Excellent post, Nita! I've been thinking for some time that the future for medicine and extending our lives is going to come from the combination of big data + AI so a lot of what you're describing makes sense to me.
I think both camps are fallible and have their respective strengths and weaknesses. Western medicine is very population-based while Ayurveda tends to be more personalized for each individual. I plan to cover these points in more detail in next week's edition!
Nita, your manifesto captures something that many of us working in healthcare strategy have been wrestling with for years. Biology operates as an interconnected system, yet the delivery model we have built is organized around isolated specialties. Your framing of humans as ecosystems and disease as a network failure is aligned with where the science is moving.
Where your argument is especially powerful is in calling out the gap between how clinicians are trained and how complex conditions actually behave. Medical education still reinforces an organ-by-organ worldview. Then we ask physicians to manage illnesses that cut across metabolic, immunologic, neurologic, and environmental domains. It is not a fair fight without a different mental model.
From a strategy perspective, I see a bridge between your vision and the current system. Rare disease Centers of Excellence are the closest real-world prototype of what you describe. They bring together multiple specialties, shared diagnostic frameworks, longitudinal data, and coordinated care pathways. They are not perfect, but they show what happens when expertise is integrated around the patient rather than around the organ.
The challenge is scale. Centers of Excellence work because the populations are small, the conditions are well defined, and the teams are tightly coordinated. Expanding that model to the much larger and more heterogeneous world of complex chronic illness is a different level of complexity. Still, the underlying principles are transferable. Cross-disciplinary reasoning, shared data, and a unified theory of disease are the foundation of any systems-based approach.
Your emphasis on multi-omics and a clear order of operations in treatment is the next frontier. Even the best Centers of Excellence do not yet operate from a single systems map of disease. They integrate people, not data. Your M5 framework could help them evolve from multidisciplinary to truly systems-based.
The place where I would push the field is in medical training. If we want clinicians to think in networks rather than silos, we have to start upstream. Systems biology, network medicine, and multi-omic interpretation cannot remain electives. They need to be part of the core curriculum. Without that shift in clinical reasoning, even the most elegant frameworks will struggle to take root.
So I am aligned with your vision. I simply see the path as evolutionary rather than disruptive. The future you describe will emerge by building on the strongest parts of the current system, especially Centers of Excellence, and by equipping the next generation of clinicians with a more holistic and integrated way of thinking.
Your manifesto provides the north star. The work ahead is designing the operating model that can carry it.
Glad I found you. You confirm my own wellness journey. I was an Arivale customer, then did a deep dive with the short-lived P4 Medicine shouldered by Dr Leroy Hood after Arivale folded. Too early for the market.
Now I am using Viome products daily with annual testing. I’d like to tell my story to help others in living a healthy life.
Somehow I feel “acquisitive mimesis” correlates with disease.
I hunch we don’t so much want to heal ourselves but rather murder our weakness, our illness. And current modern medicine fits this “kill box” concept perfectly.
Do you know of any research on this subject? Thank you for your work.
Hi Tom, really cool that you were part of the first Arivale cohort! I really enjoyed reading The Age of Scientific Wellness by Hood & Price.
In my mind, there are quite a few parallels between acquisitive mimesis and the communicability of non-communicable diseases through shared risk behaviors.
The dissonance between the kill and nourish concepts is perhaps best exemplified by the chasm between Pasteur's germ theory of disease versus "le milieu intérieur,” a model developed by Claude Bernard that stressed the importance of a healthy internal environment to guard against infectious threats.
Excellent post, Nita! I've been thinking for some time that the future for medicine and extending our lives is going to come from the combination of big data + AI so a lot of what you're describing makes sense to me.
Thank you
Thanks, Michael! I'd love to learn about your thoughts and ideas too.
I like your 5 M's but I like even more your description of the *way* or approach that is holistic, integrative, personalized.
I've been hearing more about Ayurveda recently, and wonder how that lines up with your insights relative to western pathologizes-specialized medicine.
I think both camps are fallible and have their respective strengths and weaknesses. Western medicine is very population-based while Ayurveda tends to be more personalized for each individual. I plan to cover these points in more detail in next week's edition!
Nita, your manifesto captures something that many of us working in healthcare strategy have been wrestling with for years. Biology operates as an interconnected system, yet the delivery model we have built is organized around isolated specialties. Your framing of humans as ecosystems and disease as a network failure is aligned with where the science is moving.
Where your argument is especially powerful is in calling out the gap between how clinicians are trained and how complex conditions actually behave. Medical education still reinforces an organ-by-organ worldview. Then we ask physicians to manage illnesses that cut across metabolic, immunologic, neurologic, and environmental domains. It is not a fair fight without a different mental model.
From a strategy perspective, I see a bridge between your vision and the current system. Rare disease Centers of Excellence are the closest real-world prototype of what you describe. They bring together multiple specialties, shared diagnostic frameworks, longitudinal data, and coordinated care pathways. They are not perfect, but they show what happens when expertise is integrated around the patient rather than around the organ.
The challenge is scale. Centers of Excellence work because the populations are small, the conditions are well defined, and the teams are tightly coordinated. Expanding that model to the much larger and more heterogeneous world of complex chronic illness is a different level of complexity. Still, the underlying principles are transferable. Cross-disciplinary reasoning, shared data, and a unified theory of disease are the foundation of any systems-based approach.
Your emphasis on multi-omics and a clear order of operations in treatment is the next frontier. Even the best Centers of Excellence do not yet operate from a single systems map of disease. They integrate people, not data. Your M5 framework could help them evolve from multidisciplinary to truly systems-based.
The place where I would push the field is in medical training. If we want clinicians to think in networks rather than silos, we have to start upstream. Systems biology, network medicine, and multi-omic interpretation cannot remain electives. They need to be part of the core curriculum. Without that shift in clinical reasoning, even the most elegant frameworks will struggle to take root.
So I am aligned with your vision. I simply see the path as evolutionary rather than disruptive. The future you describe will emerge by building on the strongest parts of the current system, especially Centers of Excellence, and by equipping the next generation of clinicians with a more holistic and integrated way of thinking.
Your manifesto provides the north star. The work ahead is designing the operating model that can carry it.
Glad I found you. You confirm my own wellness journey. I was an Arivale customer, then did a deep dive with the short-lived P4 Medicine shouldered by Dr Leroy Hood after Arivale folded. Too early for the market.
Now I am using Viome products daily with annual testing. I’d like to tell my story to help others in living a healthy life.
Somehow I feel “acquisitive mimesis” correlates with disease.
I hunch we don’t so much want to heal ourselves but rather murder our weakness, our illness. And current modern medicine fits this “kill box” concept perfectly.
Do you know of any research on this subject? Thank you for your work.
I’m 75 and still a student of life.
Hi Tom, really cool that you were part of the first Arivale cohort! I really enjoyed reading The Age of Scientific Wellness by Hood & Price.
In my mind, there are quite a few parallels between acquisitive mimesis and the communicability of non-communicable diseases through shared risk behaviors.
The dissonance between the kill and nourish concepts is perhaps best exemplified by the chasm between Pasteur's germ theory of disease versus "le milieu intérieur,” a model developed by Claude Bernard that stressed the importance of a healthy internal environment to guard against infectious threats.
I expound on these ideas a little further here: https://www.nitajain.com/p/the-myth-of-modern-medicine
Thanks for the discussion, and great to meet another lifelong learner.