhaps almost as great as the result of research is the atmosphere that it creates, the stimulating effect it has not only on those who undertake it but also on the hospital as a whole.

Research demands hard work knowledge, discipline and integrity, not only at the researcher but also of every member at his . team no matter how humble his task. It influences the attitude of doctors and nurses, science graduates and technicians, secretaries and assistants. Research In Christeharch to Christchurch at the Princess Margaret. Hospital there is a medical unit with a specially appointed research director. Moot of the unit's work Is of a research nature. Valuable results have been produced by his team; but even more valuable is the lead that it gives to other members of the hospital staff. At the same hospital and at the Christchurch and Burwood hospitals are other teams engaged in research, necessarily on a smaller scale

and in a more limited, field and much sound work has been done. These projects are, with a few notable exceptions, done as a side-line, as an addition to normal hospital duties, by men who are motivated by a desire to seek and a desire to learn. Each research group, however small, exerts an influence out of proportion to its size and the scope of its work.

The Director-General of Health (Dr. H. B. Turbott) said in a recent address to the Canterbury division of the British Medical Institution that . . the hospital should be the centre of medical planning. It should sponsor appropriate clinical research ... It should be the place,’* he said “that the practitioners of the community look to for the dissemination of up-to-date medical knowledge . . .” In the Princess Margaret Hospital Medical Unit research is financed from nondepartmental sources such as the New Zealand Medical Research Council, the Otago Medical School, the Canterbury Medical Research Foundation. and a small number of private bequests. Other research projects are undertaken either voluntarily or with the help of limited grants from trustee funds. The Coat The key to the problem is, of course, money. The Health Department has provided many things, including a good general practitioner service, but in spite of the encouraging statements of its DirectorGeneral, the department does not and presumably cannot afford to provide everything. The hospital is a training ground for the doctors of the future. We will not attract the best of our graduates back to our hospitals unless we provide the right atmosphere and facilities for medicine of the highest order. These young men go abroad to work in clinics under world-famous specialists and research workers. The time comes when they look to their homeland for a position in which they can continue, or develop still further, their investigations and research for at least a few years until, as mature and well-trained doctors, they either enter practice in the community or accept a permanent hospital appointment.

The opportunities in New Zeeland hospitals for our best men are all too few. Too many of them accept appointments abroad. In Christchurch we have in the past given insufficient thought to this problem. Value Of Canterbury Move At last in Canterbury it is realised that research is essential for the maintenance of the best hospital practice and that we must provide the means. The Canterbury Medical Research Foundation has been established for this very purpose. We will suffer if we do not support it. “New Zealand must” said an eminent English doctor. Sir Theodore Fox. “improve conditions for the young specialist and provide favourable circumstances for medical research. This is a first priority for New Zealand medicine.”

[Contributed by Dr. C. GRAHAM RILEY, F.R.C.P. (London), F.R.A.C.P., in support of the Canterbury Medical Research Foundation. The foundation is to benefit from the proceeds of the premiere of the film, “PT 109," at the Regent Theatre on Thursday],