[coxmichael]

Both can be true, and greater systems of medical research and analysis don’t necessarily lead to greater on-the-ground treatment.

As you’ve pointed out, access to those information systems is critical. I’d add the distribution of that information as well as the right economic incentives to participate in using that information.

I’m not sure we’ve really got any one of those things right.

Edit: adding a bit of humanity to the system, as the OP is hinting at, could very much be a part of the fix.

[throwaway894345]

> Both can be true

Not really. You can't say "doctors have become less productive" without accounting for the value incumbent in the increased documentation effort.

> greater systems of medical research and analysis don’t necessarily lead to greater on-the-ground treatment.

Maybe not "necessarily", but in practice they do. Perhaps not in every incidence, but broadly the analysis results in better outcomes or else there would be no economic incentive to facilitate medical research ("the incentive is to sell more drugs!" <- insurance companies aren't going to pay for those drugs if they aren't proven to work).

> Edit: adding a bit of humanity to the system, as the OP is hinting at, could very much be a part of the fix.

That's not how I understand the OP, but I doubt anyone would object to "adding a bit of humanity" (abstractly) to healthcare unless it implies a reduction in empirical rigor.

[coxmichael]

> broadly the analysis results in better outcomes or else there would be no economic incentive to facilitate medical research

This is true to a degree, but outcomes for real healthcare rely on much more than research, as you’ve indicated.

Documentation is part of that research, of course, and whether they have short-term or long-term effects for researchers’ ability to work out better treatment is relatively lossy.

Actual treatment also includes the rest of healthcare (training, hell, even their housing costs), and rules-based or centralised administrative systems backed by insurance don’t necessarily create the right environment for that information to be propagated more widely.

People training to be health workers don’t use the frequency or quality of medical research papers to decide whether to become a doctor.

I think there’s a view you can take on the information topology here that’s a little odd in how it’s currently set up — documentation for front-line workers and information wealth for researchers feels like it’s relatively polarised.