You're right about distillation and research debt. Additionally, though, the lag from research to clinical practice is a major issue in medicine, so speed has t

You're right about distillation and research debt. Additionally, though, the lag from research to clinical practice is a major issue in medicine, so speed has to be a factor in any solutions. This is complex, since it's not just a question of improving throughput of publication, we need to examine issues of practitioner attitudes and capacity to change practices. For refs, Google Paul Glasziou's research in this area.