By: Thomas Lee Abshier, ND
12/28/2024
Create a publically available, all-people-as-contributors, expertise-annotated, anecdotal health database with the following key elements:
1. Give all practitioners, academics, and laymen the status of research-data contributors. This allows all anecdotal observations and experiences to be considered pilot studies.
2. Establish a centralized database to catalog and collate these anecdotal reports from healthcare providers, patients, and the general public. This database would include details on the level of credibility and certainty of each anecdote.
3. Validation: Implement systems of validation and accountability where people are required to verify their credentials and credibility when sharing information or experiences to help evaluate the validity of the observation.
4. Use AI technology to search and analyze the database, identifying patterns and potential therapeutic interventions that could be further researched and validated.
5. Make this database freely accessible to the public, empowering people to take more control of their healthcare by leveraging the collective wisdom and experiences captured in the database.
The goal is to harness the vast amount of anecdotal information that currently goes uncollected and unanalyzed and turn it into a valuable resource for improving healthcare outcomes. This database aligns with the principles of free speech and the open exchange of information.
ANECDOTAL HEALTHCARE DATABASE INITIATIVE
A Proposal for Healthcare System Reform
Thomas Lee Abshier, ND
December 30, 2024
EXECUTIVE SUMMARY
I propose establishing a comprehensive national database to document and analyze healthcare outcomes across traditional and alternative medicine practices. This system would create an evidence base for treatments outside conventional medical research frameworks and democratize and instantly promulgate healthcare knowledge.
CORE OBJECTIVES
- Create a searchable repository of patient outcomes across all treatment modalities.
- Enable data-driven discovery of effective treatments for rare conditions
- Accelerate the identification of promising therapeutic approaches
- Reduce barriers to healthcare innovation
- Empower patient choice through transparent outcome data
RATIONALE
- Americans spend billions annually on alternative healthcare, demonstrating significant public demand.
- Current research models may miss effective treatments for subset populations.
- Valuable clinical innovations often remain siloed within small practitioner networks.
- Traditional research frameworks pose high barriers to validating novel treatments.
IMPLEMENTATION FRAMEWORK
- Database Structure
- Standardized documentation of patient visits
- Comprehensive tracking of treatments and outcomes
- Sophisticated AI-powered search capabilities
- Privacy-preserving architecture
2. Quality Control
- Practitioner verification system
- Credentials validation
- Treatment classification framework
- Outcome measurement protocols
3. Access Framework
- Open access for patients and practitioners
- Tiered verification system
- Research interface for analysis
- Public health monitoring capabilities
GOVERNANCE MODEL
- Independent oversight board
- Multi-stakeholder representation
- Ethical guidelines enforcement
- Conflict of interest management
BENEFITS
- For Patients:
- Access to comprehensive treatment options
- Informed decision-making capability
- Improved rare condition management
- Enhanced treatment personalization
2. For Practitioners:
- Clinical pattern recognition
- Treatment efficacy feedback
- Professional knowledge sharing
- Practice optimization tools
3. For Research:
- Hypothesis generation
- Treatment efficacy signals
- Population health insights
- Innovation acceleration
FUNDING MODEL
- A public first, but eventually privately funded, Anecdotal Database that provides a valuable service the public is eager to support because of the personal and public value it provides
- Operational independence from political, economic, or ideological partisans
- Open accounting and public accountability to ensure cost-effective administration
This initiative would democratize healthcare knowledge while maintaining scientific rigor and professional standards. It represents a practical step toward healthcare system reform that honors innovation and evidence-based practice.
The Anecdotal Healthcare Database
by Thomas Lee Abshier, ND
12/30/2024
We are all optimistic about the possibility of RFK Jr. taking control of the Health and Human Services Agency. The following is a proposal that I have been considering presenting to him to reform the medical system. The idea is to establish a system of recording every visit by an alternative practitioner as an anecdotal case study of a particular condition, therapy, and response. I propose recording every patient visit and including it in a database mineable for cures. The alternative professional healthcare community uses a materia medica outside the conventional pharma/FDA-approved drug paradigm. Doing such a recording and having it available for data mining will open the possibility of creating a new healthcare paradigm.
The amount of money the public voluntarily and without reimbursement spends each year on alternative therapies indicates the value perceived by the public. The proposed Anecdotal Database provides a vehicle for easy entry and access of symptoms, signs, assessment, and treatment for practitioners, patients, researchers, and regulators. This Anecdotal Database platform offers the potential to provide novel leads for treating illness and enhancing longevity and health span.
Such a program could provide the hypothesis of efficacy and justify placebo-controlled trials. One reason such a data collection and access program is valuable is that each person is different in their genetic makeup and susceptibility to disease, history, behaviors, mental constructs, emotional reactivity, etc. The requirement for statistical significance implicitly acknowledges the complexity of the cause-effect relationship between intervention and experimental results. To produce a statistically significant effect, clinician-researchers must treat many patients with similar disease conditions/symptoms. If an actual physiological effect is operating, there will be a statistically significant (P <.05) response in a treated group compared to a group treated with a placebo with similar symptoms. However, this assumption will dismiss a valuable therapy as statistically insignificant in a DBPC trial if the predisposition causing a condition is rare.
Research removes the placebo effect but does not validate the therapy’s efficacy for conditions with only a tiny patient population. (Note: the fact that every person is a rare/unique combination of susceptibility factors (mental/emotional/physical) may make the Double Blind Placebo Controlled Trial a test too crude to identify and predict effective treatment for most patient visits.)
The Anectodal Database will be valuable because it is accessible for both retrieval and contribution, and its near-universal (patient, practitioner, and researcher) reporting of anecdotes and postulated efficacy. This society-wide protocol will allow those with rare susceptibilities to search the database and potentially find an effective remedy/therapy/intervention for their condition and report efficacy when found.
Thus, the reporting system is a repository of ideas for potential therapeutic interventions for particular patient populations. However, finding remedies for rare susceptibilities is only one significant value from this universally reported and searchable database.
Another significant benefit is widely and openly promoting the benefits and results of unconventional/innovative therapies from alternative practitioners, theoreticians, and researchers. The alternative (non-pharma) community struggles against barriers to achieving common knowledge and adoption as effective therapies. The statistical validation of efficacy and meeting the requirements for regulatory validation entails high costs. There are logistical barriers to promulgating unconventional remedies, leaving effective remedies/treatments/interventions unknown to all but a small population of professionals and patients within an alternative doctor/researcher/theoretician’s sphere of influence.
In my 30-year experience as a naturopathic physician, I have attended many continuing education lectures by supplement companies, doctors, and academics. I usually leave with a new clinical pearl, an actionable report of efficacy, a biochemical pathway validating the importance of a cofactor (vitamin, mineral, or biochemical intermediate), a genetic effect to consider, a new lab test to use, a physical therapy, a theoretical understanding of disease, longevity, or physiology, a lifestyle, a new/effective way of thinking/speaking/walking/raising children, or a diet.
Each of these new seminar-proposed possibilities seems hopeful and potentially helpful in treating my patients’ (or my own) aches and pains or extending their/my life and health span. The many options, the application’s specificity, and the artful intuition required to use these new therapies and diagnostic criteria make applying the artfully mastered/nuanced/condition-specific body of knowledge impractical. In a typical seminar, each presentation could be an academic course with laboratory experience and virtual training. However, such support is unavailable, and the presenting practitioner/researcher’s technique/method/knowledge probably never reaches wide acceptance or duplication.
The lack of detail and cursory/summary presentation of the seminar subject results in a lack of penetration of therapeutic innovation or duplication of the individually developed art of diagnosis and therapy. The larger physician population never implements the theory and practice underlying the seminar’s proposed therapy and theory. Medicine is both an art and a science, with expertise acquired from mentors, experience in practice, and memorization of facts and theory. The large number of variables, vast quantities of information, and uncertainties in the applicability of facts result in teachers and students bearing only some resemblance in their practice of the art.
Another important category of obstacles to the promulgation of alternative treatment and theory is the reality of established financial interests such as big pharma, the laws and regulatory bodies of Federal and State agencies, and the prejudice of tradition and adopted protocol can hinder or prohibit the adoption of new technologies, protocols, and theories.
The obstacles to the adoption of new, more effective, and possibly common and inexpensive therapies and cures include the egos and habits of men, the addiction to power, the seduction of easy and sustainable large flows of money, and the comfort of group acceptance inhibit exploring the new while retaining the old. For these reasons and others of similar type, we slow our progress in widely adopting the best therapies and theories.
Therefore, I propose that the government authorize and fund the establishment of an Anecdotal Database, an open-to-all database of therapeutic anecdotes with an AI search capability to answer the questions of individuals, researchers, and practitioners about preventive, palliative, theoretical, and longevity interventions. The efficacy validation issue must be addressed on many levels: identity, institutional association, industry association, state/federal association, professional credentials, experience with this problem, and time in practice.
Since the government is (at least part of) the problem, and the free market does (nearly) everything better and cheaper than the government, people will rightly ask, “Why should this be a government project?” Government regulation and funding are deeply intertwined with healthcare, and any solution must explicitly interface with the current regulatory system. A new norm has been established with the introduction of government-mandated healthcare; people now view government-funded healthcare as a right; we cannot quickly extricate government funding of healthcare from the personal economy.
The problem with funding this program with government or industry is that power and money influence projects funded by either (and both money and power bring sex into the equation as an influence of behavior and policy). This Anecdotal Database project is a public asset/service that requires separation from commercial and regulatory bias. This project will threaten and seduce government and industry, as both social institutions will benefit from this program. The Anecdotal Database program, its establishment, and its administration will allow a government agency to implement a service that will satisfy the needs of its participants with a benign level of power. The anecdotes and extracted therapeutic data will provide the raw information the supplement and medical industry needs to develop new products. The ongoing feedback about the efficacy of the latest products/procedures will provide input that will appropriately fuel growth or diminish enthusiasm.
Harnessing human nature to motivate action is essential. This Anecdotal Database initiative/program will satisfy people’s need to share what has helped and hurt them. The human heart desires to contribute, give back, and help our fellow humans. Such an expression is warm and beneficial on a large scale. Likewise, expressing human passion in its benign/regulated form in most situations is more pleasant and relational. Thus, the Anecdotal Database can be a tool, a structural element of economy and government, that satisfies the need and desire for money and power in a way that replaces the excesses of human desire that lead to damaged health, wealth, and happiness on an individual and societal scale.
If a practitioner, researcher, or patient contributes information to the Anecdotal Database, which is eventually adopted and commercialized, their contribution should be rewarded with a royalty. There may be many who contribute the same information, and priority and size of share should be given to those who have been the earliest and contributed the most substantiation (such as research, detailed case reports, numbers of cases, statistical validation, etc.). A portion of the rewards extracted from the Anecdotal Database should also be contributed to the maintenance and operation of the Anecdotal Database. Rewarding giving/service/sharing with money/cash/remuneration incentivizes participation.
Power and money cannot be removed entirely from any human interaction. However, the rewards of money and power can satisfy the desire for both if appropriate amounts of money and power are given and taken in each human interaction. The Anecdotal Database has the potential to break the government’s control over healthcare options and the monopolistic sales of profitable but less effective (or even harmful) products.
Note: This concept of a public database (of various types and specializations) can be applied to all public-private domains of life: innovations in gadgets, solutions for family problems, technology-related problems, international relations, moral dilemmas, and philosophical questions. Experts and laymen alike could comment upon/contribute to the expansion of knowledge/ideas/innovations/solutions to the problems in all areas of human life.