What Larry Weed Understood About The Medical Profession: A Remembrance

There are courageous innovators in medicine who question conventional wisdom without fear. Dr. Larry Weed—who sadly passed away at the age of 93 on June 3, 2017—was one of those individuals.

His ideas were fresh and important. From my perspective, he was one of the first to really recognize the power of the way that we organize information and its importance to the quality of care we deliver. By the time I met him, he was already an icon for his work organizing medical notes and providing the common structure that we use today. He was also one of the first to recognize our inefficient ability to translate knowledge into practice.

I remember Dr. Weed's metaphor in which he compared inconsistent knowledge translation in the medical field to electrical lines that experienced drops in voltage due to inefficient transmission. Long before everyone was talking about implementation science, he was already writing eloquently about how poorly and non-systematically medicine moved knowledge from academic papers to the bedside.

I met Dr. Weed through my work with a group that was conducting an independent evaluation of whether one of his key projects—the Problem Knowledge Couplers—was applicable to the military. His idea was that physicians generally process complex information poorly, which conspires against their ability to make accurate diagnoses in complicated cases. He wanted to automate the process and, before most people thought about using computers to facilitate diagnosis, he was intent on cataloguing symptom complexes and relating them to the likelihood of different diseases. He was there at the beginning: creating decision-support to generate differential diagnoses and to help the busy practitioner to quickly organize high-dimensional data and produce useful information.

We were rigorous in our methods of evaluation and ultimately failed to show the benefit of his approach to the military. We published the paper and moved on. But still, even later, I was disappointed in the finding and somehow felt that the idea had much merit. The challenge was to determine how best to apply it in practice. I think that is what he thought too. And he persisted with the idea and continued to improve its application.

I remember being fascinated by him, inspired by him, and a little bit in awe of him. It was just that his ideas made so much sense. I admired his independence and his persistence — and that creativity. He recognized early on that doctors need help to truly excel, and the help must address information overload and the limitations of human memory.

Dr. Weed had ideas for medicine that are still worth spreading. And he had a dedication to change that felt noble. I applaud his contributions, I mourn the loss to the profession, and I believe that much of what he promoted will ultimately become standard in medicine.

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