World Organization of Family Doctors — WONCA

The Future of Primary Care Research | Prof Mehmet Akman

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The book "Future Perspectives in Primary Care Research," part of the WONCA family medicine series, addresses the critical need for evolving research methods as primary care faces unprecedented complexity. With aging populations, rising multimorbidity, persistent health inequities, and significant workforce pressures, the traditional approach of transferring evidence from highly controlled specialist settings is no longer sufficient. Professor Mehmet Akman emphasizes that primary care is where patients first encounter the health system and where long-term care occurs, necessitating research that reflects real patients, real communities, and real-life contexts. Consequently, strong primary care research is not merely an academic pursuit but an essential component for developing health systems that are effective, equitable, and sustainable. Looking toward the next decade, Akman expresses excitement about expanding the scope of what constitutes legitimate primary care research rather than focusing on a single technology or methodology. While artificial intelligence, big data, and digital tools offer new opportunities, he argues that the future should be question-driven rather than technology-driven. Important developments include advancements in implementation research, patient and community-centered designs, mixed methods, and novel approaches to clinical trials. The field is also extending into personalized care, genomics, planetary health, and the resilience of health services, with the ultimate goal of using new methods to answer important questions more rigorously and efficiently while maintaining relevance to patients and communities. A global perspective is vital because primary care is deeply dependent on local context, including service organization, workforce availability, financing models, disease patterns, culture, and community expectations. Solutions that succeed in one health system may not be directly transferable to another, making international exchange of evidence crucial for understanding which interventions work best in specific settings. This approach prevents the assumption that innovation always flows from high-income to lower-income countries and instead highlights valuable experience emerging from resource-constrained environments and countries undergoing health system transformation. By combining local relevance with international collaboration, researchers can learn from diverse models and ensure that innovations do not widen existing inequalities. For young doctors struggling to balance clinical demands with research, Akman advises starting by understanding their own community and analyzing the data they already generate in daily practice. The most effective strategy is to form or join research networks where GPs can share data for quality improvement before evolving these efforts into specific research questions based on real-life observations. This approach ensures that the resulting evidence is highly relevant to future practice and addresses the actual problems faced by patients. Ultimately, the future of primary care research depends on combining scientific rigor with real-world relevance and a clear commitment to improving the health of the people and communities served, ensuring that innovation serves as a tool for equity rather than a barrier to it.

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Future perspectives in primary care research is one of the newest titles in the Wonka family medicine book series published by CRC Press. It is edited by professors Bob Mash, Felicity Goodyear Smith, and Mehmet Akman is with me today. It looks at where primary care research is heading from new methods and study designs to growing role of digital tools and AI. Mehmet, why is primary care research so important now more than ever? >> Well, primary care is facing a level of complexity that we have never seen before. Populations are aging. Multimorbidity is becoming the norm. Health inequities remain persistent, and health systems are under increasing financial and workforce pressure. At the same time, digitalization, artificial intelligence, and new forms of data are changing how care is delivered and how research can be conducted. Therefore, the primary care is where most people first meet the health system and where much of long-term care takes place. Still, many of the questions that matter most in everyday practice cannot be answered simply by transferring evidence from highly controlled or specialist settings. So, therefore, we need research that reflects real patients, real life, real communities, and real health systems just where people are living. For me, this is why strong primary care research is not just an academic interest, but it is essential for developing more effective, equitable, and sustainable health systems. >> So, the title of this book looks to the future. What developments in primary care research are you most excited about over the next decade? >> What excites me most is not actually one particular technology or methodology, but the widening of what we consider legitimate and useful primary care research. We are becoming better able to understand complexity and study it's better rather than trying to remove it's from our research designs. So, this is a plus actually. And um, the artificial intelligence or the big data, digital tools will clearly create new opportunities. But equally important are developments in implementation research for example, or uh, patient and community core designs, or mixed methods, and new approaches to clinical trials. We are also seeing uh, primary care research extend into areas such as personalized care or even genomics, uh, planetary health, and resilience of health services. The real opportunity is bringing all these together. The future should not be technology driven, it should be more question driven. Uh, we should use new methods and technologies where they help us answer important primary care questions more rigorously, more efficiently, and with greater relevance to patients and to our communities. >> So, one of the strengths of this book is it's international authorship. Uh, so why is a global perspective so important in primary care research? >> Oh, the primary care is highly dependent on the context. Uh, for example, the organization of services, available workforce, how you finance your system, the disease patterns, culture, and the community expectations differ enormously between countries. A solution that works well in one health system may not transfer directly to another. So, therefore, uh, primary care research needs both local relevance and international exchange. So, if we, uh, do, I mean, uh, different research, uh, in different countries and in different settings, uh, then we can really exchange the evidence and we can understand which is working better in which contexts. A global perspective allows us to learn from different models rather than assuming that innovation always moves from high-income to lower-income settings. There's a great deal of experience and innovation emerging from resource-constrained environments, community-based systems, and countries undergoing health system transformation. So, bringing all the others from all different regions and settings is very important, I think, for such a book. And if you're an editor of a such a book, it reflects the character of Wonca itself, too. Primary care is a global discipline, but it is practiced locally. Good research has to respect both realities. >> Great. So, if readers take away just one message from future perspectives in primary care research, what would you like it to be? >> Well, I would like to I would like the readers to remember that the future of primary care research is not simply about adopting new methods or new technologies. It's about asking better questions about the problem that matters to patients, communities, and health systems. And then choosing the most appropriate ways to answer them. Research must remain significantly rigorous, but it must also be relevant, ethically inclusive, and capable of improving care. That means connecting evidence generation with implementation, uh strengthening research capacity, involving patients and communities, and ensuring that innovation doesn't widen existing inequalities. If I had to put it in one sentence, I would say the future of primary care research depends on our ability to combine scientific rigor with the real-world relevance and a clear commitment to improving the health of people and communities we serve. >> Uh I saw that Pilar was giving an interview in Spain and she spoke about the importance of primary care research and how difficult it is for young doctors to find the time balancing it with, you know, family commitments and you know, and increasing workloads and everything else to actually, you know, dedicate time to research. What advice would you give to young doctors who struggle to find the time to do research in primary care? >> Uh I mean, I it's totally understandable. So, primary care is quite demanding and it is person-centered, so you are inside the community. You are in the real life. So, you have a lot of demands. But at the same time, you are creating the data of that community. So, one way to tackle with the problem of timing could be having research networks. Actually, it started as a practice-based networks and and even you can share your data and then analyze it just for quality improvement. But later on, you can ask questions to your data as well or new questions can emerge from what you summarize and then you can build up a research question around that and start to make a specific research for the specific research question. So, I think the best idea to start if you're a young GP working in a primary care center, first to understand the community you are living in and to look at your own data. And then the try to combine these data with your neighbor, I mean, GPs and try to understand the community and then come up with a research question from the real life itself. And this will make really relevant uh mean, outcomes and and it will create relevant evidence for future practice of primary care. >> Mhm, great. Uh all right, thanks very much for doing this, Muhammad. >> Hey, you're welcome. >> The book will be officially launched at the Wonca Africa region conference in in Botswana, uh where Professor Bob Mash will be attending. Okay, best of luck. >> Yep. >> Take it easy. Good to see you again. >> Bye.