Clinician Scientists

Yesterday, I was at a meeting of the Canadian Child Health Clinician Scientist Program in St. John's Newfoundland. I was inivited to give a keynote address and I talked about "The Central Role of Clinician Scientists in Improving Child Health: the View from the perspective of a clinician-scientist and a politician". Clinicians are those who directly provide health care. They include not only doctors but nurses and many related health fields. Clincian Scientists are those whose job is both to provide care and to do scientific research.

For several years in the last 1980s and early 1990s, I served as the Responsible Investigator for Manitoba for the Children's Cancer Study Group - a North America wide group from many centres which was particularly effective in combining the care of children with cancer with research to improve the care provided. In 1971, when I graduated from McGill Medical School, it was not certain that children with leukemia could be cured. In 1993, when I entered politics, we were at the point where 75-80% of children with acute lymphoblastic leukemia were being cured. This dramatic improvement was only possible because of the close integration of care and research.

Today, we need similar efforts in areas like the prevention and treatment of fetal alcohol spectrum disorders, in the prevention of childhood and adult type 2 diabetes, and in the prevention of early childhood tooth decay. Clinician scientists have central roles in these efforts, along with many others in a multidisciplinary team, if we are to be successful.

One of the clinician scientists from Manitoba presenting his work at the conference was Dr. Robert Schroth. He has done some impressive work in the area of early childhood tooth decay. His efforts stand out in a field which deserves much more attention given the public health issues involved and the significant public health care dollars being spent to provide dental surgery to children at age 2, when this condition is preventable.

Another Manitoba clinician scientist presenting was Dr. Alison Elliot. Her work concerns a rare skeletal condition. Sadly, the Fetal Anomalies Registry, which was operative in Manitoba up until about 1993, had its funding cancelled (shortsightedly) by the Conservative government of the day. The funding for this registry has still not been restored even after 6 years of NDP government. It is sad, because the Registry, fully operational, would have been very helpful to Dr. Elliot's work, as well as providing an ongoing means of understanding the situation for many conditions in Manitoba - conditions as diverse as rare skeletal conditions and as common as Fetal Alcohol Spectrum Disorders. Indeed, because the funding for this registry was cancelled, we do not know accurately the incidence or prevalence of FASD in Manitoba. I have raised this issue several times in the legislature, but apparently the NDP do not think it is important. Sad.