Primary care physicians' views about gate-keeping in clinical research recruitment: a qualitative study

Guillemin, Marilys, McDougall, Rosalind, Martin, Dominique, Hallowell, Nina, Brookes, Alison and Gillam, Lynn 2017, Primary care physicians' views about gate-keeping in clinical research recruitment: a qualitative study, AJOB empirical bioethics, vol. 8, no. 22, pp. 99-105, doi: 10.1080/23294515.2017.1305007.

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Title Primary care physicians' views about gate-keeping in clinical research recruitment: a qualitative study
Author(s) Guillemin, Marilys
McDougall, Rosalind
Martin, DominiqueORCID iD for Martin, Dominique
Hallowell, Nina
Brookes, Alison
Gillam, Lynn
Journal name AJOB empirical bioethics
Volume number 8
Issue number 22
Start page 99
End page 105
Total pages 7
Publisher Taylor and Francis
Place of publication Abingdon, Eng.
Publication date 2017-03-16
ISSN 2329-4515
Keyword(s) research in primary care
physician researchers
recruitment practices
dual roles
Summary Background: Clinical research is increasingly being undertaken in primary care settings. This developmentoffers both benefits and challenges. The ethical challenges of occupying the roles of both clinician andresearcher may be accentuated in primary care settings, where relationships are longer lasting andmedical conditions are less acute. This article examines primary care physicians’ experiences ofundertaking research, particularly their decision making about recruiting patients in the context of theirown dual roles. Methods: This project comprised in-depth interviews with eight Australian primary carephysicians working in general or specialist practices that were involved in clinical research. Data wereanalyzed using inductive thematic analysis. Results: Physicians involved in recruiting their patients intoclinical trials acted as gatekeepers; they were selective about which patients to recruit and did notnecessarily approach all patients who met the research eligibility criteria. Physicians’ accounts suggestedthey prioritized their clinician role over their researcher role. In addition to the rigor and merit of theresearch, physicians considered the possible benefit of trial participation for individual patients. Physiciansdescribed making recruitment decisions based on their perceived knowledge of patients’ personal,behavioral, and attitudinal characteristics—often derived from their long-standing relationships with theirpatients. Conclusion: Our data show evidence of gatekeeping by primary care physicians when decidingto participate in, and recruit their patients to, clinical studies. We argue that such gatekeeping is a way ofaddressing the dual and sometimes conflicting roles of clinician and researcher. It need not be ethicallyproblematic, but primary care physicians should be reflexive about their recruitment practices and biases.In addition, this form of gatekeeping should be explicitly recognized in protocol design and the analysis oftrial findings.
Language eng
DOI 10.1080/23294515.2017.1305007
Field of Research 110399 Clinical Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2017, Taylor & Francis Group
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