How to Democratize Knowledge in Healthcare

A personal journey highlighting the need for freely accessible information in dentistry and medicine

I recently started reading The Crime of Reason by Nobel Laureate Robert B. Laughlin. It’s a startling book that makes one question and reminds us of moments in life when we didn’t have answers to certain questions — questions we were probably scared to ask or about which we were simply naïve. The book is about information and how, over time, the perception of knowledge and access to it have changed.

I remember back when I was in 5th grade, I asked my chemistry teacher if the nucleus of a molecule could be further broken down into particles. She gave me a strange look because the 5th grade was when science was first divided into physics, chemistry, and biology. She thought I had asked the question too early and told me I would get further answers in my higher classes, effectively dismissing my question.

Fast forward many years; when I joined dental school, I still possessed the same wide-eyed, naïve idealism. But as the textbooks piled up, so did the barriers. The sheer cost of information became overwhelming. Vital research was locked behind paywalls or hidden in costly books.

Even some of the most practical clinical guidance felt like a closely guarded secret. There was an expectation that clinical knowledge should simply be absorbed through some form of osmosis. Resources were limited, yet expertise was demanded.

Laughin states in his book:

As a practical matter, our rights to learn have already been circumscribed. People often have trouble speaking about this problem because it’s a worldly matter — like the practicalities of having children — that polite individuals don’t discuss. Instead they smile and insist that education is golden and that the various ways of withholding knowledge — intentional generation of confusion, stonewalling, lying, disinforming — are obnoxious but not conspiratorial. They then deflect the discussion in a new direction by declaring the concerned person to be paranoid. This denial is extremely irresponsible. The issue is the criminalization of learning. It’s important. It’s something we need to think about.

Our society is sequestering knowledge more extensively, rapidly, and thoroughly than any before it in history. Indeed, the Information Age should probably be called the Age of Amnesia because it has meant, in practice, a steep decline in public accessibility of important information. This is particularly ironic given the rise of the Internet, which appears to spectacularly increase access to information but actually doesn’t.

Laughlin’s words cut deep, but they hit the right spot. It made me think about how an open-source philosophy for dental and medical sciences could democratize knowledge.

The Price We Pay

They call it the Information Age, but try telling that to a dentist struggling to find the latest research on a new root canal technique or a maxillofacial surgeon trying to find updates on the management of vascular anomalies.

Here’s the real cost of keeping healthcare knowledge locked away:

Stifled Innovation: Progress slows when vital research is out of reach for smaller practices and researchers with limited budgets. Imagine a promising treatment for periodontal disease held back because a small practice can’t afford to access the pivotal study.

Unequal Access: Differences in resources between institutions and regions can create knowledge gaps, ultimately impacting patient care. A student at a well-funded school might have access to the latest materials, while a rural dentist struggles to find updated information.

Burnout: The constant struggle to stay updated with expensive journals and conferences can contribute to stress and disillusionment among practicing dentists.

Open-source philosophy for Dental and Medical Sciences

What do we mean by open-source?

The term open source comes from open-source software. Open-source software (OSS) is software where the underlying source code is freely available for anyone to inspect, modify, improve, and redistribute. This stands in contrast to proprietary software, where the code is usually hidden from users.

Why does open-source matter?

Open source software offers unparalleled cost-effectiveness, often being free or extremely low-cost. Users gain the freedom to customize the software to their precise needs, while the transparency of the codebase fosters rapid security improvements. This open model drives innovation as collaboration thrives, and a strong sense of community emerges around successful projects.

Ways to explore the open-source concept beyond software

Open Science

PLOS (Public Library of Science): A large publisher of open access scientific journals. https://plos.org/

Center for Open Science: An organization advocating for transparency and reproducibility in scientific research. https://www.cos.io/

Open Science Framework (OSF): A platform for sharing and collaborating on research projects. https://osf.io/

Open Educational Resources

OER Commons: Extensive repository of open educational resources. https://www.oercommons.org/

Creative Commons: The organization behind licenses commonly used for OER and other open content. https://creativecommons.org/

Open Data

Open Knowledge International: Nonprofit promoting open data globally. https://okfn.org/

In dental and medical sciences, open source can be implemented by:

Freely Accessible Textbooks & Resources: Projects like OpenStax (https://openstax.org/) demonstrate the power of free, high-quality textbooks. This model could revolutionize dental education.

Peer-Reviewed Knowledge Bases: Shareable, updatable repositories of clinical techniques, best practices, and even anonymized case studies would benefit the entire profession.

Open Research: Accelerating breakthroughs by removing financial barriers. Discoveries that could transform patient care shouldn’t be locked away.

Teaching Programs: Esteemed institutes can conduct teaching programs on relevant subjects and reshape academia and the dispersion of knowledge.

We also need to keep in mind models that protect the intellectual property of authors and researchers while promoting open access. Rigorous peer-review systems are essential to ensure the quality and accuracy of shared knowledge. Finally, sustainable funding mechanisms, such as grants, institutional support, or tiered memberships, will be crucial for the long-term success of open-source medical and dental resources.

Conclusion

The free-flowing exchange of knowledge fuels higher cognition. As knowledge empowers individuals to think critically and solve problems, society as a whole thrives. The competitive nature of academia can sometimes hinder the free flow of experience and discovery.

In conclusion, I would like to say that it’s time to revolutionize the sharing of information to empower students, practitioners, and researchers. The open-source approach has the potential to improve patient care, level the playing field, and re-energize the profession. Because ultimately, knowledge shouldn’t be a privilege — it should be the foundation of better health for all.