A decision to use the distribution as the main working operating system can only be made when the user can be as productive as with an alternative OS. Part of that consideration is the availability of software that contributes to everyday's routine and beyond.
This do-ocracy principle enables individuals or small groups to actively influence the support of certain fields of work. Here, community-driven Linux distributions have an edge over commercial Linux distributions. The number of users that may use a package, i.e. that ``pay back'' for an initial packaging effort, is not the decisive factor in favor of or against the maintenance of a package. One only needs a sufficiently large community of active package maintainers to have confidence that the current infrastructure will be maintained, that new packages will be brought into the distribution, and that one will possibly be allowed to improve current workflows with personal contributions. Debian Med is actively benefiting from this aspect and is supporting a lot of applications that are very specific to medical care and are not integrated in any other large distribution.
The advantage of plugging Free Medical Software directly into a large Linux distribution as opposed to creating a separate distribution with a specific focus on medical care will be further discussed below.
Andreas Tille 2010-12-10