alt Hacker News>I'd go so far to say this is probably the case for most people. Your average person is in really poor fitness-shape but just fine health-shape.
Modern medicine has failed to move into the era of subtlety and small problems and many people suffer as a result. Fitness nerds and general non-scientists fill the gap poorly so we get a ton of guessing and anecdotal evidence and likely a whole lot of bad advice.
Doctors won't say there's a problem until you're SICK and usually pretty late in the process when there's not a lot of room to make improvements.
At the same time, doctors won't do anything if you're 5% off optimal, but they'll happily give you a medicine that improves one symptom that's 50% off optimal that comes along with 10 side effects. Although unless you're dying or have something really straightforward wrong with you, doctors don't do much at all besides giving you a sedative and or a stimulant.
Doctors don't know what to do with small problems because they're barely studied and the people who DO try to do something don't do it scientifically.
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It’s not medicine. It’s healthcare system. Doctor isn’t paid enough to go thoroughly through the complaint and dig deeper. In Germany you get 5 minutes diagnose and that’s all from health insurance. And this from the better doctor. For normal one diagnose comes from 2 minutes interaction. Believing that the diagnose is right is very naive.
> Doctors won't say there's a problem until you're SICK and usually pretty late in the process when there's not a lot of room to make improvements.
As someone who is fit and active,in their 60s with zero obvious symptoms, but is nonetheless on cholesterol and blood pressure medication, this isn't true (in the UK, at least)
It’s also cultural. Most American doctors don’t bother to tell people if they are overweight and out of shape. It’s not something their customers reward.
Maybe I'm not getting you right, but IMO it hasn't? I, as a customer/patient, just don't weekly converse with my MD about small issues, and frankly, they have better things to do, for example treating sick people.
Instead I use the health benefits programs of my health care insurer. My insurer has an interest in prevention, so I can get consulting for free (or very low fees), and even kickbacks if I regularly participate in fitness courses and maintain my yearly check-up routine. Now, I live in Germany and it probably is different in other countries, but it just makes economic sense from the insurer's point of view so that I would be surprised if it were very different elsewhere.
I think one of the major problems is that biologists/scientists cannot legally treat people. Physicians take their studies and have monopolistic treatment powers over them.
I think this creates a huge knowledge gap.
A worthwhile book to read on this topic is Outlive by Peter Attia (MD). The core premise is that American healthcare focuses far too much on treating problems after they’re extremely severe. It is would be cheaper and healthier to invest more into conservative & preventative care, trying to prevent or minimize problems early in life before they become incredibly dangerous and expensive/difficult/impossible to treat.
I have a close friend who works in conservative care, and it’s astonishing what they see. For example, someone went to a number of specialists and doctors about a throat condition where they really struggled swallowing. They even had to swallow a radioactive pill to do some kind of imaging. Unnecessary exposure, and an expensive process to go through, and ultimately went exactly nowhere.
Meanwhile, it was a simple musculoskeletal issue which my friend was able to resolve in a single visit with absolutely no risk to the patient.
Medical schools need to stop producing MDs who reach for pills as the first line of defense without trying to root cause issues. Do you really need addictive pain killers, or maybe some PT, exercise, massage, etc. to help resolve your pain.