There is always tension between objectives in real-world systems. There are essentially two frontiers in our healthcare system--a core of educated professionals that are conservative and move slowly with ample evidence behind decisions, and a wide range of laymen who are comfortable with personal risk (e.g. bodybuilding community). I have respect for both, and they work together. The core will always have too many false negatives and the horizon group will have too many false positives. Saying the balance right now slows things down too much needs more support as an argument, there will always be things on the roadmap for medicine and there will always be edge cases that can't get addressed perfectly

From what I've seen medical researchers are champing at the bit for new areas of treatment that they think are promising and they just need the smallest amount of convincing evidence to research. If they don't have it for something you think is valuable, collect the information in a systematic way and find someone to send it to.

Yes they will miss rare cases or where symptoms aren't quantifiable or where no understood biological mechanism exists. Yes you can take on research and treatment yourself with the risk associated. No a bunch of anecdotal evidence on experimental treatments do not substitute for structured research. No you won't come back here in 3 years if you develop serious side effects that would have been identified in clinical trials and tell everyone you were wrong.

I think this article is a pretty good complement to ask vs. guess culture https://jeanhsu.substack.com/p/ask-vs-guess-culture

in my experience, people from ask-heavy cultures will only respond to clear lines. otherwise they will just keep pushing. if you have people in your life who are very good at recognizing soft boundaries, you don't need this skill with them, but it will be helpful for people who ignore soft boundaries.

1. Often an implicit call to action from the person asking the question. Maybe YOU don’t mean it that way, but people have learned to be cautious

2. A distraction from actual work, and not worth it personally for a public discussion. Maybe the answer is “I don’t know” or “This is the fastest good-enough thing I could build to satisfy a dumb requirement”. But no one wants to say those things publicly, so they are cautious before answering

It’s especially aggravating when you get those questions from someone new in authority

I thought it was an interesting behind the scenes look at how seriously they take their “art” but nothing world changing. Which part of the article did that for you?