Data Driven Healthcare

And the Future of Healthcare in the US

Introduction

The U.S. healthcare system struggles with competing priorities: insurers and administrators focus on cost reduction, while medical practitioners balance treating their patients based on demographic results versus individual patient needs.

When cost-cutting and population statistics drive decisions, patient outcomes suffer and system costs increase. Reducing the cost to the provider is obviously bad for the patient, and doctors internalizing study results that apply to a large group while ignoring the symptoms in front of them does not help real people. Data driven preventative healthcare, historically reserved for the wealthy, offers a solution – and this transformation is already beginning in the United States. This movement is currently driven by patient demand, but clinicians should be ready for it and ideally can use it to better align themselves with patient outcomes.

Leaning on Cost Controls and Population Level Outcomes

I won’t focus on the administrator’s desire to cut provider costs as the negative effects on the patient should be relatively clear. Optimizing for population-level outcomes at the clinical level creates subtler harm. The medical literature emphasizes reducing false positives – citing cost savings and reduced patient anxiety – which often compromises individual care. While profit-driven administrators naturally prioritize cost reduction, doctors' internalization of this mindset leads to delayed treatment and paradoxically higher system costs.

Medical diagnosis should mirror systematic debugging: gather comprehensive data through overlapping non-invasive methods and treat potential issues as real until definitively ruled out. While a conservative approach may show "net positive" results across populations, it burdens individuals with repeated testing and delayed care if initial testing results prove to be concerning.

Two personal cases illustrate this problem. In one, repeated creatinine testing was restricted to a single marker instead of a comprehensive panel, resulting in multiple visits and delayed specialist care. In fact, a self ordered comprehensive blood panel finally showed there was no need to be concerned about an underlying problem, while several intermediate steps wasted time and money.

In another, insurance requirements and a 30-day appeal process delayed hip surgery by six months despite clear initial diagnosis. The delay led to abnormal gait development, canceled plans, and doubled recovery time. Though population statistics rightly suggest conservative treatment through physical therapy, this ignores the patient's specific needs, activity level, and desire to return to sports.

These patterns particularly impact those who rely on their physical capabilities - not just athletes, but workers across many professions such as x-ray technicians, nail technicians, mail carriers, and bartenders. For these individuals, delayed treatment often leads to compensatory behaviors that compound the original injury and extend recovery time from months to years.

The False Positive

The medical establishment's fixation on false positives – portrayed in thousands of studies as costly, anxiety-inducing evils – misses the mark.^[1] While reducing unnecessary tests matters, gathering data through non-invasive testing is far better than operating in the dark. Increased anxiety is better than a false negative or a terminal illness left uncaught for me. We all probably know someone who would rather get cancer than go to the doctor, but these decisions belong to patients. Patients should be free to weigh the time and financial costs against potential benefits, rather than having medical professionals restrict access to non-invasive testing.

The consequences of insufficient testing – particularly false negatives – can range from chronic quality-of-life issues to delayed cancer diagnosis. Non-invasive testing like imaging and blood work should be the default approach, prioritizing early detection over false positive anxiety. This shift would reduce the time to intervention and the missed diagnoses that ultimately lead to worse outcomes.

Medical Literacy in a Changing World

Patients now have unprecedented access to medical information, allowing them to better understand their doctors' recommendations and take a more active role in their healthcare. After more than 25 years of being online, tools such as WebMD have transformed online health research from the butt of jokes into a potentially life-saving resource. People today have access to even more accurate tools. The internet is awash with reports of (successful) self diagnosis via ChatGPT and other LLMs. Entirely online based support communities have sprung up around different maligned health conditions where the traditional medical community gave people few options such as autoimmune diseases and other rare and complicated diseases.

Not only has our awareness of our health changed since the turn of the century, but the world around us has changed drastically. Environmental hazards pose evolving threats to human health, from declining air quality^[2] and microplastic pollution^[3] to PFAS contamination^[4] and heavy metal exposure.^[5] New risks continue to emerge as we better understand how humanity has affected the environment and our food chain in the industrializing period following the second world war. For instance, only recently it’s been published that incidents of colon cancer in those under 55 have doubled in the past decade only, with no known cause.^[6] People are sick and facing new threats, and need help. The medical community needs to adapt quickly.

Conclusion

Healthcare is at a turning point. While comprehensive preventative care was once reserved for the “executive physical”, patients now demand broader access to proactive health management. The system must evolve to support individuals who want to prevent illness and actively participate in their care, not just treat problems after they arise.