Although there are about 720,000 licensed physicians in the United States, only a small percentage – 10 percent to be specific – participate in clinical trial research in which pharmaceutical companies spend more than $3.3 billion a year in their quest to develop new drugs.

In San Antonio, Alan Preston, CEO of Synergyst Research, hopes to reverse that low participation rate by encouraging more physicians to get involved in clinical trials.

“There’s lots of reasons why physicians don’t participate,” Preston says. “One is that if you don’t understand the clinical trial process, you’re going to be reluctant to get involved. The complexity of getting involved keeps many doctors at bay. Our company helps physicians who are clinically research naïve get started in the clinical trial business.”

Founded in 2004, Synergyst Research offers marketing, legal, financial and regulatory services to strengthen and increase a physician’s clinical research capabilities.

“We’re a clinical trial management organization,” Preston says. “We find trials for physician groups, do the legal documents, negotiate budgets on their behalf, help them prepare for site visits and assist with all other aspects of the study start phase of clinical trials.”

Clinical trials are vital in the development of new drugs. Therefore, participation in clinical trials is a win-win situation for physicians and patients, Preston says. Individuals who volunteer to be test subjects in new drug research receive free medicine and care, and are often paid for their time and travel. They also get a tremendous amount of attention from the physician overseeing the study, the clinic coordinator and biostatisticians who monitor their charts.

“For physicians, they get to be part of leading-edge technology in the pharmaceutical business,” he says. “They get a sense of what is in the pipeline of new drug treatments that are going to come out on the market.”

San Antonio is ideal for conducting clinical trials because of its renowned Medical Center and the various research projects it conducts, Preston says. He estimates about 200 clinical trials occur here each year. The range of therapeutic specialties of which clinical trials are conducted range from the A to Zs, including allergy and asthma, cardiology, gastroenterology, neurology, oncology, psychiatry, rheumatology and urology, among others.

Developing one new drug – which can take years from the start of Phase I, II, III and IV clinical trials all the way to getting FDA approval – can be exorbitant, somewhere to the tune of $800 million. Basically, a pharmaceutical company first has to hire scientists who must understand the effect that the drug will have on animals. Years can go by before the drug is ready to be tested on humans.

“Then they will often pay doctors $50,000 per trial to $250,000 per trial to conduct these trials,” Preston says, adding that 10 patients per trial must be enrolled. “It becomes costly to pay physicians, find subjects to enroll in clinical trials, collect data and report that data back to pharmaceutical companies.”

Each phase can take as long as a year to complete, he says. Because there are four phases, four years can pass for a drug to be tested on humans until the time it goes to the FDA for review and approval.

Before he established Synergyst Research, Preston was CEO of four different managed care payors, as well as a large multispecialty physician group. Doing so, he says, has given him a leg up for working in healthcare.

“When you’re on the third party side, you see all the challenges from the perspective of insurance companies. You see claim forms that come in and how inaccurate they are or the amount of information they are missing,” he says. “On the physician side, you see the challenges when they do it right and managed care companies don’t get it right. Each side has some areas of complexity that the other doesn’t understand.

“When you have both of those, you get an insight that is substantially different than either one of them. You add to that the academic component of it. Those are the three legs that really give you a stable platform upon which to look at healthcare industries and try to figure out what are the needs in that industry and how can we solve that need.”

That insight led Preston to start his company, he says, as well as an experience he had with a physician, who was seeking help in obtaining a clinical trial. “We fulfilled that need,” he says. “We realized that if this one provider has this need, then other provider groups might also have this need, so we scaled the company upward. Now we’re in 13 markets in the United States that does clinical trial research.”

Preston says he’s fortunate that his job allows him to pursue activities outside the sphere of Synergyst Research. He currently is working with members of the community to help the University of the Incarnate Word establish a master’s program in health administration. It is scheduled to launch in fall 2009.

Daniel Dominguez, UIW founding director, graduate program in health administration, H-E-B School of Business and Administration, credits Preston as the impetus for the program’s development when he approached President Lou Agnese in 2007 about the need for such a program in San Antonio.

“As our executive in residence, Alan has significantly contributed to our efforts by encouraging key members of his extensive network of healthcare executives to follow his lead and volunteer their time in service on our Executive Advisory Board. Further, he has leveraged his exceptional leadership and communication skills to generate excitement and support for the program both within the university and in San Antonio.”

The CEO flies to New Orleans once a month to fulfill his position as an adjunct professor at Tulane University’s School of Public Health and Tropical Medicine where he teaches statistical research strategies to doctoral students. He also is a guest lecturer at St. Mary’s University and Trinity University.

“I get to be surrounded by some of the top-notch people in the country,” Preston says of his career. “Some are working in the area of medicine and healthcare and healthcare improvement. To think that you get paid to rub elbows with these individuals is the icing on the cake. It’s a humbling experience and exciting all at the same time.”