disclosing information is not a medically neutral act. Knowing you have a medical condition can create a great deal of anxiety and anguish and prompt lots of tests. If the result of all those tests and anxiety is "no action indicated," you've basically given your patient a condition that reduces their quality of life for no upside.

I once had a misdiagnosis of an incurable illness that I didn't actually have, and the stress of dealing with that caused me to develop another, very real medical condition that took a year to get under control.

We're not talking about hiding information, we're talking about not looking for it in the first place. Information that is costly to acquire but not actionable once acquired.

Hypothetically (totally made up numbers), if a positive result on the test means there is 1/10000 chance you have cancer, and negative result means a 1/20000 chance, with the test also having a 1/1000 chance of giving the patient an adverse reaction, i think the questions most patients would ask is why was the test run in the first place?

This is a "why don't you just" answer. The reason the establishment does this is that we know the outcome of telling people is worse than not telling them. This is an expensive lesson learned over over a century of medical treatment.

You could say the same thing about diagnosing cancer via astrology.

A test that with low specificity is simply not a useful test.

> we don't always know at the individual level if a specific tumor is harmless at the moment of diagnosis.

You didn't know prior to the test either.

We don't know if a tumor is harmless, but we do know that treatment has significant harm. Radiation and chemotherapy are nasty. We also know that the stress of a positive diagnosis has significant harm.

First do no harm.

I'm glad your dad got better, it had nothing to do with his diet and fasting. It's no different than Steve Jobs stubbornly becoming a fruititarian to treat his cancer. If his immune system had fought it off, then fruit would be a cancer cure and all his doctors would be idiots.

Youtube/Internet experts are one of the largest propagators of medical misinformation and are actively harming people every day, and if I've ever been in favor of restricting free speech, it's giving out medical advice without a license. If we can restrict giving legal advice, and everyone understands how painfully stupid you'd have to be to represent yourself in court without a law degree, then we can restrict giving medical advice, and hopefully people can realize how painfully stupid you'd have to be to manage your own medical treatments without a medical degree.

I'm pretty sure every medical show had an episode where the "money-grubbing hospital admin" character want to start selling full body medical scans, and the "very well-respected and honor-bound doctor" character points out how this is quite literally one of the most useless and corrupt ways for a hospital to make money.

There are probably a dozen things wrong with your body right now. That doesn't mean they're even affecting you. While you may have some type of cancer that is at the absolute first day of detectability, or a bone slightly out of place, or a weird spot on your heart, someone else has a case that is 6 months deeper and needs more dire treatment.

There is zero benefit to society to massively overburden our healthcare system (this is true of any nation) by searching constantly for random problems that may or may not exist.

If there were good reason to do this, you'd have regularly-scheduled checkups, like with colon or breast cancer.

It's a human factors thing. If two patients both have a cancerous tumor that does not need treatment, the patient that did not have a screening is better off. The patient who was screened will deal with anxiety from having a positive screening result in addition to any negative effects from the screening and follow ups. Many patients are not comfortable living with a detected tumor, even if the standard of care is to watch and wait. Of course, the opposite scenario is also true --- if both patients have a tumor were removal would be best, the one that gets screened has a better outcome.

Maybe if we were all pretty rational people, we could better manage positive screening results and follow up actions that lead towards taking no specific action; but that's not where people are at the moment.

There's a tradeoff of early detection of fast growing tumors that are likely to cause issues vs detection of slow growing tumors that are likely to not cause issues except if they're detected. You can see how the consensus is shifting on things like breast, prostate, and colon cancer screenings over time. My TLDR is that we developed tools and methods, started applying them and have generally reduced the screening frequency over time as we understand more about the tradeoffs.

It's significantly more wicked to pretend that tests, treatments, and more aren't done by healthcare workers (yes, even private ones), and to inundate them with unimportant medical procedures while truly sick people are dying.

Yes, this is true even if the person opting for the elective surgery has millions, potentially even billions of dollars to pay with. Having money doesn't make your illness more important.

Don't get all holier-than-thou on topics like this; it's already a difficult-enough topic.

> What did the medical field do to earn such credibility with you?

For oncology? A whole lot. It's actually miraculous what they've developed to treat cancer. Cancer treatment has gotten so good that it's common for oncologists to caution against the 5 year study survival rates due to new and better treatments rapidly coming online. A 5 year study is necessarily 5 years out of date.

Medicine isn't a unified field. Having broad skepticism is an irrational position as there's a huge difference between the oncology field and the nutrition field.

This opinion makes me sad.

There truly are experts in areas we can't--or shouldn't--all try to duplicate ourselves. Civilization is advanced by specialization. We identify these experts with a reputation system so you might call them authorities.

Similarly, there truly are institutions that have decades or more of people, procedures and culture to benefit society and a track record of these benefits.

The malicious erosion, by propaganda and by rhetoric, of the public's trust in our authorities and institutions is one of the biggest crimes of this century.

> The idea that a position of authority means ~anything~ anymore is completely ridiculous.

In that case, should we just get rid of licensure for professional engineers while we're at it? No special education or experience needed to build a bridge, nuclear reactors, or life-critical systems... since authority is meaningless now in the age of the internet?

The medical field isn't perfect, but it's hubris to believe that most people will perform better at treating disease than somebody with 11 years (minimum) of specialized education and countless hours of experience in a real clinical setting.

There's a pretty stark difference between medical science, medical practitioners, and medical institutions.

Medical science has done a lot to earn credibility over the last couple hundred years. It fully eliminated a disease that was a leading cause of death in multiple human civilizations. It reduced rates of infant mortality by staggering numbers. It created vaccines and surgeries that have each saved countless lives and effectively cured life-altering disabilities and injuries, and demoted tons of diseases from death sentences to mere manageable disabilities or even mild temporary inconveniences

Medical practitioners are a mixed bag that ranges from total altruists to total mercenaries. Most people can learn a skill and incentivizing any skill via things like money or social status creates some goal-misalignment, but also dramatically increases the prevalence of the skill and also the community surrounding it, including research, pedagogy, and infrastructure. I think there's considerable value in not automatically trusting every medical practitioner, but on the whole many of them have earned credibility

Medical institutions have mostly been responsible for the existence of trustable practitioners and research, though in the rich world and especially the US specifically there are significant misalignments that come from capture from power-hungry parties in both government and the private sector. The American medical establishment in particular seems at this point near unsalvageable, having broken so badly that it often deliberately tanks quality of care to enforce state power or to turn a profit. We should probably rethink a lot of how institutions fund research, administer hospitals, prioritize care, act as financial buffers, what legal and enforcement authority we vest in medical practitioners sanctioned by the institutions, etc. So I agree with you there, especially in the United States specifically, though much of this was apparent well before 2025 (practically before I was born)

It also has to make financial sense, everyone's insurance would be much higher, cancer treatments are $$$, in countries with a public healthcare system it's a no go

It's literally true that cancerous cells happen all the time in our bodies and no treatment is necessary because the immune system handles it. The ideal diagnostic test would only detect cancers that need intervention.

No, it’s nothing like that.

I won’t even get into the irony of you not realizing that not all forms of diabetes are related to insulin (diabetes insipidus) while simultaneously claiming that you don’t need to be a doctor to be qualified enough to make complex medical decisions.

In the first place, the analogy is wrong. You need insulin, you need blood sugar. Both SHOULD be present. Cancer never SHOULD be present, it just happens to be there often, like any other thing your body clears out.

Edit: the word “diabetes” originally comes from a word meaning “to pass through”. Literally the only thing linking all diabetic conditions is needing to pee a lot