A question that I’ve considered often the past few years is: where does medical information come from?

And, how and why do we know what we know?

First, a little on Epistemology – one of the major branches of philosophy.  Epistemology is the study of the origin of human knowledge.  While it’s fun to wade into the mind-expanding world of philosophy, it’s way, way above my pay grade.  But, to give you a better idea of Epistemology and some interesting ways to think of ‘knowing,’ check out this short video from Jennifer Nagel:

She tells us that knowing comes from a confident belief in a truth, combined with a good basis of judgment, and she does a great job of explaining how these aspects that equal knowledge can themselves be explored.  Like I said, fun, but above my pay grade.  Also, not practically applicable, as far as I can tell.

My considerations of knowledge are more about how we know what we know, and where that knowledge comes from, in the real-life application of healthcare.

So, the search continues – where does healthcare-based knowledge come from? Eventually, I discovered Medical Epistemology.  Sweet!  This field exists!  My work at NTA with Meredith Kinsel-Ziter led us to the discovery of a few great resources, including the book Making Medical Knowledge by Miriam Solomon, this paper on epistemological problems in evidence-based medicine, and this paper exploring evidence-based medicine versus expertise.

These links are for those of you who want to nerd out hard, and please do!  I’d love to talk shop with some other folks about medical epistemology.  My takeaway is that there are other people out there grappling with the question of – where does applicable, accurate, and practitioner-accountable medical knowledge come from, and how can we get better at acquiring it, understanding it, and holding ourselves accountable to a standard of knowledge?   

It may be more beneficial than I currently realize to examine this question under a philosophical lens, and I’m game to put in the time.  But, for now, I want to share my own considerations that have led me to create four categories of knowledge attainment.  These categories are practically applicable to folks interested in the practice of healthcare.

Before we get to those categories, though, why does it matter?

Why does it matter where our information comes from?  For me, this question formed as an (unintentional) exercise in examining my own knowledge-limits (that were vast).  Grad school, apparently, does this to a lot of folks, but it has had a profound impact on how I interact with my clients, my students, and my colleagues.  I couldn’t easily accept information anymore without a hearty (and oftentimes time-consuming) dive into the subject of interest.  I’ve become highly and happily skeptical, because a skeptical stance is helping me to learn.

The short story: the more I learn, the more I realize I don’t know shit, and the exploration to educate myself is way more exciting than being ‘right.’

The end-game of this has been an attempt to understand where our medical knowledge is actually coming from, and ultimately trying to put categories around the types of knowledge that I’ve found to be clinically helpful and, to some degree (the degree that I’m able to assess…) accurate and reliable.  I hope you’re still with me here. 🙂

If we are able to understand where knowledge comes from, we can better assess the clinical usefulness, the accuracy, and the reliability of the information that we rely upon to practice healthcare.  This is the crux: I believe the practice of information tracking will allow the cream to rise to the top.  Digging back and deeper in, in an attempt to clarify WHY and even how we know what we know, will strengthen our knowledge base, teach us new and better information, improve our clinical skill set, etc., etc. – basically all the good stuff.

So, what are these categories already?!?

The categories of information that I’ve discovered to help me best understand and track information are:

  • personal experience
  • traditional practices
  • observational information 
  • scientific research

In the next blog, I’ll dive into the details of each of these information categories – we’ll explore why these categories are useful and the responsible practical application – the how.

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