Engaging Referring Physicians in the Clinical Trial Process

Abstract

Referring physicians play a vital role in facilitating patient access to clinical trials. Introducing the concept of clinical trials to their patients before referral to the treating oncologist, as well as referring only to oncologists who participate in clinical trials are two simple approaches that can help increase the number of patients willing to participate in clinical research. Educating referring physicians about clinical trials is thus an important and yet overlooked mechanism for increasing accrual to cancer clinical trials. 1 A survey conducted by investigators at Michigan State University found that primary care provider (PCP) attitudes and attendance at education sessions about cancer clinical trials consistently predicted referrals. 2 Although referring physicians can play an important role, they often have little knowledge about cancer clinical trials and do not discuss this treatment option with patients. The National Cancer Institute (NCI) conducted a survey of 706 PCPs and found that 98% of respondents referred their patients to cancer specialists without discussing the topic of clinical trials. 3 Of these respondents, 37% stated that they were unaware that clinical trial participation might be an option for their patients. 3 These data highlight an important missed opportunity to improve clinical trial participation.This article, part of the series on exemplary attributes of clinical trial sites, 4 provides practical advice on how oncologists can engage referring physicians in the clinical trial process. The article is accompanied by a Data Supplement consisting of a slide presentation that parallels this article and is designed to be used by oncologists when talking with referring physicians about clinical trials. Build RelationshipsRelationships with referring physicians can be initiated through formal or informal presentations; conversations at conferences, grand rounds, or meetings; or even during casual conversations with colleagues. In discussing the services offered by the oncologist or available in his or her practice, we suggest mentioning the added value to patients of being offered opportunities to participate in cutting-edge research. This also gives the oncologist the chance to allay common fears, address common misconceptions, and recast trial participation as a high-quality treatment option. A way to begin the conversation might be by saying something like, "I provide a full range of treatment options to patients with cancer, including clinical trials" or "I provide quality care that includes clinical trials." The oncologist should then offer to answer any questions the referring physician has about clinical trials and welcome continued contact.There are a number of ways to build relationships, and another effective option is to offer to travel to the office of the referring physician and provide an interactive talk over breakfast or lunch, if the oncology practice has sufficient resources to do so. These discussions provide the occasion to answer questions and educate PCPs and ...

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