Lately I’ve been reading about medical education reform.  I found this quote from Abraham Flexner, “Think much; publish little.” Ironic given that this is the man who’s early 20th century disruption of medical education spawned modern academic medicine and its adopted credo, “publish or perish.” It seems the idea of publishing less never took hold in the system he created.

So what was Flexner thinking? Perhaps he recognized the danger of a system preoccupied with publishing for publishing’s sake.  Maybe he was predicting that publication would become the single-minded metric of academic fertility.  Or maybe he believed that solutions, innovation and amazing ideas aren’t born amidst the security and certainty of medical journals.  Perhaps he was preparing 21st century physicians for the slow dissolution of peer review and implosion of traditional publishing models.

We’ll never know, but I suspect Flexner feared the creation of a system that disallows risk and discourages independent thinking.  He likely foresaw the expiration of his own model and the creation of a lock-step medical generation not only unable to reinvent itself but unaware of the need for reinvention.  Maybe he worried about a generation of medical leaders lacking the vision, versatility, and creative insight necessary to meet the challenges of 21st century medicine.

The 100 year anniversary of Flexner’s report has brought a call for education reform. But we’d do well to take Flexner’s advice to think much and publish little. Real education reform will come from thinking and social innovation, not more publishing.