Beyond Barriers and Facilitators: A Qualitative Study of the Interests Driving Physician-Led Innovation

Clinical innovation-where physicians develop and use novel interventions that differ significantly from standard practice and that have not been shown to be sufficiently safe or effective for regular use in healthcare systems-has the potential to transform patient care and drive medical advancement. However, it is not without risk. It is important, therefore, that policymakers and healthcare institutions develop strategies to encourage responsible clinical innovation. For these strategies to be effective, they need to be based on a comprehensive understanding of the factors driving physicians' development and use of innovative interventions. While research has provided important insights into contextual barriers and facilitators, individual factors, particularly physicians' interests, remain underexplored.

The aims of this qualitative study were to investigate the factors that drive and deter clinical innovation in diverse medical specialties and to examine whether these factors differ significantly between specialties.

Thirty-one semi-structured interviews were conducted with Australian physicians from surgery, reproductive medicine, and cancer care.

Physicians' interests (e.g., obligations to patients and personal financial concerns) were perceived to play an important role in driving their use of innovative interventions, along with individual traits and contextual factors. There were also significant differences between specialties-with fertility specialists and surgeons more strongly emphasizing financial and commercial interests as key drivers of clinical innovation than oncologists.

Our findings suggest that while addressing structural barriers to clinical innovation at the health system level remains important, policymakers must also give attention to the diverse interests of physician-innovators. Understanding these interests, the ways in which they align and conflict, and which are most prominent across different specialties, will enable policymakers and healthcare institutions to develop targeted strategies to encourage physician-led innovation and ensure it is responsible.