Researchers who want to include surgeries in studies have to make first contact through non-medical administration staff who act as roadblocks, says a group of researchers whose planned leg ulceration study was hamstrung by a physician recruitment rate of 2% and who have published the reasons why so many surgeons did not participate.

The qualitative information, featured in the open access journal BMC Medical Research Methodology, may be of use to those designing trials of their own.  Given the current health care debate in America, another layer of bureaucracy and the impact on research studies is one facet of the discussion that has been least considered. 
Administrative personnel are especially unlikely to 'put through' non-medical doctors and also may not understand the importance of the study to be carried out. Other factors they listed include general practioners' fear of extra work and concerns that the results of a study might somehow be used to assess them. 

Dr. Oliver Herber, from the University of Witten/Herdecke, Germany, worked with a team of researchers to collate the overwhelmingly negative responses received from their potential pool of 1822 medical practices. He said, "Interdisciplinary research studies, especially those between the medical and nursing professions, require careful consideration in the development and tailoring of research designs. To reduce rates of refusal and lack of initial contact, the time, money and effort needed during the planning and recruitment phase of a study must not be underestimated".

Speaking about the implications of this study for people designing trials, Herber said, "A sustainable and reliable network of teaching surgeries demonstrating interest in research is vital for the successful execution of scientific studies"

Article: Oliver R Herber, Wilfried Schnepp and Monika A Rieger, 'Recruitment rates and reasons for community physicians' non-participation in an interdisciplinary intervention study on leg ulceration', BMC Medical Research Methodology