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A Non-Traditional Career Path in Implementation Science

Posted on December 2, 2011

Brian Mittman reflects on his path from working in the labor, population and demography area at RAND to his current role at the VA Center for Implementation Practice and Research Support.

 

I think my career path and my entry into the field of implementation science was somewhat non-traditional. I began my career at RAND, initially working in the labor and population and demography area. With a father and older brother who are physicians and some consideration at my point when I was a college student to medical school, the idea of entering a health-related field was always in the back of my mind.

I think at some point as I was considering my next set of projects at RAND in the labor area, I was invited to a meeting convened by the head of the RAND health program to talk about the challenge of implementation and adoption of RAND's version of clinical practice guidelines or evidence-based medicine. At the time the label that was used was "appropriateness criteria," and the question that we addressed in that meeting was, "What are the prospects for actual benefit and application of appropriateness criteria in addition to their use as a research tool?"

And that question intrigued me and stimulated some thinking and some discussion with colleagues at RAND about the challenge of stable practice patterns in the medical care field, and the conservative nature of physicians and healthcare professionals and made me and others realize that there's some important policy and practice questions and research questions in the health services field that would benefit from some social science and behavioral science perspectives and expertise.

A couple of years later, I was invited to participate in a grant application to establish a new health service research center within the Department of Veterans Affairs with a focus on physician behavior. We subsequently re-titled the center to use the phrase "provider behavior" to indicate that it's not just physicians who represent the clinicians of interest but other clinicians and professionals as well, but also from my perspective, organizations, and the fact that "provider behavior" is meant to imply organizations delivering care in addition to clinicians.

And I was faced with a number of opportunities to become involved in activities, conducting research, leading VA's quality enhancement research initiative, providing leadership in establishing the journal Implementation Science and a number of other activities that basically represented being in the right place at the right time, having an interest in helping to develop and grow the field, and having an interest in helping to bring other perspectives and other colleagues and researchers into the field as well.

So it's been a somewhat non-traditional career in that I've spend a much greater proportion of my time focusing on field development as opposed to conducting my own projects or working with others on their projects, but I've certainly enjoyed it, and I believe there's been some benefit to the contributions and to that role.

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Excerpted from interview with Dr. Mittman at the 2011 Global Implementation Conference in Washington, DC. Dr. Mittman is the director of the VA Center for Implementation Practice and Research Support.

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