Publications
APS Bulletin • Volume 10, Number 5, September/October 2000
Publications
Scientist Participation in APS: Challenges and Opportunities
C. Richard Chapman, PhD
Although most members of our multidisciplinary society are clinicians, our membership is multidisciplinary in a broader sense than comprising multiple clinical specialties. Our ranks include scientists from a variety of disciplines that contribute to the scientific basis of medicine. Their participation is one of the features that sets us apart from other national societies concerned with pain. As I mentioned in a previous “President’s Message” (Vol. 5, No. 3), we have witnessed gradual erosion of our science membership in recent years. We face the challenge of identifying the needs of the scientist membership, evaluating how well we are meeting those needs, and initiating corrective action where appropriate. This “President’s Message” provides an update on these issues.
Who are the scientists within APS?
Most scientists are researchers and teachers who hold a doctorate in philosophy or doctorate in science, and the majority work in universities. Many have faculty appointments in science departments, but others belong to the research cadre of clinical departments in medical, dental, or nursing schools. We usually think of scientists as neuroscientists: neurophysiologists, neuropharmacologists, pharmacokineticists, biologically focused psychologists, and bioengineers. However, in addition to the neuroscientists, APS has a number of behavioral scientists and social scientists. Most neuroscience research involves highly technical pursuit of the basic mechanisms of pain with animal models rather than humans, but there are noteworthy exceptions such as studies involving human functional brain imaging. Behavioral scientists may study animals or humans and quantify behavior, subjective reports derived from introspection, psychophysiological measures, human performance on perceptual tasks, or responses to skillfully constructed questionnaires. Social scientists concern themselves with the incidence and prevalence of pain, social trends in the use of interventions for pain, practice patterns, public attitudes, social policies, as well as the study of legislative and regulatory issues. All three types of scientist contribute to the evidence base that sustains and evolves medicine. They differ in that some uncover new biological facts and feed them forward, others study the processes that constitute the practice of med.icine and feed their information back to the system, and still others work at the in.terface of medicine and society as a whole.
What are the challenges?
Historically, the APS annual meeting has immediately preceded the Society for Neuroscience meeting. We have found it necessary to hold a separate meeting because both organizations have grown to the point where it is no longer feasible to maintain this arrangement. APS cannot get suitable hotels with adequate poster and exhibit space if it is locked to the neuroscience meeting. In addition, it is hard for scientists to attend APS professional development courses because they overlap in time with neuroscience satellite meetings, and neuroscientists routinely lose the Sunday morning portion of the APS meeting because they must travel to the neuroscience venue at that time. Moreover, academic members who teach courses have found that the back-to-back meetings keep them away from the classroom for too long. Separating the APS meeting from the neuroscience meeting confers some clear advantages, but it may mean that fewer neuroscientists will be able to afford to attend both meetings.
We are fortunate to have solid neuroscience representation on the board of directors through Linda Watkins and Linda Sorkin. They have helped us understand some of the concerns that our scientist members raise. In recent years, we have taken our basic scientist membership for granted and have not attended sufficiently to their needs. As I see it, preoccupation with clinical economic stresses over the last decade has created a climate within APS that makes it difficult for basic science to thrive within our ranks. We need to correct this situation.
We must address at least four problems if we are to retain and expand our scientist membership. The first is an issue of critical mass. APS can be an exciting organization for a pain researcher, but only if the membership includes a sufficient number of other pain scientists. Our parent organization, the International Association for the Study of Pain (IASP), is a role model for how to do this well. Scientist participants value and enjoy their contacts with other scientists at the IASP congresses and in other IASP activities. For this to happen within APS, we need to maintain a critical mass of research members, including the leaders in the pain research field. Furthermore, our meeting programs need to include stimulating scientific presentations, and science needs to be at the center rather than the margin of our overall effort as a society. There is a good deal of pain research going on in neuroscience and the other sciences, but for the most part those who conduct the studies present their findings elsewhere. There are far more presentations on pain at the neuroscience meeting than at the APS meeting. We need to recruit these pain researchers into APS and retain their involvement by providing a more intimate, attractive environment than the neuroscience meeting affords. APS could, and should, be the center of social gravity for American scientists investigating pain.
Second, we need to improve the relationship between the scientist members of APS and the clinical members. Because of sustained economic stresses, our clinical membership has become preoccupied with issues of reimbursement for services, coping with managed care, and sustaining pain clinics amidst shifting bases of economic support. Today, some of our clinician members see APS as a clinical society dedicated primarily to pain management, for which science is marginally relevant. I can recall a time when clinicians came to our meetings primarily to get an update on progress in pain research. Our clinician members enjoyed the role of science watcher and often learned things that improved their understanding and practice skills. Conversely, one of the benefits for a researcher in a multidisciplinary society is that one’s clinical colleagues can provide a window on clinical phenomena of interest. Seeing pain through the eyes of a clinician is extremely valuable for many pain researchers. This can only happen when clinicians are open to this type of sharing and when our programs foster such exchanges. Currently, some basic scientists are frustrated because clinician members call upon them for teaching and support of clinical efforts but give nothing in return.
Third, the climate of the APS meeting has gradually changed so that the atmosphere is less that of a multidisciplinary meeting than a medical convention. This change has become a subtle barrier in attracting scientist participants. The imposing presence of multiple pharmaceutical companies at the exhibits and in the peripheral activities (invited luncheon and dinner clinical programs) leaves some researcher participants feeling marginal. Our exhibits provide little from manufacturers of scientific equipment and software. Researchers are unlikely to receive invitations to attend the clinically focused luncheon and dinner programs that the pharmaceutical companies sponsor, and such programs rarely include scientists as speakers. It is time to pay attention to the atmosphere of the meeting as well as the content of the program. It should reflect the multidisciplinary character of the organization.
Finally, cost is an issue. Now that the APS meetings are no longer linked to the Society for Neuroscience meeting, neuroscientists must make two trips rather than one if they wish to participate in APS. This burdens their limited resources. We must ensure that the value of our member benefits is equal to, or greater than, the cost.
What is APS doing to encourage and sustain scientist participation?
We have formed a task force to address the needs of our basic science membership and formed a Special Interest Group (SIG) for basic science. The task force is addressing all of the above-mentioned problems, including identifying pain researchers outside of APS and recruiting their participation. The formation of our new journal, The Journal of Pain, is helping identify APS as a key organization in the world of pain research. Starting next year, we will publish scientific abstracts from our meetings in a special supplement of The Journal of Pain. Finally, the board has added two items related to basic scientists to its list of strategic goals. This reflects the high priority that APS now gives to fostering an environment for science.
There are many exciting improvements in the works for the spring APS meeting, and they will help make the experience better for basic scientists. We are making a renewed effort to include high-quality science in our meeting program. To make the meeting more attractive to researchers, we will invite research-relevant exhibitors to the convention and encourage the pharmaceutical industry to put together luncheon and dinner programs that truly fit the multidisciplinary membership and not just the clinical membership. The planning committee for the spring meeting is improving the poster presentations so that attendees will have more time available for viewing them. The posters, after all, are ideal vehicles for encouraging dialog between researcher and clinician members. Finally, we are now reviewing the financial factors that constrain the participation of researchers and their students in the convention and other activities of APS. We will explore ways to make APS affordable to our scientist membership.
Opportunities for the future
I suggest that APS exploit the potential inherent in translational research. In the broadest sense, translational research refers to the two-way transfer between work in the laboratory and the treatment of patients. In most of medicine, it means linking bench research to clinical care. Often there is a lag between when medicine gains important knowledge through research and when it benefits patients by applying the knowledge. Conversely, clinical needs arise when new diseases or problems emerge, but substantial time may pass before scientists become aware of the problem and begin working on it. If we could address translational research formally in the pain field, we might derive more benefit from it. Basic scientists steadily produce new insights into how pain problems develop and why they persist, but these insights can only improve pain assessment and intervention if clinicians are aware of them. Conversely, pain clinicians observe myriad inexplicable phenomena at biological and psychological levels. It is easy to dismiss these as anomalies, but they may be important clues for basic scientists or even doorways into new areas of research. A formal emphasis on translational research might help the society attract and hold more basic scientist members. If we are to maintain our unique position as a society of researchers and clinicians, then it is imperative that we not only recognize our needs, but act on them as well.