The Root-Cause Healthcare Problem Nobody Wants to Talk About: Knowledge Deficit
Look at the volume of knowledge medical science has accumulated–truly a Mount Everest. From the microscopic level of subatomic particles to the level of the entire human organism, we have developed disciplines from biochemistry to histology to embryology to physiology to anatomy—and everything in between.
CT scanners look into the most minute details of the human body with slices that are a fraction of a millimeter and getting smaller. What CT scanners cannot see, MRI scans can.
How about surgical procedures? How about the fantastic level of knowledge needed to transplant the heart itself? How about surgeons sitting on one side of the globe operating on patients on the other side? It's dazzling.
And then there are the vaccines and medicines we develop. Trillions of dollars have been spent over decades to develop such solutions.
And all that was before AI.
Medical science isn’t perfect–no science is–but it has been doing a fantastic job right?
Wrong.
In the above commonly presented view of medical science, what you do not see is the century-old fault lines in its foundation that today have become wide chasms of distortion. This makes it easy to believe that medical science is doing quite well. But I submit to you that we believe this because we have been trained to have such low expectations of healthcare. We’re looking to squeeze out a few more years and a few better years, rather than profoundly deeper, more meaningful, and much longer lives.
Low expectations have also led us to believe that the major healthcare problems are operational in nature. Many even believe that the problems we have are the result of our success. Apparently we have done such a good job that we are fortunate to have new problems of incurable diseases to deal with. Clearly not a knowledge problem. (?)
The call for operational solutions is deafening.
We just have to get the knowledge we have to the people that need it.
We just have to bring down costs.
We just have to improve access.
We just have to collect data.
We just have to care a little bit more.
We just have to figure out how to work with AI.
We just have to…
It's tempting and easy to fall into the trance of this belief. It’s a trance that permeates much of the healthcare reform and innovation world, from executives to pundits to clinicians to entrepreneurs.
Popular opinion rarely revolutionizes a field.
Don't get me wrong, operational problems need solving. We need better access, lower costs, and better healthcare delivery across the board. But first we have to ask a critical question:
What is the level of the knowledge we are delivering?
Despite everything I've said above, I can also say with full heart that the level of knowledge in medical science is abysmal. And nobody wants to talk about it.
Here are a few important points to consider.
When we talk about medical science, what we actually mean is Allopathic medical science. Allopathic medical science is a philosophy that focuses almost exclusively on the physical aspects of a human being. It has codified this philosophy as anatomy and developed it as a science by investing trillions of dollars into this philosophical model. Yet, almost nobody recognizes the foundation of philosophy that we call science today.
The Flexner report of 1910 cemented a low level of understanding of human nature as the standard for science and, furthermore, used language such as "quacks" and "pseudo-scientific" to label people who think differently and scare them away. The result is the vast majority of doctors and other healthcare professionals are afraid to question assumptions that desperately need questioning. It’s science after all, right? The true quackery and pseudoscience, if there are such things at all, is the Flexner report itself, the clearly stated purpose of which was to set the (low) standard for medical education, which it has accomplished.
Healing systems around the world that were honed over thousands of years, such as Ayurveda and Traditional Chinese Medicine, have models of anatomy that Allopathic medical science simply cannot comprehend. Such models live entirely beyond our limited science. Pause and think about the significance of that. And what is our solution for the glaring problem of a science that cannot understand different models of anatomy of the same species? It has largely been to ignore what we don’t understand–and occasionally ridicule it. Fortunately, over the last decade or so, integrative medicine has started to pick up, and we have dared to at least place these models of anatomy alongside each other, wondering about them. But wondering is not enough. We must discover the underlying knowledge that unites health and healing.
We don't have a standardized understanding of health or healing. The World Health Organization came out with a definition that essentially describes health as well-being, creating yet another word we have not defined precisely. This is akin to saying, "I'm going to Washington, DC," and having no idea whatsoever what the phrase Washington, DC means or where it is located, while investing trillions of dollars to get there.
Medical research is profoundly compromised. It's not a fun topic, and most people in healthcare likely underestimate the level of corruption and compromise in medical research. Look up quotes from editors of major journals like NEJM and Lancet, and you will begin to scratch the surface. This doesn't mean all research is corrupt. It just means it's difficult to determine what is legitimate and what is not. Compromised science takes many forms, including not studying concepts that would help the public (rarely spoken about), believing that the mechanisms we are studying are truly the mechanisms that matter (rarely spoken about), manipulating trial data, and paying investigators and clinicians to regulate what they say and don't say. Such behavior puts clinicians who are truly doing our best in a very difficult place. We know the science is compromised, “but it’s the best we have,” as one colleague told me.
These mostly unacknowledged chasms in the foundation of medical science have taught us one thing above all: to lower our expectations for health, healing, cure, and human potential.
Because the brand of medical science has been built with trillions of dollars and innumerable advanced degrees, we take it at face value. We must not. We must find the way to walk the fine line of being able to take the best of medical science, which is truly great, and discard the marketing, which is truly prolific.
Since I’ve said this much, I'm obligated to fill out the picture better and present the solution, which is well within our reach. I will be writing two more articles to do that. One will be about the confusing messaging and belief system that dominates healthcare today, which is the direct result of the knowledge deficit in medical science. The second will be about the solution, which is a new set of models–the Numocore Core Models–that will develop and organize the knowledge of wellness, healthcare, medical science, and public health into the new health system.
Dr. Anoop Kumar is Co-founder and CEO of Numocore, a company building the new health system with a focus on healing, cure, and human potential. Join our wellness practitioner learning track.