Medical Research,an essential part of quality health care By Who? Miracles of modern medicine that we now take for granted, such as heart transplants and laser surgery, would not exist today if it were not for the intellectual curiosity and vision of medical researchers. But even with the enormous advances that have been made in the last century, there are still many medical mysteries left to solve,from the causes of cancer to a cure for the common cold. Pursuit of knowledge is an absolutely essential commitment. As with the best hospitals and other medical centers of excellence, the pursuit of knowledge and a commitment to research are essential components to effective healthcare systems as applied by managed care. Kaiser Permanente is an example of such dedication. Kaiser has been involved in medical research for more than 40 years, and are one of only six HMOs in the country with an extensive research program. Over 1,000 research studies are now being conducted by Kaiser Permanente investigators and by physicians, nurses, pharmacists, and other health care professionals in our medical facilities throughout California. The mission of the best HMO research programs, such as Kaiser Permanente’s is to conduct and publish research to improve the health and medical care of not only employees and their families, but also society at large. Whether the subject is cancer, cardiovascular disease, nutrition, or alcohol and substance abuse, researchers hope their work will contribute to the medical community’s body of scientific knowledge and ultimately effect positive change in health care worldwide. Over the years, Kaiser Permanente researchers have collaborated with investigators at UCLA, Harvard, Memorial Sloan-Kettering Cancer Center, RAND, USC, Stanford, UCB, and UCSD, and others. Without Kaiser Permanente’s large, diverse, and long-term membership, as well as the depth and breadth of the computerized health records that are available for analysis, many important studies with and without these prestigious institutions would not have been possible. HMOs that exhibit a dedication to research can ultimately help to provide a worldwide influence on public health. Not a day goes by without a report from the media about a new treatment, a better drug, a different diagnostic test, or a lifestyle change that researchers have discovered to improve health care. Here are just two of the major contributions HMO physician researchers have made to the public’s health and the practice of medicine. ? Harry Ziel, M.D., an obstetrician/gynecologist, was the first person to report that estrogen replacement therapy (ERT) for menopause was associated with an increased risk of endometrial cancer. Until the publication of Dr. Ziel’s article in the New England Journal of Medicine, it was thought there were no known risks with ERT and estrogen had not been looked at as a carcinogen. Dr. Ziel’s research completely changed the way physicians prescribed estrogen for menopause, ended what some considered to be an epidemic of estrogen-induced endometrial cancer, and was the catalyst for further research into the effects of ERT on other diseases. Now we know that estrogen taken in combination with other prescribed hormones does not increase the risk of endometrial cancer and helps to offset the side effects of menopause such as osteoporosis. ? Bruce Flamm, M.D., an obstetrician/gynecologist, successfully changed the conventional thinking about cesarean childbirth with the results of a nationally acclaimed, 10-year study involving more than 22,000 women. His approach to vaginal birth after cesarean (VBAC) has helped to lower the national cesarean rate. Research is just one of the many investments committed HMOs such Kaiser Permanente make for the health and well-being of members and the communities they serve. And such organizations will continue to make the advancement of medical knowledge through clinical and health services research a priority to help ensure that members receive safer and more effective medical treatment and live longer and healthier lives.