A Goal Fulfilled
I made several goals during my family medicine residency training program, one of which was to publish a research paper. I did an extensive research project where we interviewed homeless folks in Columbia about their health. While I very much enjoyed this project, I ended up graduating from the residency program without publishing a paper.
Fast forward to the present day in which I am a practicing Direct Primary Care (DPC) family physician. I have personally seen the benefits of Direct Primary Care for both patients and doctors, but there is very little published research about DPC. In my opinion, more research highlighting the benefits of DPC is needed in order to expand DPC’s reach, and convince policymakers to support the movement. There’s a difference between individual patients and physicians saying that DPC is beneficial, and a research study, using rigorous scientific methods, showing/proving the benefits.
A few years ago, I realized I might finally be able to fulfill my unchecked goal from residency. I was given the opportunity to work with a few family medicine residents, who were interested in doing research on DPC and burnout. We decided to compare burnout and fulfillment scores between Direct Primary Care doctors and primary care physicians working in non-DPC practices in SC, NC, and GA. We completed the data collection and then the residents graduated, but I thought this could be my opportunity to turn the data into a research paper.
I partnered with statistician Deborah Hurley, and we published our paper “Comparison of Burnout and Fulfillment Rates between Physicians in Direct Primary Care and Other Practice Models” in the Southern Medical Journal this month, May 2025. I learned a lot doing this project and writing the paper, and thought I would share some of my personal observations, not about the specific findings of our paper, but about doing research. Of course, these epiphanies were personal, but are well-known to the research community.
#1 – Doing research is time-consuming. I did not keep track of the number of hours I spent working on this project, but it was certainly more than I thought it would be! I did this project without a grant, and on my own time. I enjoy writing (hence the existence of Noreta’s blog that you are reading right now!), but writing a research paper was a whole new experience – draft, after draft, after… Writing in a way that does justice to the data requires a lot of trial and error, and editing.
#2 – It is hard to do research without the backing of a large institution. I relied on the generosity of Deborah Hurley, statistician extraordinaire (who works for a large institution), who offered to help when she heard that I wanted to try to publish the data. The data analysis software we used is simply not available to individual, non-institutionally affiliated researchers, like myself. I also came across many medical journal paywalls when trying to access previously published research to cite in our paper (citing previous research is not only required, but also good practice). Institutions have libraries with paid subscriptions to a vast array of journals to search through. This is simply not financially viable for individual researchers. (Ironically, our paper is now behind a paywall!) I was thankful to have worked with partners who had access to these institutionally funded resources. I strongly feel these tools should be available to anyone who wants to advance medical research.
#3 – You can’t do a “perfect” research study. There is going to bias introduced somewhere – in how the study is designed, in the characteristics of the study participants, in the observations about the data, and potentially in other ways. When taking these biases into account, one single study may not be enough to prove (or disprove) the study’s hypothesis. See #5.
#4 – You have to learn as you go. For instance, we sent out a survey to hundreds of doctors, and while the response rate was significant, it was not what we had hoped for. We can’t go back and try to add more responses after the fact. The data is what it is, and we just have to learn from it for the next project. With research, new and unexpected things come up all the time which is similar to owning a small business!
#5 – We have more work to do. It is very clear to me that a researcher’s work is never done. With every project, new questions are generated. Can our results be reproduced on a larger scale? Will other researchers take the questions that we posed and add to our results? I hope to pique the interest of other physicians who can take aspects of our work and expand on them. If I find some partners, perhaps I will be one of them!
#1 – Doing research is time-consuming. I did not keep track of the number of hours I spent working on this project, but it was certainly more than I thought it would be! I did this project without a grant, and on my own time. I enjoy writing (hence the existence of Noreta’s blog that you are reading right now!), but writing a research paper was a whole new experience – draft, after draft, after… Writing in a way that does justice to the data requires a lot of trial and error, and editing.
#2 – It is hard to do research without the backing of a large institution. I relied on the generosity of Deborah Hurley, statistician extraordinaire (who works for a large institution), who offered to help when she heard that I wanted to try to publish the data. The data analysis software we used is simply not available to individual, non-institutionally affiliated researchers, like myself. I also came across many medical journal paywalls when trying to access previously published research to cite in our paper (citing previous research is not only required, but also good practice). Institutions have libraries with paid subscriptions to a vast array of journals to search through. This is simply not financially viable for individual researchers. (Ironically, our paper is now behind a paywall!) I was thankful to have worked with partners who had access to these institutionally funded resources. I strongly feel these tools should be available to anyone who wants to advance medical research.
#3 – You can’t do a “perfect” research study. There is going to bias introduced somewhere – in how the study is designed, in the characteristics of the study participants, in the observations about the data, and potentially in other ways. When taking these biases into account, one single study may not be enough to prove (or disprove) the study’s hypothesis. See #5.
#4 – You have to learn as you go. For instance, we sent out a survey to hundreds of doctors, and while the response rate was significant, it was not what we had hoped for. We can’t go back and try to add more responses after the fact. The data is what it is, and we just have to learn from it for the next project. With research, new and unexpected things come up all the time which is similar to owning a small business!
#5 – We have more work to do. It is very clear to me that a researcher’s work is never done. With every project, new questions are generated. Can our results be reproduced on a larger scale? Will other researchers take the questions that we posed and add to our results? I hope to pique the interest of other physicians who can take aspects of our work and expand on them. If I find some partners, perhaps I will be one of them!
Have a good week! Feel free to contact me with any questions.
Melissa Boylan, MD, FAAFP
Family Physician and Owner of Noreta Family Medicine
