Ep 2.29: "That's Not a Performance Problem, It's a Structural One" Scott Burgher on Why Sites Stop Recruiting (Part 2/3)

In Part 2 of this three-part conversation, Liam and Ted continue with Scott Burgher, Director of Patient Operations at Quest Diagnostics, going deeper into why recruitment keeps falling short.Liam reframes the problem from the ground up: the industry treats recruitment as a marketing function obsessed with filling the top of the funnel, when the real work is moving patients all the way through it. Scott connects this to his experience running end-to-end mock trials years ago, testing the full patient journey, not just whether an ad worked, but whether someone could realistically sit through a four-hour infusion or navigate a handoff between site staff who'd never met them.The conversation turns to site economics, which Scott calls structurally broken: sites invest in staff and training months before seeing payment, and when that investment doesn't pay off, they quietly stop prioritizing the study. As Scott puts it, that's not a performance problem, it's a structural one, though it shows up in the data looking exactly like one.Ted pushes the conversation toward what actually closes that gap: a real feedback loop between sponsors and sites, where issues get surfaced, acted on, and communicated back, not just logged and forgotten.A grounded look at what it actually takes to fix recruitment from the inside.