Reaffirming Scientific Medicine Through Physician Leadership in Health Care Technology and Innovation

Executive Summary

Since the early 1800s, American medicine has reflected a persistent divide between two opposing worldviews: scientific versus sectarian medicine. Scientific medicine was first brought to America in the late 1700s by physicians who trained at the University of Edinburgh where they became steeped in the views of the Scottish Enlightenment before emigrating to the North American British colonies. Over the next two hundred years, such views and attitudes converged with laboratory science and the expanded availability of high-quality microscopes and other scientific instruments. In time, scientific medicine embraced discoveries based on modern molecular and cellular biology. In contrast, alternative or sectarian medicine approaches such as homeopathy and eclecticism emphasized personal experience and theoretical frameworks outside the scientific mainstream.

The rivalry between these approaches endures, reflected in the rise of wellness and influencer industries that represent a modern iteration of sectarian medicine. In 2025, it energized and gained political influence from the U.S. Department of Health and Human Services (DHHS) and its Make America Health Again (MAHA) campaign.

In its effort to revive sectarian medicine, the MAHA movement and DHHS secretary simultaneously seek changes that could erode public confidence in scientific medicine. These efforts risk weakening U.S. medical schools and academic health centers (AHCs), which the movement claims have been influenced by the pharmaceutical industry or that their principal outputs, namely scientific journals and papers, are compromised. Accordingly, the U.S. government has proposed significant reductions to the budget of the National Institutes of Health (NIH) and other health care cuts, as well as new political criteria for research universities and potential financial penalties on taxes on their endowments.

Even before 2025, all was not well in American medicine. MAHA is emerging in a period of accelerating physician dissatisfaction and burnout and steady declines in the physician-scientist workforce.

However, the situation is not entirely bleak. The U.S. health care industry sits atop the food chain as America’s top employer, accounting for one third of all employment growth. Even with significant cuts to government funding, there is sufficient private equity and venture capital in the system to ensure sustained health sector growth.

This working paper considers these new realities and offers the following objectives or recommendations:

• Objective 1: To explain how the wellness and influencer industry (and its MAHA representation in the U.S. government) became the latest iteration of a sectarian medicine movement in America that goes back to the early 1800s.
   
• Objective 2: To detail the threat of this new version of sectarian medicine to modern scientific medicine in America, especially for AHCs. Also, how these shifts are occurring on top of rising physician burnout and declines in the physician-scientist workforce.
   
• Objective 3: To offer recommendations and a path for reshaping scientific medicine. This will require revising medical education and redirecting and retraining the physician workforce for leadership and entrepreneurship. Examples include both traditional business entrepreneurship and social entrepreneurship for the benefit of society or humanity. It means empowering NextGen physician entrepreneurs to establish health technology enterprises and lead the reinvention of health systems through AI or other technologies.
   
• Objective 4: To further recommend our nation’s major metro life science clusters (also known as life sciences complexes or biohubs) as implementation sites for this purpose.

MAHA, the resurgence of sectarian medicine, and the reductions in government support for biomedicine should be a wake-up call for America’s medical schools and AHCs. We can respond by placing physicians in charge of reimagined U.S. health systems. 

View the full paper (PDF).

This publication was produced in collaboration with Rice University’s Baker Institute for Public Policy. It has not been through editorial review. Wherever feasible, this material was reviewed by outside experts before it was released. Any errors are the author’s alone.

This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s), and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.