Research led by clinician educators accelerates advances in patient care

The expansion of patient-centered research is expected to accelerate the integration of improved treatments and care-delivery methods into the Stanford Health Care provider network.

An increasing number of the medical school's clinician educators have been serving as principal investigators for clinical research studies.
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Two years after Stanford modified its research policy to allow School of Medicine clinician educators to serve as principal investigators on clinical studies, 192 proposals have been approved, and 83 of these have been funded.

The expansion of patient-centered research is expected to accelerate the integration of improved treatments and care-delivery methods into the Stanford Health Care provider network. It also has provided career growth opportunities to Stanford clinician educators interested in research.

“Clinician educators are valued members of our faculty community, and it is rewarding to see so many talented clinicians moving the breakthroughs made in our labs into the realm of patient care,” said Lloyd Minor, MD, dean of the School of Medicine, who helped lead the effort to allow clinician educators to serve as principal investigators on clinical studies involving Stanford Medicine subjects and patients.

At Stanford, there are four career paths for school of medicine faculty: a clinical care and research-focused medical center line; a patient care-focused clinician educator line; a university tenure line, which emphasizes scholarship and teaching in addition to some clinical activity; and a nontenured line for either research or teaching. Previously, the role of principal investigator — the lead scientist on a research project — was restricted to MCL, UTL and NTL faculty. (The only exception was for multicenter, industry-sponsored clinical trials, in which clinician educators could apply for a PI waiver to serve as a Stanford site director.)

Lloyd Minor

Now, clinician educators have the opportunity to advance medicine within their own practices or other practices at Stanford Medicine, designing and managing studies that address questions about therapeutic interventions, disease diagnosis, patient satisfaction and treatment compliance. Those with the rank of clinical assistant professor and above may request waivers so they can lead trials focused on the patient populations that they serve at Stanford Health Care, Stanford Children’s Health, the Veterans Affairs Palo Alto Health Care System, Santa Clara Valley Medical Center and other Stanford-affiliated medical centers. PI waivers are not granted for research on basic science mechanisms or studies that require laboratory space.

Once a waiver is approved, a clinician educator can be listed as a principal investigator on a grant application submitted to private foundations, industry or government funding agencies, such as the National Institutes of Health, the Agency for Healthcare Research and Quality, or the Patient-Centered Outcomes Research Institute.

This policy change, which took effect Feb. 21, 2013, was based on recommendations by Mark Cullen, MD, professor of medicine and chief of the Division of General Medical Disciplines; Harry Greenberg, MD, senior associate dean for research; Ann Arvin, MD, the university’s vice provost and dean of research; and Minor.

“As biomedical research becomes more patient-centered, the demand for more clinician investigators increases — not merely people who once trained as physicians, but investigators who remain at the proverbial bedside,” Cullen said. “In my role as chief of general medical disciplines, meeting this need has been one of my highest priorities. This new policy achieves precisely that.”

“I am very pleased that this new process has worked so smoothly and that a substantial number of clinician educators have stepped up to the challenge of moving medical advances into mainstream patient care here at Stanford,” said Greenberg, who also directs Spectrum, the Stanford Center for Clinical and Translational Research and Education.

For more information on PI waivers, visit the school’s Research Management Group website:

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