From Medicine 2.0 to Medicine 3.0

Peter Attia's- Outlived

Feb 02, 2025

I make detailed notes in my diary about books that stand out to me, and this book's insights and first-principles thinking on health will stay with me for life.

It’s Dr. Peter Attia’s Outlive.

While I love nerding out about ‘longevity’ (a term I hate for personal reasons) by reading research, books, and listening to podcasts over the years, this book lays down the foundations for longevity and emphasizes the importance of healthspan over lifespan.

I don’t usually write blog posts dedicated solely to books, but I thought this one was worth it. The concepts it explains could fundamentally change society’s approach to health—shifting the focus from treatment to prevention through a first-principles lens.

I’ve also documented some of what I learned from this book in my own book, framing it as a first-principles model in the chapter: Health Is Invisible to the Naked Eye.

In the book, Peter emphasizes why the medical system should shift from a model focused on treatment to prevention. It’s a deep, fascinating read, rich with insights.

How does this shift happen? By moving from Medicine 2.0 to Medicine 3.0.

But first, let’s start with Medicine 1.0.

Medicine 1.0: The Era of Hippocrates

Medicine 1.0 lasted for almost two thousand years after Hippocrates’ time. It was based on direct observation, paired with guesswork—some of which was accurate, and some of which wasn’t.

Hippocrates’ major contribution was groundbreaking for its time: the insight that diseases are caused by nature, not by the gods, as previously thought.

The Arrival of Medicine 2.0

Medicine 2.0 emerged in the mid-19th century with the advent of germ theory. This monumental breakthrough shattered the idea that most illnesses were spread by “bad air.”

The shift from Medicine 1.0 to Medicine 2.0 took centuries and was met with resistance from authorities. It was driven by new technologies like the microscope and, more importantly, a new way of thinking.

Medicine 2.0 has been transformational. It’s responsible for the eradication of diseases like polio and smallpox, the containment of HIV and AIDS in the 1990s and 2000s, and the recent cure for Hepatitis C, among many other breakthroughs.

But Medicine 2.0 has its limitations. Its primary focus has been on treating disease rather than addressing its root causes.

The Shift to Medicine 3.0

This is where Peter Attia’s book challenges the status quo: by emphasizing a shift from treatment to prevention. Medicine 3.0 focuses on keeping people healthy in the first place.

Here’s the key difference:

Medicine 2.0 relies on two primary tactics:

Procedures (e.g., surgery)
Treatments (e.g., medications).

Medicine 3.0, on the other hand, relies on five tactics:

Exercise
Nutrition
Sleep
Emotional health
Exogenous molecules (e.g., drugs, hormones, or supplements).

The Philosophy Behind Medicine 3.0

Medicine 3.0 takes a page from Noah’s Ark:

When did Noah build the ark? Long before it began to rain.

Medicine 2.0, by contrast, scrambles to figure out how to get dry once the rain has started.

Medicine 3.0 studies meteorology. It asks: do we need a better roof or perhaps a boat?

Another key difference is personalization. Medicine 3.0 treats the patient as a unique individual. Medicine 2.0, by contrast, treats everyone the same by relying on clinical trial findings trials and evidence-based medicine.

In Medicine 2.0, you’re a passenger on the ship, carried along passively.

In Medicine 3.0, you’re an active participant. It demands more from you: