From Scurvy to Social Media: Why Healthcare Innovations Take a Tortoise's Pace (and How to Speed Things Up)

Samir D’Costa in Health & Wellness July 2025 • 4 min read.

"Unraveling the mystery of slow progress in healthcare adoption—lessons from history and a call to action for faster change."

One of the most persistent challenges in healthcare is the time it takes for research findings to translate into everyday practice. It’s often estimated that it takes around 17 years for evidence to become mainstream. But why does it take so long, and why are some innovations adopted quickly while others languish for decades?

Think of it as a race between the hare and the tortoise. Some breakthroughs, like the impact of the Term Breech Trial on vaginal breech births, are adopted almost overnight. Others, like the recognition of the importance of midwifery continuity of care, crawl along despite strong evidence. This raises a critical question: How can we ensure that valuable research doesn't get stuck in the slow lane?

To understand this challenge, let's look back at a historical example. In 1749, James Lind, a Scottish surgeon in the Royal Navy, conducted an experiment demonstrating that citrus fruits could treat scurvy. His findings were published in 1753, but it took another sixty years before the Admiralty recommended that lemon juice be routinely issued to the entire fleet. Sixty years! What caused this delay, and what lessons can we learn from it?

The Tortoise and the Hare: A Tale of Two Speeds

Tortoise and hare racing to represent slow and fast healthcare adoption.

The story of scurvy highlights a common theme in healthcare: evidence alone is not enough to drive change. Lind's discovery was initially met with skepticism because the prevailing belief was that scurvy was a disease of putrefaction. This illustrates how existing beliefs and biases can hinder the acceptance of new evidence, even when it's based on rigorous research.

Contrast this with the rapid adoption of certain other practices. The Term Breech Trial, published in 2000, dramatically changed the management of breech births. Many clinicians immediately embraced the trial's findings, leading to a significant decrease in vaginal breech births. But why was this evidence accepted so readily?

Clear and Immediate Benefit: The Term Breech Trial presented a seemingly clear-cut solution to a perceived problem.
Reduced Risk (Perceived): Caesarean sections were often seen as a safer alternative to vaginal breech births, even though subsequent research has challenged this assumption.
Alignment with Existing Preferences: The trial's findings aligned with a growing trend toward more interventional approaches in childbirth.

The contrasting experiences of scurvy and breech births underscore the importance of factors beyond the evidence itself. These include the perceived benefits and risks, alignment with existing beliefs, and the influence of professional norms and preferences. But what about more complex interventions, like midwifery continuity of care?

Bridging the Gap: A Call to Action for Faster Change

So, how can we accelerate the translation of evidence into practice? The key lies in addressing the challenges on multiple levels. We need to plan for implementation from the outset of our research, engage with women as consumers and end-users, and collaborate with providers, policymakers, and health service leaders. By working together, we can identify roadblocks, find champions, and monitor progress to ensure that valuable innovations reach those who need them most. The challenge is clear: let’s transform healthcare, one tortoise into a hare, and ensure the best possible outcomes for mothers and babies in all settings.

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Everything You Need To Know

What was the primary challenge James Lind faced in getting his scurvy cure adopted, and how does this relate to modern healthcare innovations?

The main obstacle James Lind encountered was the skepticism stemming from prevailing beliefs about scurvy being a disease of putrefaction. This resistance to new evidence, despite Lind's rigorous research, mirrors current challenges in healthcare. Modern innovations often face similar hurdles. Established beliefs, biases, and a reluctance to change existing practices can significantly delay the adoption of proven advancements, much like the initial resistance to citrus fruits for treating scurvy.

Why did the Term Breech Trial findings experience rapid adoption compared to midwifery continuity of care or James Lind's citrus fruit treatment for scurvy?

The swift acceptance of the Term Breech Trial's findings contrasted sharply with the slow uptake of James Lind's discovery and midwifery continuity of care due to several factors. The Term Breech Trial presented a clear solution to a perceived problem, aligning with a trend toward more interventional approaches. In contrast, Lind's work challenged existing beliefs, and the benefits of midwifery care, though supported by strong evidence, faced resistance rooted in established practices and professional preferences. Also, the swiftness of Caesarean section was perceived as a safer alternative.

How did the prevailing beliefs of the time impact the acceptance of James Lind's scurvy treatment?

Prevailing beliefs were a major roadblock. The predominant understanding was that scurvy resulted from putrefaction, which clashed with Lind's findings on citrus fruits. This mismatch created skepticism, slowing the acceptance of his evidence-based cure. This emphasizes how firmly entrenched beliefs can outweigh even strong scientific evidence in the initial phases of innovation adoption.

What are the key factors that have historically slowed down the adoption of proven healthcare innovations, and what can be done to speed up this process?

Several factors contribute to slow adoption, including the perception of benefits and risks, the alignment with existing beliefs, and the influence of professional norms. To accelerate this, we must proactively plan for implementation, engage end-users (like women in maternity care), and encourage collaboration among healthcare providers, policymakers, and health service leaders. Identifying roadblocks, finding supporters, and carefully monitoring progress are essential steps.

Can you explain the significance of the 17-year timeframe often cited for the mainstream adoption of healthcare evidence, and what does this mean for the future?

The 17-year timeframe represents the often-lengthy period it takes for research findings to become standard practice. This delay highlights inefficiencies in the healthcare system, as it means patients may not benefit from proven treatments and approaches for years. It underscores the urgency of accelerating innovation adoption. The future requires a shift toward proactive implementation strategies, collaborative efforts, and a focus on ensuring that valuable innovations, such as improved midwifery care, reach those who need them quickly.