Viewpoint: who's watching out for the clinical academician?

The plight of the physician-scientist in academia has been extensively documented. Unrecognized is that there are three distinct types of these physicians. The academic clinician, who is involved in patient care delivery and participates in clinical research by enrolling patients; the clinical academician, whose primary objectives are academic; and the physician scientist, who is involved principally in basic laboratory research. It is the clinical academician who is best able to promote translational research, but it is also this type of physician who is most difficult to recruit, retain, promote, and support in the academic medical center. Clinical academicians develop hypothesis-driven investigator-initiated trials, facilitate collaborations between clinicians and basic researchers, and mentor trainees and junior faculty in the conduct of clinical research. Their contributions must be recognized, and new approaches to supporting their time spent in academic and clinical research activities must be developed, in order to prevent their extinction.