Innovation in Medicine: A Slow and Deadly Process

Rodgers, Everett M. Diffusion of Innovations, Fourth Edition. Free Press, 1995.

There is a lot of talk about evidenced based medicine, i.e. medicine based on statistically valid studies. However, only about 15% of medicine is evidence based. Most of it relies on the intuition and practice of the physician. Medicine is more of an art than a science and people’s attitudes about medicine often resemble religious beliefs more than opinion based on study and research. The solution to your problem may be published already in the medical journals and you may die without discovering this.

Just to show how bad it can get, Rodgers documents the elimination of scurvy in the British Navy:

1497 – Vasco da Gama’s crew of 160 men sailed around the Cape of Good Hope. 100 men died of scurvy. This was a typical mortality rate from scurvy on this type of journey.

1601 – English sea captain James Lancaster tries lemon juice experiment on some of his ships. Most men stayed healthy. On the three ships without lemon juice, 110 out of 278 men died of scurvy.

1747 – British Navy Physician James Lind tries a similar experiment on the HMS Salisbury. Men with scurvy were cured within a few days with citrus juice.

1795 – British Navy adopts citrus juice policy and all scurvy is eliminated on military vessels.

1865 – British Board of Trade adopts citrus juice policy on merchant marine vessels and eliminates all commercial scurvy.

In this case it took 264 years to eliminate all scurvy by eradicating Vitamin C deficiency on long ocean voyages.

I have read and reread the earlier editions of Rodgers book. The only other book that comes close in causing such a radical change in thinking about technology innovation is Christensen, Clayton M. The Innovator’s Dilemma: When New Technologies Cause Great Firms to Fail. Harvard Business School Press, 1997.

Amazon’s comments: Since the first edition of this landmark book was published in 1962, Everett Rogers’s name has become “virtually synonymous with the study of diffusion of innovations,” according to Choice. The second and third editions of Diffusion of Innovations became the standard textbook and reference on diffusion studies. Now, in the fourth edition, Rogers presents the culmination of more than thirty years of research… The fourth edition is (1) a revision of the theoretical framework and the research evidence supporting this model of diffusion, and (2) a new intellectual venture, in that new concepts and new theoretical viewpoints are introduced. This edition differs from its predecessors in that it takes a much more critical stance in its review and synthesis of 5,000 diffusion publications. During the past thirty years or so, diffusion research has grown to be widely recognized, applied and admired, but it has also been subjected to both constructive and destructive criticism. This criticism is due in large part to the stereotyped and limited ways in which many diffusion scholars have defined the scope and method of their field of study. Rogers analyzes the limitations of previous diffusion studies, showing, for example, that the convergence model, by which participants create and share information to reach a mutual understanding, more accurately describes diffusion in most cases than the linear model.

Rogers provides an entirely new set of case examples, from the Balinese Water Temple to Nintendo videogames, that beautifully illustrate his expansive research, as well as a completely revised bibliography covering all relevant diffusion scholarship in the past decade. Most important, he discusses recent research and current topics, including social marketing, forecasting the rate of adoption, technology transfer, and more. This all-inclusive work will be essential reading for scholars and students in the fields of communications, marketing, geography, economic development, political science, sociology, and other related fields for generations to come.

Strongly recommended. This is one of the few books that I reread periodically.

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