“…Physicians act as gatekeepers and provide a majority of patient education regarding clinical trials; therefore, they influence recruitment and patient decision-making. Research has shown that participation and recruitment barriers include physicians' lack of clinical trial awareness, attitudes, level of comfort explaining the trial, fear of losing patients, mistrust of medical institutions and researchers, lack of time and structural support, limited resources for data management, complexity of the study protocol and level of burden, feelings about the patient's age and comorbid conditions, and lack of adequate compensation for involvement [1,2,[8][9][10][11][12][13][14][15][16][17][18][19][20]. Physicians may also feel that referring patients to trials might negatively affect and threaten their relationship with patients, manifesting in patients either blaming the physician for any negative consequences of study participation or threatening the physician's income as patients seek increasing care via trial physicians [17,[21][22][23].…”