RE-INVENTING THE MEDICAL BOARD
by Clifford Lane, Clinical Director, NIAID
The changing face of the Clinical Center (CC) is also bringing changes to its
Medical Board, giving the body a more prominent, dynamic role in the
decision-making process for clinical research at NIH. Traditionally, the
mission of the Medical Board, which represents and acts for the Medical Staff,
has been to advise the Director of the CC and help develop policies governing
standards of medical care. Until recently, the expertise of the advisory panel
in other areas has gone largely untapped. However, the new challenges and
opportunities for intramural research have prompted the Board to take a hard
look at both its makeup and its mission.
The Medical Board is currently composed of the Clinical Directors of the
Institutes and Centers that have intramural clinical research programs, the
CC's Deputy Directors, the CC's Associate Director for Nursing, a
representative of the CC Department Heads, and a representative of the Junior
Staff. The Board met Jan. 12-13 in Annapolis, Md., to review the issues that
currently confront investigators interested in clinical research at NIH. The
Board drew up the following list of goals that it plans to pursue over the next
The work in these areas will involve members of the Medical Board, members of
the CC, and members of the Institutes. Volunteers interested in helping with
this work are encouraged to contact their Clinical Directors. The recently
established Clinical Research Interest Group should serve as a key forum for
ensuring that the thoughts and concerns of all NIH investigators with an
interest in clinical research are addressed. For more information on the
Clinical Research Interest Group, contact Jack Klippel (phone: 496-3374;
- Achieve an improved Clinical Center. This includes providing input to the CC
Director on the type of new hospital that will be needed, helping develop
guidelines to ensure the quality of the services delivered within the CC,
improving the budgetary process, and establishing clear linkages between bench-
and patient-oriented research.
- Identify and reduce obstacles to clinical research. As was pointed out at the
organizational meeting of the Clinical Research Interest Group on Jan. 11, an
increasing number of forms and committees need to be cleared before a clinical
trial is initiated. Although the protection of human subjects remains foremost
in our concerns, it is also important to facilitate the rapid implementation of
clinical research projects.
- Promote education, training, and career development for individuals who have
an interest in clinical investigation. This includes establishing incentives
for retention, such as the recently approved Title 38 pay scales, as well as
developing educational programs for clinical associates and senior staff.
- Improve the efficiency of CC operations, including an evaluation of the
current satellite clinical programs, the CC consultative services, and shared
support services such as DCRT, BEIP, DES, and Ober United Travel Management,
NIH's contract travel agency.
- Develop guidelines to ensure that appropriate standards are met by those who
conduct and support clinical research programs.
- Redefine the roles of the Clinical Directors and the Medical Board. It is not
clear whether the Board, as currently configured, is best suited to carry out
its mission and whether the mission as originally stated is appropriate in the
- Improve the public relations image of NIH, in particular, the research
conducted in the CC. These efforts should be linked with efforts to improve the
recruitment of patients and fellows.
- Develop a state-of-the-art medical information system that can keep accurate
and complete medical records and meet the evolving needs of investigators to
store, retrieve, and analyze data.
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