Anomie, a term coined by French sociologist Emile Durkheim in his book Suicide, refers to the breakdown of shared societal values, standards, or moral guidance, leading to a combination of aimlessness and deviant behavior.

When it happened in industrial society at the turn of the 20th century, some of the behaviors as a consequence were an insatiable appetite towards infinity for an indefinite goal, and strongly held views that do not hold up under scrutiny.

These should feel familiar to anyone today, particularly poignantly if following the longevity medicine movement.

Medicine's industrial revolution is happening today
Anomie emerged at the turn of the 20th century with industrialization. Durkheim described it as a consequence of times of transition, when the values and norms from the old period are no longer valid, but new ones have not yet evolved to take their place.

We all feel “modern” medicine failing us and needing to give way to something new. We are all disenchanted with the bureaucratic, impersonal activities doctors spend their time doing and know it is not serving society well. But we also don’t know what will take its place.

Reminiscent of the disruptive reorganization of roles from industrialization, today there is an explosion in sources of information but a vacuum of authority in health and medicine. That vacuum is leading to medical anomie.

Why we become more hopeless as we get better off
The changes on face value seem positive. All at once, medical dictums with poor evidence are getting scrutiny, AI tools are catapulting biosciences, and traditional medicine modalities and psychedelics from other cultures are resurfacing.

A lot of people are benefiting from this upheaval. But in the absence of a coherent framework for where to go and who to trust, people feel constantly unfulfilled, unsure of what they are missing, concerned they made a wrong choice and are missing out.

With social anomie came a pursuit of wealth as an end in itself, as its potential became seemingly limitless with industrialization. “Health is the new wealth” as many say unironically, as they pursue health as an end in itself. It’s not surprising they’re coming up empty.

What doctors can do about it
We can’t un-see the paradigm shift in medicine (nor should we). Instead, we need to figure out what solid ground to keep through the process. The salve for social anomie is community cohesion and moral codes. For medical anomie, it too is cohesion and a value system, but from the medical community.

In the future, doctors won't be needed for rote knowledge. Their value will be if they have been practicing a more integrated modern conception of medicine, over many patients, and what they have learned about what works, for whom, under what circumstances.

Communal ties are needed not just in our social lives. They’re needed in our mental models as well. While maintaining curiosity and an open mind that rules may change, we need to be able to debate ideas and have some arbitration of the answer we believe. Doctors, theoretically the practitioners studying health and wellness their entire careers, should be doing this.

Carte doctors protect the time and space to integrate new technology and science with our biologic and pathophysiologic training to give better medical guidance. If physicians don't evolve to fill this void, who will patients count on instead?