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June 1988

Clinical Investigation: A Crisis

Author Affiliations

Nashville, Tenn

Arch Otolaryngol Head Neck Surg. 1988;114(6):620. doi:10.1001/archotol.1988.01860180034022

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A critical shortage of trained clinical investigators in otolaryngology-head neck surgery confronts our specialty with a crisis that must be immediately and vigorously addressed, if we are to survive.

Byron J. Bailey, MD, in the November 1987 issue of The Bulletin of the American Academy of Otolaryngology-Head and Neck Surgery, cautions that "those who practice in a specialty with insufficient clinical investigation are destined to become an endangered species." Bailey describes clinical investigation as the "research and development department of the ORL-HNS enterprise" and points out that corporations devote 5% or more of their assets to development, and that other medical disciplines, such as cardiology, immunology, and endocrinology, are forging ahead as leaders in innovation, while ours is lagging behind.

Bailey estimates that otolaryngology-head and neck surgery is (conservatively) a $7 billion enterprise annually in the United States, but that less than 1% of the annual $7 billion is devoted

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