Neurology Notes

Not Practicing

It looks like I’m not alone in Maryland as a non-practicing physician:

State lacks practicing physicians — “While the state has about 25,000 licensed physicians, the second-highest rate per capita of any state, nearly 40 percent are engaged in teaching, research and administrative duties, according to the study, and some of the rest spend part of their time in such nonclinical work.”

One the insights that I had many years ago was that in practice, one had no way to leverage one’s activities. Economically a physician is valued for their direct time in providing care. And procedural activity, like surgery or angioplasty, is valued per unit time way above examining and diagnosing. In research and business, there are value multipliers as others participate in the enterprise. The return on time is potentially much higher for a phyisician outside of practice.

Low FDA Approval Rates

The rate of new drug approvals for the pharmaceutical industry is dropping. One reason may be FDA delay:

Eye on FDA: Impact of Approvable Letters 2007 – Part 1: “However, it is important to think about the implications of so many approvable letters.  They represent more than an inconvenience to companies and to patients who are awaiting therapies with serious implications for both, as well as for investors in companies, particularly smaller companies that do not yet have a product on the market.  ”

The drug is safe and effective, but is not yet allowed to market. This in between status for a drug can drag on for years, destroying companies.

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