Ep 2.28 Scott Burgher on Why 86% of Trials Miss Their Enrollment Deadline (Part 1/3)

In Part 1 of this three-part conversation, Liam and Ted sit down with Scott Burgher, Director of Patient Operations at Quest Diagnostics, who brings over 20 years of patient recruitment experience spanning healthcare marketing, clinical trial agencies, large consulting, and big tech, to talk about the good, the bad, and the ugly of patient recruitment.In this episode, Scott breaks down why recruitment keeps missing the mark. He argues that sponsor decision-making cycles are a massively underestimated blocker, a recruitment strategy can be fully approved by the study team and still sit untouched in legal or procurement for months while the clinical timeline keeps ticking, often defaulting back to digital and social media ads as a last resort. Liam connects this to a separate problem he's seen across budgets: an "iceberg" of recruitment costs sitting below the surface, the centralized strategy and patient-processing work that rarely gets line-itemed alongside site costs.They Explore:1. Why the 86% missed-enrollment-deadline statistic hasn't moved in over a decade, even as industry awareness has grown2. How sponsor decision-making cycles quietly stall recruitment strategy for months before outreach even begins3. The "iceberg" problem: recruitment costs that never make it into the visible budget4. Why most patients never hear their doctor recommend a clinical trial, and what that gap costs5. Where AI is genuinely useful in patient identification, and where it's being oversold as a fix6. The role of primary care physicians in patient recruitmentA candid look at the structural issues behind patient recruitment.