How Did Healthcare Get to Its Current State?

Surgeon state of healthcare

At the turn of the 19th Century the healthcare system, not just in the United States, but in the world went through a dramatic change. It actually starts at about 1860 with Florence Nightingale and culminates around 1910 with people like Sir William Osler, Father of Internal Medicine, and William Stewart Halstead in surgery.

They did three main things:

  1. They redefined clinical education to the current version we have today
  2.  They separated administration from clinical practice
  3. They adopted the Scientific Method – this has been one of the biggest impacts

Now, fast forward a hundred years to 2016. The science they adopted has not only given us thousands of ways to intervene to change a patient’s future, but it also made healthcare dramatically more complex. We had an approach that was massively successful, but now we’ve reached its limits and it’s pushing us beyond our old capacities. It’s not just the rate of production far exceeds human capacity, but the rate is increasing exponentially.


When I was in medical school we believed medical knowledge doubled about every 30 years. However, today it is about 5 years. That means a new internist coming into practice is going to have to learn, unlearn, and relearn half of her medical knowledge base a minimum of six times just to stay current.

RELATED: 4 Steps to a Learning Healthcare System

How do you do that when your days are full of patient care? The simple truth is, we don’t. Empirically we know you can’t. In a modern system the questions are:

  1. How can you extract that knowledge?
  2. How do you package knowledge and deploy it out in a consistent reliable way?  
  3. How do you use that same system to systematically improve the knowledge base, so we can accelerate knowledge generate even further?

This is the task for the healing professionals today.