Site Spotlight: How one Missouri doctor aims to change rural care

After working as the Clinical Trial Director at a large research center for twelve years, Dr. Jaswinder Singh, Director of the MidAmerica Cancer Center, seeks to bring clinical trials to patients in rural areas.

With the rising pressures and costs in clinical trials, the challenges to generate effective research are unrelenting. Still, as competition rises in large, academic sites, a vast population of patients continue to be excluded. Willing, eligible patients, who are located in rural areas are enthusiastic to participate yet continually miss out on trial opportunities. One oncologist in Missouri is aiming to change that.

After working as the Clinical Trial Director at a large research center for twelve years, Dr. Jaswinder Singh, Director of the MidAmerica Cancer Center, aims to bring clinical trials to patients in rural areas. While directing research at the academic site, Dr. Singh took note of the main barriers preventing rural patients from participating in clinical trials, including hours of travel throughout the week. With the additional time and money required to make this commitment, participation was nearly impossible for many patients. Dr. Singh hopes to change this by creating a network of satellite sites so patients can access care in their own communities with the doctors they know and trust.

“These satellite sites will be a part of my organization so that two rural healthcare patients can get the same benefits as the patient sitting in the large academic center,” Dr. Singh said.

Since he had already been practicing in these communities for years, Dr. Singh had no trouble establishing trust with patients when opening his own site. “The trust is already there,” he explained. He added that cancer research is an area of healthcare that requires extra sensitivity and compassion. Dr. Singh ensures both are prevalent in his care.

“If you show your sincerity it’s not difficult to win their hearts.” Dr. Singh said. “[The patient] has put their life in your hands and that’s a pretty big deal. They’re trusting you.”

To Dr. Singh and his patients, these connections go beyond the walls of any healthcare facility. In oncology, there are no guaranteed outcomes, especially with clinical trials. This makes it even more critical for Dr. Singh’s patients to know that they are fighting together, often with the entire tight-knit community supporting them.

“When you go to these communities, you’re not just touching one family,” he said. “You’re touching twenty families because each of them is connected.”

These connections are particularly evident in Dr. Singh’s approach to educating patients about upcoming trials. In his experience, most patients are initially excited to participate, but don’t fully understand what it entails and the travel and time commitments involved. He emphasized the importance of taking the time to break down the science and the treatment to make sure the patients truly comprehends what they would be signing up for and the risks and benefits that go along with it.

“It has to be an art,” Dr. Singh said, and one that needs to be learned and taught. He likens it to cooking. If a chef breaks down the steps and ingredients, the recipe will make sense but without this step, it’s impossible to understand how to cook the food. If a researcher can explain to a patient how they will receive the treatment, what the treatment is exactly, why it will help them, then finding patients that are enthusiastic and willing to participate shouldn’t be a challenge. Dr. Singh said one of the more noticable benefits of running his own site is the freedom to select which trials he wants to run based on the needs of his patients. “It is much easier to run the trials,” he said. It is much more productive.”

Of course, there are several challenges that go along with running a small research center. Amidst a number of factors, Dr. Singh mentioned the expenses as one example of something that is significantly more burdensome. “If you have money available you can run things easily,” he explained. He added that he can no longer acquire equipment and funds with the ease that he could at the larger academic site. Regardless, Dr. Singh maintains that any difficulties are firmly outweighed by the fulfillment he gets from running the MidAmerica Cancer Center.

The impact of sites like the MidAmerica Cancer Center is crucial to shifting the way patients receive treatment. And for the patients receiving that treatment, work like Dr. Singh’s is life changing. Dr. Singh emphasized that this shift doesn’t need to happen all at once. By slowly bringing more and more studies to rural populations, we can make a noticable change in the future of clinical trials.

“If you can bring in even 25 or 30 percent of trials to rural healthcare, it’s a win win for everybody,” Dr. Singh said.

Inato’s mission is to empower investigators like Dr. Singh to bring care to each and every patient, fighting for a future where inclusivity and accessibility in clinical trials is the standard.

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