With neurology practices facing ever narrowing profit margins, diversifying sources of income becomes increasingly important. One popular way to do this is by adding clinical trials to your practice – it can be lucrative and rewarding, says Dr. David Weisman.
But Weisman also urges caution before taking the plunge. Clinical trials can be hard in ways you may not realize.
Weisman, a practicing neurologist just outside of Philadelphia, founded the Clinical Trial Center at Abington Neurological Associates in 2008. When he started the center, he says, he didn’t really know how to build a trial center, and he didn’t know it was going to take off.
“But I knew how to do trials, thanks to my fellowship,” he adds. “I thought that it would be good because it is a very moral and ethical thing to do; we are trying to beat Alzheimer’s disease.”
He still directs the center and is currently running about 40 drug trials (the COVID-19 pandemic notwithstanding).
“It’s been terrific because we’ve helped develop new treatments in MS and stroke and we’ve had some wins in Parkinson’s disease, and in dementia with psychosis,” Weisman says. “We are part of that. We show the data that these interventions and medications have benefits. So, we get to be part of something really big and that’s exciting.”
Being a part of clinical trials can also, ultimately, be a good source of income. Once you’ve built it, says Weisman, “it is definitely lucrative.” But that might not be enough.
“I used to think when I was out of my fellowship, every doctor should open up a side business doing clinical trials,” he adds. “But now I see a bunch of doctors, who I really love and respect as doctors, who just don’t have all the components to be able to do this.”
One of those components is a certain level of commitment and dedication to advancing the field as a whole. This means seeing beyond the individual patient, and not all doctors can — or would want — to do that.
“If you get a subject into a trial, even if you believe in the medication or whatever the intervention is, it might not work, or they might be getting placebo. These are people who are right in front of you, and you have to look them in the eye when the informed consent is going on and during the trial when things go wrong,” Weisman says. “It really hits home when you see some of the sacrifices that the subjects make, and their caregivers. They are putting their lives on the line in this fundamental way. It’s truly incredible.”
This view toward the greater good is something Weisman hears from his patients all the time. It resonates with him and keeps him motivated when things get hard. If you want your focus to remain solidly on the patient in front of you, (and that’s the doctor Weisman says he would want for himself) then clinical trials might not be for you.
It is also important to have the right temperament and a certain level of diligence. You also need to have “a belief structure that aligns with pharma. It’s not ego-driven,” he says. “You’re not doing your chest-pumping research that you get to brag about. You are not going to be a Dr. Oz. If that’s your temperament, then don’t do this.”
Starting a clinical trial center is also a lot of work and takes an initial investment that can take years to pay off.
“If someone wants to do this just for the money – and I have no problem with that, by the way – [but] in isolation, that is not sufficient to do it,” Weisman says.
Working harder clinically, getting an infusion center, or doing more legal work have more pure income potential and they’d probably be the easier thing to do, he adds.
There are some serious stop signs in place that you should pay attention to if you are thinking about adding clinical trials to your practice. But the rewards can be great too, and not just financially, Weisman says. Sometimes knowing who shouldn’t do something shines the best light on the people who should.