Physician referrals

Why physicians rarely refer patients to clinical trials, and what fixes it

By TrialNotice · Updated
Busy physician in navy scrubs and a white coat walking quickly down a clinic hallway holding a tablet
Short answerPhysicians rarely refer patients to clinical trials because they cannot easily find current study information and do not have time to look for it, not because they oppose research. Tufts CSDD found 90% of physicians are comfortable discussing trials, yet they refer less than 0.2% of their patients. Sites that bring study information to physicians and close the loop after referrals fix most of the gap.

How big is the physician referral gap?

Tufts CSDD surveyed 755 physicians and 1,255 nurses, mostly in North America and Europe. Physicians reported referring a median of five patients into clinical trials per year, less than 0.2% of their annual patient volume. Nurses referred a median of two (Getz, Applied Clinical Trials). At the same time, 90% of physicians said they are comfortable discussing clinical trial information with patients (Applied Clinical Trials).

Ken Getz, who led the study, said the results challenge the long held idea that health care providers are a barrier to recruitment (Tufts CSDD).

What are the real reasons physicians don't refer?

  • No access to study information. Physicians and nurses cite the inability to access information as a key reason for not referring.
  • Not enough information or time. A busy practice has no room to search registries for studies near the office.
  • Silence after referring. Nearly 30% of physicians and 45% of nurses reported never receiving contact from site staff after a referral.

Notice what is missing from that list. Only 9% of physicians said fear of losing the patient influences their decision (Tufts CSDD).

Why do the physicians who know patients best sometimes refer less?

Tufts' analysis suggested that the more involved a physician or nurse was in a patient's care, the less likely they were to refer, because they judged fit using criteria beyond the protocol's inclusion and exclusion requirements (CenterWatch). That is not an objection to research. It is clinical judgment. Physicians who understand exactly what the study involves and what their patient will experience can make that judgment with confidence.

Does practice setting change referral behavior?

Yes. Physicians in clinical practice were 2.7 times more likely to refer patients into trials than physicians in hospital based settings (Tufts CSDD). Community practices near a research site are often the highest yield place to start outreach.

Do patients want their doctor to bring up trials?

They do. In CISCRP's 2017 study of 12,427 respondents, 58% said they would begin a search for a clinical trial by asking their doctor, yet only 10% of people who had never participated had been asked to join a study (CISCRP). And 95% said it is important for their regular doctor to be aware of studies (CISCRP).

What fixes the physician referral gap?

  1. Bring the information to them. Send each relevant physician a one page study summary instead of expecting them to find it.
  2. Match the study to the specialty. Reach the physicians who manage your study population, near your site.
  3. Make referral one step. Give a named coordinator with a direct line and email.
  4. Close the loop. Confirm every referral and report on screening outcomes.
  5. Stay present. Follow up by email and LinkedIn, since a single letter arrives on a busy day.

For the full playbook, read how to get physicians to refer patients to your clinical trial.

Get your study in front of the right local physicians

TrialNotice builds a physician referral pipeline around one active study. We identify relevant local physicians within driving distance of your site, send study aligned direct mail, follow up by email and LinkedIn, track engagement with recipient level QR codes, and route warm responses into your site team's workflow.

Talk to TrialNotice

Sources

  1. Applied Clinical Trials, "Tufts CSDD Study Explores Low Recruitment Rates"
  2. Ken Getz, Applied Clinical Trials, "Rebooting the Statistic That 5% of Eligible Patients Participate in Clinical Trials"
  3. CenterWatch, "Engaging healthcare providers as research facilitators"
  4. CISCRP, 2017 Perceptions and Insights Study: Decision Making Process
  5. CISCRP, Highlights from the 2017 Perceptions and Insights Study

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