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An often-unrecognized consequence of the rise of generalist departments and divisions in US medical schools has been an improved sense of affiliation between physicians in community practice and schools of medicine. Generalists-in-training now rub shoulders with generalist researchers; continu- ing education for primary care providers is fre- quently conducted by primary care faculty; and generalist faculty increasingly contribute to the practice-relevant research literature. All these things have made today's family physicians, general pediatricians, and general internists feel a greater kinship with schools of medicine and, consequently, a greater willingness to participate in research. The most overt expression of this increased will- ingness to participate in research has been the re- markable rise in practice-based research networks (PBRNs). Beginning in the 1980s and growing slowly in the 1990s, the PBRN movement has ac- celerated markedly during the past decade, thanks in large measure to encouragement and support from the US Agency for Healthcare Research and Quality (AHRQ), the Robert Wood Johnson Foundation's Prescription for Health Program, and the emphasis being placed on community engage- ment by the National Institutes of Health's Clinical and Translational Science Award program. Still, the true heroes in the growth of PBRNs are the primary care clinicians and staff who have been willing to engage and participate in research, de- spite the increasingly burdensome nature of every- day practice.

Increasing the Role of Practice Networks in Medical Research