Medicine doesn’t take kindly to scientific oversight like eg the me/cfs nice guidelines analysis of their methods but heck it needs it.I doubt that more than maybe a few hundred get it, out of tens of millions. They just don't see it, they're trained by the failing system. This is partly because of the complete separation between physical and mental health, ironically on the basis of a magical duality between mind and body that is used to free everyone from responsibility. It's very obviously abused to escape accountability, and is beloved by self-serving interests who don't value the long-term greater good. The biggest drivers are the insurance industry, who would actually make giant long-term savings if the systems were competent, but it would involve short-term disruption and losses. This can't happen on a volunteer basis, this is why we have governments. But the governments are advised by the same systems that have always failed at this. It's a stalemate.
If anything, most seem to think that the solution is to do more biopsychosocial, more of the problem. They just don't see the problem for what it is, they work in echo chambers insulated from real world data and hostile to other fields of expertise, which basically means that medicine has to come up with solutions to non-medical problems while having no relevant expertise, such as engineering or information technology. This is where the pandemic was failed, and if COVID had the potential to kill 500M people, this is who many would have died. They just got lucky, and still killed 20M+ and disabled 100M+.
The profession seems to be willing to lay the blame anywhere but on them. You can see how obsessed most seem to be about tiktok and social media being the new source of everything wrong. It's the same old process they've always used to blame anything but themselves. Because they are not accountable.
The solution probably involves some sort of shift away from top-down expertise onto a mixed system that allows significant bottom-up representation and genuine accountability. Technically this would be elections, but health care is not impacted by changes in government, because ultimately all important decisions are made by physicians, or on their advice. A shift away from a technocratic/aristocratic model towards a representative model, where patients have influence on the system and can hold it accountable. This is unlikely to happen until AI takes over most medical decisions.
Health is too important to be left to physicians. They only see a small part of the whole, and because of how medical culture works, sick people are never involved, since being ill is incompatible with working in health care. It's a system identical to having only the richest people make all economic decisions. There is no such thing as benevolent systems with top-down decision-making. The myth of benevolent medicine needs to be shot twice in the back of the head and buried down the deepest grave. Nothing works like that. Accountability is what brings benevolence, it isn't a thing in itself.
and it needs to be kept separate in recruiting and career pathways so those oversighting don’t have to play nice because those people might be on an interview panel fir their next job
Increased professionalism and taking away the power from the wrong places so we’ve actually got some innovation that isn’t conflicted (by this short term political cycle it’s packet stuff) is needed. But even those seem to get infiltrated.
I’d start with kicking out or back to doing wards only and having proper management of those who churn out manifestos rather than proper research with proper methods. If you aren’t up to understanding enough methods in your own papers then of course you aren’t unbiased in your consideration of the literature based on methods vs your own ideologies. We can’t have wards full of unmanaged people just using their power and independence to force tgat on the social order by who gets a life or not