The scientist-practitioner in the twenty-first century

Abstract

The development of the role of the scientist­ practitioner may be a powerful way of meeting the demands of providing effective, high-quality care at a reasonable cost in the next century. The four commentaries provide impressive and thought­ ful depth to the issues raised in the Focus article as well as pointing out potential weaknesses. I am sincerely grateful for the insights provided. I especially relished the suggestions provided for improving evidence-based prac­ tice (ESP) and the transfer of knowledge from research to clinical practice. Clearly, there is considerable labor and cooperation needed from us all, if our common goal of providing the best possible pain management is to be met; however, if we do not realize that the behavior of health care practitioners is governed by much more than evidence summarized in a meta-analysis, the results may be disappointing and far from maximal. The great need for pain relief demands continual advancements in clinical practice and ESP is designed to enhance this process. Consequently, ESP is a wel­ come tool. A basic part of ESP is to obtain the latest information, and here meta-analysis is put forth as a means of objectively summarizing the results of several trials. These basic aims are worthy objectives indeed, and I not only endorse them, I also attempt to employ ESP. In addition, I am also involved in documenting the best evidence regarding neck and back pain treatment, along with a panel of others, for the Swedish Council on Technology Assessment in Health Care. Thus, I recog­ nize the need for summaries as well as ESP. Neverthe­ less, the Focus article, as the title implied, was designed