I awoke this morning inspired to describe the interesting and unusual pharmacokinetics of a drug I have deep experience both using and abusing: the doctor salary.
Absorption
Doctor salaries have a delayed onset from the time of initial ingestion. 4 years of university education plus 4 years of medical school plus 3-7 years of residency creates a situation rarely encountered in other therapeutic scenarios: by the time the drug takes full effect, the patient may be cured of the symptoms that drove her to ingest it.
Once delayed onset finally occurs, doctor salaries can be further subdivided into two varieties: physician employee salaries are more immediate-release formulations hitting lower peak concentrations early, while physician-run businesses can have a further gradual ramp-up period in serum levels that ultimately delivers a more potent high.
Absorption demonstrates tremendous individual variation. For a small proportion, the salary is absorbed via the super-ego, which subdues wants and desires and diverts the salary into energy storing end-organs like the 401k, HSA, Roth IRA and the taxable brokerage. For these patients, the results of ingesting the drug are difficult to notice at first but impossible to ignore as time goes on.
The reason is that the quantity of doctor salary which is stored in these organs behaves like a prion, reproducing itself until the dollars created from the internal organs eventually exceeds the amount ingested exogenously. Super-ego absorbers, over years, build an internal store of dollars that eventually eliminates their need to ingest more doctor salary.
The vast majority of patients are not super-ego absorbers. For this majority, the salary is absorbed primarily through the id, whose wants and desires rapidly absorb and diffuse most of the drug leaving little residual drug to enter those same energy storing end-organs. Id absorbers appreciate a rapidly noted onset of effect with an early peak, but a long tail.
Whereas a super-ego absorber may require only 15 years of doctor salary before discontinuing the medication, an id absorber is likely to require half a lifetime of treatment.
There is promise that id absorbers can undergo radical transformation into super-ego absorbers, lessening their dependence on the doctor salary drug.
Distribution
Super-ego absorbers create large deposits of drug in specific organs with less available to circulate elsewhere.
Id absorbers exhibit rapid distribution of drug to numerous competing organs that cause it to diffuse rapidly out of circulation.
It is worth noting that distribution can be affected by both parasitic and symbiotic organisms living within the patient.
Parasitic organisms such as asset under management advisors charging excessive fees and whole life insurance salespersons masquerading as advisors can create deleterious effects on the host by reducing circulating levels of dollars to subtherapeutic amounts.This is known as inhibition and can lead to toxicity.
Conversely, a fairly priced, flat fee advisor who serves as a fiduciary can promote enhanced circulation of existing drug levels for maximal effect. This is known as induction.
Metabolism
All patients contain a unique enzyme called compound interest.
Super-ego absorbers augment their ingested doctor salary through the action of this enzyme on deposited dollars. Their lower baseline metabolic rate consumes fewer dollars than it produces, and is therefore anabolic, leading to a net creation of dollars. These excess deposits of dollars can lead to morbidly obese FIRE, a state of supratherapeutic wealth.
Id absorbers experience more rapid depletion of their dollars due to the effect of compound interest on credit card debt. Their higher baseline metabolic rate consumes dollars, and is therefore catabolic, leading to a net breakdown of dollars.
Excretion
Super-ego absorbers excrete levels far below the amount of dollars they produce.
Id absorbers excrete close to the amount of dollars they produce, and in some pathologic states, can excrete more than they consume or produce.
More To Come
Now that we understand the pharmacokinetics of the doctor salary and its component dollars, we'll attempt to understand its potential for abuse in the next installment.