Introduction

            Your academic research paper advances the body of knowledge because it is a presentation of your original ideas. It requires you to verify through various sources of information how you came to develop those ideas and to conclude with unique results or suggestions on what impact you believe your research will have. The process of creating an academic research paper begins when you identify a topic and continues as you gather your sources, evaluate their information and zero in on your own conclusions.

            Coming up with a research topic depends on the specificity of your assignment. For example, a professor might ask you to compare editorials written on immigration during the past 12 months in the New York Times and the Wall Street Journal. The topic is focused and the sources of information are identified for you. However, an instructor might have a more open-ended assignment that asks you to expand on a topic that was covered in class during the semester using 10 sources beyond the textbook. You will find the research and writing process to be much easier for this in-depth, insightful paper if you 1) narrow your topic and 2) find a topic that will keep your interest through all the research and writing.

            The actual writing of the paper is evolutionary. It is unlikely that you will sit down and write the paper in logical order from introduction to conclusion. You could begin in the middle with a discussion of your sources’ information, for example. Know that you will return to each section several times to add or delete or rewrite. Any which way you approach your paper, be kind to yourself and write as you conduct your research. Do not save all the writing until you are all done collecting your information. Take everything you find that supports your ideas and draft paragraphs or sections as you go along researching. As you are doing this, you might find that your Introduction will emerge.

            The Introduction narrows your subject to a single, central idea that conveys your purpose for writing. It is specific and sharply focused, and it previews both the kind of sources that will be used to support your thesis and the arrangement of information to be presented. Your instructor likely will require an Introduction of a certain length. It could be as short as 50 words in a single paragraph if the paper is not very long, or it could go on for a page or two if the paper is of a substantial length.

            The Introduction can take different written forms. Regardless of the form you choose, the Introduction is a contract with your readers that promises what they can expect from the rest of the paper.

            One form gets right to the point of the paper in a way that is similar to that of a typical news story you might read in a newspaper. Such stories start with a sentence, known as a “lede,” that answers some or all of the questions: who, what, when, where, why and/or how. For example: The city councilmembers (who) during their Monday meeting (when) agreed to spend $2 million (what) to reconstruct the aging band shell (why) that has served City Park (where) visitors since 1950. The story continues in “inverted-pyramid” format that presents the most important information first and ends with the least important information. An Introduction following this straightforward format looks like this:

            A loophole in the federal Stark Law (why) has facilitated the overcapacity of imaging scanners (how) during the past 10 years (when) in Western New York doctors’ offices (where), which has lead to overspending (what) by patients and insurers and double-digit increases in insurance premiums. (This tightly focused declarative statement neatly summarizes the paper’s topic. Notice how the rest of the Introduction follows the pattern set by the lede: Information about the Stark Law is followed by information about the overcapacity, which is followed by a reference to Western New York. )

            The Stark Law was intended to stop doctors from referring patients to health-care facilities in which they had ownership. However, an exemption in the legislation permits doctors to send patients to ancillary services they offer in their own offices. The loophole has allowed doctors who are facing slipping salaries from static or decreasing reimbursements to take an entrepreneurial approach to boost earnings. This has prompted many to install magnetic resonance imaging scanners and other medical imaging equipment in their offices.

            The result is that more scans are being done, and insurers and patients are spending more on imaging services. Both Medicare and commercial insurers such as Blue Cross have noted that imaging is growing more rapidly nationwide than any other physician service. The doctors found little interest on the part of heath plans, hospitals and purchasers to stop these activities (Pham, Devers, May, and Berenson, 2004, p. 77).

            Western New York as a whole has experienced such rapid growth in medical imaging technology during the past decade that the proportion of available units to the population of the eight western counties has outpaced that of the entire United States. The ratio becomes even more significant when the United States and Western New York, operating in a market-driven economy, are compared to Canada and other countries practicing controls on health-care spending.          

            This paper discusses how the Stark legislation has contributed the overcapacity of imaging scanners in doctors’ offices in Western New York, and offers recommendations to health-care policy makers to improve distribution without limiting access to the technology throughout the region.

            Another form is similar to a lede in a newspaper or magazine feature story. It backs into the point of the paper by beginning with a description, an anecdote, an unusual fact, an analogy or some other detail that illustrates the topic of the paper. The actual point of the paper will be made later in the Introduction, as it does in this example:

            Western New York is not unlike other areas of the country facing annual, double-digit increases in health care insurance premiums. With health care costs rising so rapidly, the last thing the region needs is a trend that makes them rise even faster. Yet that is what is happening in doctors’ offices in Western New York.

            Many doctors have installed magnetic resonance imaging scanners and other medical imaging equipment in their offices. Although this might seem convenient to a patient, the result is that more scans are being done, and insurers and patients are spending more on imaging services. Both Medicare and commercial insurers like Blue Cross have noted that imaging is growing more rapidly nationwide than any other physician service.

            Western New York as a whole has experienced such rapid growth in medical imaging technology during the past decade that the proportion of available units to the population of the eight western counties has outpaced that of the entire United States. The ratio becomes even more significant when the United States and Western New York, operating in a market-driven economy, are compared to Canada and other countries practicing controls on health-care spending.

            Two factors primarily contributed to the trend: money and a loophole in federal legislation. Doctors facing slipping salaries from static or decreasing reimbursements have taken an entrepreneurial approach to boost earnings. They found a friend in the federal Stark Law. The law was intended to stop doctors from referring patients to health-care facilities in which they had ownership. However, an exemption in the Stark legislation permits doctors to send patients to ancillary services they offer in their own offices. They found little interest on the part of heath plans, hospitals and purchasers to stop their entrepreneurial activities (Pham, Devers, May, and Berenson, 2004, p. 77).

            This paper discusses how the loophole in the Stark legislation has facilitated the overcapacity of imaging scanners in doctors’ offices in Western New York, and offers recommendations to health-care policy makers to improve distribution without limiting access to the technology throughout the region.          

            The genesis of this paper was a story in a newspaper that merely pointed out that there were an inordinate number of imaging services located in Western New York compared to other parts of the country and Canada. The researcher wanted to know why this was the case. Only after doing some investigation did the Stark Law appear to the researcher to be an important driver in the trend. That is why the Introduction should be written while the research is underway, not before.