The investigators were sold. Their practice partners weren't.

Eligible patients were walking through the door and enrollment still lagged. The investigators were keen. The partner physicians they shared a practice with were not, so the patients who qualified never got asked. Nobody was being obstructive. Nobody had ever put the case to those partners in terms that meant anything to them.

So we ran the campaign practice by practice rather than as one national message. In each one we set out what taking part was worth, to the patient in the room and to the physician doing the referring, in the terms that practice valued. It is slower to set up than a single national push, and more expensive per site.