Andy
Retired committee member
"Change in medicine is never easy, especially when practitioners are asked to dispense with long-held beliefs about an illness. It is this challenge—of steering an entire community to collectively revise its understanding of reality—that philosopher Thomas Kuhn flagged in his classic analysis of scientific revolutions. Kuhn described such an inevitably messy affair as a “paradigm shift.”
When emerging science diverges from past assumptions, it follows that the prevailing base of knowledge will need updating. In theory, this epistemological process seems straightforward. The problem arises in practice, as such updates often face implacable resistance from individual human beings and the institutions they control. Kuhn’s insight was to highlight the social psychology of scientific transitions. When people invest their professional credibility in a specific idea or approach that is later surpassed by advances in science, many will be frozen by the dread of looming personal obsolescence. While some succeed in gradually pivoting to the new reality, others respond with various acts of resistance, seeking to delay and disrupt the forces they feel are promoting the discomforting change. And even after the revolution has become inevitable, some practitioners cling to the old ways.
This tortuous process is currently on vivid display in the debate over the causes of prolonged illness after an acute viral infection—especially the conditions known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), formerly called chronic fatigue syndrome, and long COVID—the popular name for what the National Institutes of Health (NIH) calls postacute sequalae of SARS-CoV-2—or PASC. The controversy revolves around whether these are largely caused by pathophysiological processes, or—as some in the medical establishment have asserted—by a combination of physical deconditioning and mental health issues, including anxiety, depression, post-traumatic stress disorder, and other conditions."
https://www.healthaffairs.org/conte...cy-makers-push-paradigm-me-cfs-and-long-covid
When emerging science diverges from past assumptions, it follows that the prevailing base of knowledge will need updating. In theory, this epistemological process seems straightforward. The problem arises in practice, as such updates often face implacable resistance from individual human beings and the institutions they control. Kuhn’s insight was to highlight the social psychology of scientific transitions. When people invest their professional credibility in a specific idea or approach that is later surpassed by advances in science, many will be frozen by the dread of looming personal obsolescence. While some succeed in gradually pivoting to the new reality, others respond with various acts of resistance, seeking to delay and disrupt the forces they feel are promoting the discomforting change. And even after the revolution has become inevitable, some practitioners cling to the old ways.
This tortuous process is currently on vivid display in the debate over the causes of prolonged illness after an acute viral infection—especially the conditions known as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), formerly called chronic fatigue syndrome, and long COVID—the popular name for what the National Institutes of Health (NIH) calls postacute sequalae of SARS-CoV-2—or PASC. The controversy revolves around whether these are largely caused by pathophysiological processes, or—as some in the medical establishment have asserted—by a combination of physical deconditioning and mental health issues, including anxiety, depression, post-traumatic stress disorder, and other conditions."
https://www.healthaffairs.org/conte...cy-makers-push-paradigm-me-cfs-and-long-covid
