CLINICAL TRIALS: MD Partnerships Boost Participation
In an effort to regain the $400 billion in research funding lost in the past 10 years to private industry, some academic medical centers are exploring partnerships with suburban physicians in order to boost clinical trial participation and improve relations between academic and community health care providers, the Boston Globe reports. Boston's Partners HealthCare is investing $500,000 over four years in its Partners Research and Education Program, which has already signed up 50 community physicians, who have recruited 70 patients to enroll in six trials. Partners officials say they are trying to avoid the ethical concerns that surround private research companies -- which have been criticized for paying large sums to physicians who enroll patients regardless of whether they are appropriate to the study -- by reimbursing physician researchers for each test or exam performed, at a rate 25% to 50% higher than what an insurance company would pay for a regular patient. Project directors say it is "crucial" for community physicians to consider the welfare of the patient first, as some patients will enroll in trials strictly on the suggestion of a trusted doctor. The shift away from medical centers could also be a "boon" to patients, who will get access to the most cutting-edge treatments. "Our objective is not to be the highest enrolling center, but to export some of the excitement to doctors who are not in the hospital. If we do it well...that will give us a leg up," Dr. Marc Pfeffer, Brigham & Women's cardiologist and medical director of PREP, said.
Nonetheless, academic researchers in areas where such programs have been underway for one to two years say training community physicians to participate in clinical trials can be "far more difficult that expected" and raises "ethical" questions. Officials of the clinical research program at the University of Rochester are concerned with the "blurring" of the line between researcher and caregiver, since clinical trials are "not about what's best for the patient." They are also trying to decide if investigators should disclose to patients how much they are earning for trial participation. "It's much more involved than we ever imagined. There is a misperception among doctors out there that doing clinical trials is either an easy way to get into research or...to earn money. It's neither of those," Dr. Cynthia McGuire Dunn, Rochester's clinical research director, said. Still, the shift of research to the suburbs can be an outlet for community physicians with "frustrated academic aspirations," allowing them to "delve deeper" into their medical fields (Kowalczyk, 8/15).