Understanding how nature drives entropy production offers novel insights regarding patient care. Whilst energy is always preserved and energy gradients irreversibly dissipate (thus producing entropy), increasing evidence suggests that they do so in the most optimal means possible. For living complex non-equilibrium systems to create a healthy internal emergent order, they must continuously produce entropy over time. The Maximum Entropy Production Principle (MEPP) highlights nature’s drive for non-equilibrium systems to augment their entropy production if possible. This physical drive is hypothesized to be responsible for the spontaneous formation of fractal structures in space (e.g., multi-scale self-similar tree-like vascular structures that optimize delivery to and clearance from an organ system) and time (e.g., complex heart and respiratory rate variability); both are ubiquitous and essential for physiology and health. Second, human entropy production, measured by heat production divided by temperature, is hypothesized to relate to both metabolism and consciousness, dissipating oxidative energy gradients and reducing information into meaning and memory, respectively. Third, both MEPP and natural selection are hypothesized to drive enhanced functioning and adaptability, selecting states with robust basilar entropy production, as well as the capacity to enhance entropy production in response to exercise, heat stress, and illness. Finally, a targeted focus on optimizing our patients’ entropy production has the potential to improve health and clinical outcomes. With the implications of developing a novel understanding of health, illness, and treatment strategies, further exploration of this uncharted ground will offer value.

Physical laws dictate that energy is preserved; yet energy gradients irreversibly dissipate, thus producing entropy. As living complex non-equilibrium systems, humans must produce entropy continuously over time to create healthy internal emergent order. Entropy production is measured by heat production divided by temperature. Several hypotheses are presented. First, human entropy production is due to both metabolism and consciousness, dissipating energy and information gradients. Second, the physical drive for maximal entropy production is responsible for spontaneous formation of fractal multi-scale self-similar structures in time and space, ubiquitous and essential for health. Third, the evolutionary drive for enhanced function and adaptability selects states with both robust basal and maximal entropy production (i.e. the capacity to augment it when required). Last, targeted focus on optimizing our patients’ entropy production will improve health and clinical outcomes. These hypotheses have implications for understanding health, metabolism and consciousness, and offer novel clinical treatment strategies.