Physicians have a direct line of contact with potential clinical trial participants that many in the research industry don’t have. Trust established through regular communication, coupled with their knowledge of the patient’s health history, makes physicians the ideal source for clinical trial referrals.
So, why aren’t we seeing more patient referrals from physicians?
Research organizations aren’t adequately engaging healthcare providers to encourage more patient referrals. As revealed during a discussion at the inaugural Bridging Clinical Research and Health Care collaborative forum, there are a number of assumptions about patients, health care providers and the referral process that seem to inhibit productive conversations between researchers and physicians. Here are just a few of the misconceptions that act as barriers for physician referrals to clinical trials:
1. When looking for a clinical trial, patients know to ask their physician for more information
When asked where they can find information about a clinical trial, we would likely assume most people might say they would ask their primary care physician. Asking a physician for more information seems like a logical step to learn more about a new form of care or potential treatment option. Right?
A clinical trial awareness survey conducted by SubjectWell reveals this may not be the case. Of the over 2,000 Americans surveyed, only 11% said asking a physician or other healthcare provider would be their first step to learn more about a clinical trial. Contacting a pharmaceutical company comes out ahead with 16%, along with 15% of people saying they would do a general internet search or ask their pharmacist first. Out of the nine available options, asking a physician for more information about a clinical trial wasn’t even one of the top five first steps someone would take.
In many ways, physicians are the best resource for potential trial participants to learn about a clinical trial. They are often able to have face-to-face conversations with their patients about their potential eligibility and are the most equipped to alleviate potential concerns about participating in clinical research. With the majority of people saying they don’t know where to find more information about clinical trials, there’s clearly a need to encourage patients to talk to their physicians.
2. Physicians will not refer to clinical trials because they don’t want to lose their patients
The best way to increase the number of physician-patient conversations about clinical trials, is to get buy-in from the physician first. However, it’s commonly believed that physicians are hesitant to start those conversations and refer their patients to clinical trials because they don’t want to lose that person’s business. With the potential for study participants to receive standard of care procedures at the research center, physicians may worry their patients will choose to switch healthcare providers for the sake of convenience.
While this may be true for some physicians, in the majority of cases this belief is simply untrue. A survey of 2,000 nurses and physicians conducted by the Tufts Center for the Study of Drug Development (Tufts CSDD) found that 90% of physicians are happy to refer a patient to a relevant clinical trial. Only 9% said the fear of losing patients influences their decision not to refer. So, why don’t we see more patient referrals from healthcare providers?
3. Given the study protocol, physicians have the information they need to refer their patients
In general, the Tufts CSDD survey found that the majority of physicians and nurses feel at least somewhat comfortable referring their patients into clinical trials. To many researchers, this implies the physicians have at least an adequate knowledge of the studies they’re referring to and understand the protocols provided to them. When given a protocol, the physician is expected to read and understand it.
In truth, just giving physicians the protocol doesn’t fully enable them to refer patients to a study. According to Ken Getz, associate professor and director of sponsored research at Tufts CSDD, the number one barrier to physician referrals is that they don’t know where to find the right information to feel confident in making that referral; they also don’t have the time to comprehend that information when they have it.
Often, a protocol is placed on a physician’s desk with the expectation that they read through it to learn the information they need to know about the clinical trial. In reality, the physicians who refer patients often don’t have the time to even read their emails, let alone read a multi-page protocol document full of complex language. Most physicians don’t feel comfortable referring their participants to a trial they don’t fully comprehend, and because they don’t have the time or resources to completely understand the protocol, they don’t refer their patients to the study.
It’s time to make referrals easier
Physicians are an underutilized asset for the clinical research industry and it’s important that we take steps to encourage and enable confident patient referrals. Read our recent blog post “How to Engage Healthcare Providers and Encourage More Clinical Trial Referrals” to learn more ways researchers can build positive relationships with physicians and make patient referrals easier and more frequent.