Let me simply start this essay with a question - What would be your reaction if you got to know Thomas S. Kuhn, in his famous and inspiring book: The Structure of Scientific Revolutions Compared Myths with Science? When I first read it, I was in disbelief for the initial few minutes until I read the entire paragraph a few times.
If these out-of-date beliefs are to be called myths, then myths can be produced by the same sort of methods and held for the same sorts of reasons that now lead to scientific knowledge. If, on the other hand, they are to be called science, then science has included bodies of belief quite incompatible with the ones we hold today.
Thomas's book, "The Structure of Scientific Revolution," is among the most challenging books I've encountered in my lifetime. But I think all the Books on science and history that I have read, and if I apply the first principle. I think I have a fair understanding of Thomas’s hint behind comparing Myths with Science.
By delving into the annals of scientific history, it becomes evident that many paradigm-shifting scientific breakthroughs have arisen from identifying and rectifying anomalies. In numerous instances, successors have challenged the established scientific views of their predecessors by substantiating their claims with objective and measurable data, which were replicable and independent of geographical location.
Consider the example of the prevailing myth that the Earth is flat. Over time, this belief was debunked through the efforts of a few individuals, leading to the acceptance that our planet is indeed round. Similarly, early observations suggested that Earth, along with the Sun and Moon, constituted the center of the solar system. However, subsequent scientists discovered evidence contrary to this notion, establishing the Sun as the solar system's central body through objective observations.
For a significant time many mythical narratives used to suggest it there is some god, who is responsible for the creation of different weather - winter, summer, rainy etc. But all of them failed to give any explanation on why the timing of weather varies on the different parts of the Earth. And when we break the space barrier - we discover the Earth is tilted on its axis and naturally, when a tilted part of the Earth gets exposed to the Sun, that portion of the Earth used to experience Summer and vice versa. And this scientific explanation was repeatable and true across the surface of the Earth.
What emerges from these examples is a discernible pattern. One of the patterns evident is that scientific progress often evolves from myths, which are subjective in nature, towards science, characterized by objectivity. This correlation is one of the reasons why Thomas drew a comparison between myths and science in his influential work. However, the intent of this essay extends beyond dissecting the propagation of scientific advancements. Its purpose is to underscore the driving force propelling humanity from decade-long leaps to rapid advancements measured in days, thereby dispelling myths and instilling objectivity into our systems.
Consider the contrast between the timeframes required to dispel the subjective notion of a flat Earth or a geocentric solar system versus the speed of modern progress. In the contemporary intersection of time and space, the eradication of subjectivity-driven concepts is achieved exponentially faster, often instantaneously. This accelerated pace of change is made possible by our ability to create and develop cutting-edge technologies. These technologies serve as the catalyst for the elimination of subjectivity from systems, leading to the birth of new, objective-driven systems. Notably, systems designed to eradicate subjectivity inherently deliver enhanced productivity and personalization. Moreover, technology's role in instantaneously removing subjectivity significantly reduces costs.
Hence, it becomes evident that our limitations are predominantly defined by the extent of our technological capabilities. Failure to devise superior systems, independent of subjectivity, can be attributed to a lack of technological support. It is imperative that if technology is available, we refrain from merely rebranding old systems under the guise of innovation while preserving subjective core hypotheses. Adhering to the same system is likely to yield familiar solutions, hinting at a failure to pinpoint the problem's root cause. Consequently, implementing a new solution within such a framework will invariably lead to the emergence of new challenges.
We at Jile Health have, accidentally, discovered a framework to identify the root cause of the problem and solve it without creating a new problem through a new system approach. But that is only possible because we have available technologies.
This part of the essay involves systems, hence let’s start with a quote on systems:
If a factory is torn down but the rationality that produced it is left standing, then that rationality will simply produce another factory. If a revolution destroys a government, but the systematic patterns of thought that produced that government are left intact, then those patterns will repeat themselves…There’s so much talk about the system. And so little understanding.
By: Robert Pirsig, Zen and the Art of Motorcycle Maintenance
We have been working on Jile Health for the past 12 months of course, we started with a problem statement rather than a business idea or solution. Throughout the past 11 months, we have patiently worked on developing and refining solutions. As I write this, we firmly believe that what we have constructed and devised has the potential to make quality healthcare accessible and affordable.
During our journey, serendipitously, we've stumbled upon a framework that we're currently employing. This framework guides us in navigating from identifying the underlying cause of an issue to devising solutions, all while ensuring that our solutions don't inadvertently give rise to new problems.
And we can use this framework across the industry. Hence this essay:
If we look at any problem, there would be two types of indicators
Visible (Mostly Subjective but it can be Objective)
Invisible (Mostly Objective but it can be Subjective)
In fact, we can create a 2X2 matrix with Visible, Invisible and Objective, Subjective
In some cases, visible indicators can be objective and invisible indicators can be subjective. We will take a look at all types of examples.
In general, we made a mistake by looking at one out of two and create a hypothesis about problems and solutions. The real magic comes out when we merge both and ask tough questions.
Let’s take an example:
Progress and Growth of Nation: There are two Invisible but Objective indicators,
GDP and
GDP per Capita
Unfortunately, these two visible objective indicators give us no indication of the real progress of a nation on multiple fronts. For example, revenue from deforestation also gets added to the GDP, but do we want that? However, as soon as we add another opposite indicator (Visible, Subjective), we get a real sense of the Growth and Progress of a nation. In the case of the Nation’s progress, here are some Invisible, Objective indicators:
Wealth with the lowest throughput
The lowest infant-mortality
The greatest political freedom
The cleanest environment
The smallest gap between the rich and poor
I am sure there will be many other Visible-subjective (but measurable) data points that might indicate the progress of a nation better than Invisible-objective indicators - GDP and GDP per Capita.
The fact is every discovery of a solution or solving problems is nothing but creating a system - entirely new or renovating an old system. As Robert Pirsig said if the system is kept intact - it will produce the same output. And a system can’t be evaluated just based on one type of goal or purpose. There might be the case that a lack of infrastructure or technology could prevent us from measuring another type of indicators but that is the purpose of science and technology. The development of science and technology mostly allows us to validate many of our subjective indicators.
Let’s take another example:
There is already a thread on Rainmatter’s Discussion:
Chronic Menstrual issues in women (let’s focus on PCOS (Polycystic Ovary Syndrome))
Most of the startups are tackling to solve this problem for women by looking at visible-subjective indicators
Irregular menstrual cycles (long or absent periods)
Hirsutism (excessive hair growth on face, chest, back, etc.)
Acne and oily skin
Male-pattern baldness or thinning hair
Weight gain or difficulty losing weight
Dark patches of skin (acanthosis nigricans)
Skin tags
Menstrual cycle length and regularity
Ovulation-related fertility issues
Mood swings and emotional disturbances
Fatigue and low energy levels
As there is so much stigma around menstrual issues and PCOS not many women open and disclose the above visible-subjective indicators. In fact, most women ignore such subjective-visible indicators considering it not a big deal.
And if anyone is designing a solution based on just one type of indicator - that solution will end up creating a new problem. As Sameer (CEO@Rainmatter Foundation) says, we create new problems to solve old problems.
In that case, the real question is - what would be the best method to
Identify the problem
Solve that problem without creating a new problem
And hence we need another type of indicator, for the above example, - “invisible-objective”
Health Vitals and Indicators (Invisible signs):
Blood glucose levels (fasting, postprandial)
Insulin sensitivity/resistance
Lipid profile (triglycerides, LDL cholesterol)
Blood pressure
Androgen levels (testosterone)
Hormone levels (FSH, LH, estradiol, etc.)
Micronutrients (Invisible signs):
Vitamin D
Omega-3 fatty acids
Iron (hemoglobin and ferritin levels)
Folate (vitamin B9)
Vitamin B12
To understand this in detail, I have created a summary: https://bit.ly/Menstrual-Issues-Women
Even, from the above, many indicators can be found in Health Records - Lab tests, EMR/EHRs, others etc. that most of us throw it considering useless.
Not all invisible indicators are necessary, however, even if we take the most suitable one and match that with the visible subjective, we shall have a better chance of
Identify the root cause of the problem
Solve it without creating a new problem
Let’s say, we don’t have the technology to measure invisible-objective indicators that is a different case. However, if there is available technology by which we can measure the invisible-objective: before even doing anything - we should be comparing both visible-subjective and invisible-objective. And at this stage LLMs (AI) create real magic. In fact, we at Jile Health believe LLMs and Health Stack will make Quality Healthcare affordable and accessible for everyone in the country.
And in this way, we will create a new system that will produce better results. And such systems will solve problems without creating new problems. And such solutions will be scalable.
The above framework is also true for Mental illness, All types of NCDs, Chronic diseases etc
We think this is especially important for any Healthcare/Healthtech solution. And this is what we discovered after 11 months of work. But again, we are lucky simply because thinking to solve this problem at scale would have been almost impossible without Health Stack (ABDM)
With all the developments - Health stack, PPG, LLMs etc. - it is a good time to think of Healthcare/Healthtech solutions from a new SYSTEM POV rather than layering the old system with some renovations and paintings. :)
Also thinking/building a new system does take a bit longer compared to layering the old system with some paintings. But India is probably the world's best investment destination for investors and it should not be a problem to extend the fund span for a few years to unlock the potential of billions of people.
Concluding this essay is a reflection on Thomas S. Kuhn's poignant comparison of myths with science. As we contemplate the progress made over the past 75 years, it becomes evident that our journey began amidst myths, but the current juncture presents a ripe opportunity to transform these myths into scientific truths. This is particularly true given the abundance of technology readily accessible at our fingertips.
Thanks for reading, if you like my essay, please sign up and share this in your network! I shall see you all next week :)
PS: I have published a portion of this essay, on Rainmatter’s Discussion