Dr. Andrew Rudin, MD, on the Quiet Harms of a Culture Obsessed with Diagnostics
In today’s world of instant answers and limitless information, it’s no surprise that modern medicine often mirrors that urgency. You feel a symptom, you go to the doctor, and often, you leave with a list of tests—blood work, scans, ultrasounds, and maybe even a referral to a specialist. It feels like progress. Action. Control.
But what if this reflex to “test just in case” is actually doing more harm than good?
A growing number of doctors, including Andrew Rudin, MD, a nationally respected cardiologist in Tennessee, are asking this very question. With over two decades of experience, Dr. Rudin has watched as the culture of medicine shifted from careful observation and clinical judgment to a kind of diagnostic overdrive—and he’s concerned about where it’s headed.
“We’ve mistaken more information for better care,” says Andrew Rudin, MD. “But not all information is helpful. And some of it leads us—and our patients—down the wrong path.”
The Trouble with “Just to Be Safe”
Most patients assume that tests are harmless. And if they’re covered by insurance, why not? But few people realize the chain of events that one simple test can trigger.
A slightly elevated lab result might lead to more blood work. A scan could reveal a tiny, harmless lump. That lump could mean a biopsy. That biopsy could come back unclear. And suddenly, a healthy person is swept into a whirlwind of appointments, procedures, and anxiety—all for something that might never have caused a problem.
This cycle is known in medicine as the diagnostic cascade, and according to new research, it’s happening more and more frequently.
Dr. Rudin has seen it countless times. “It usually starts with good intentions,” he says. “The doctor wants to be thorough, the patient wants reassurance. But once we open the door to unnecessary testing, it’s hard to shut.”
The Risks No One Talks About
While we tend to think of tests as passive or risk-free, many carry hidden dangers:
- Radiation exposure from repeated imaging, particularly CT scans, can increase long-term cancer risk.
- False positives lead to emotional distress and often more invasive testing.
- Incidental findings (things discovered by accident) are common and usually harmless—but they often prompt follow-up procedures “just to be sure.”
- Unnecessary treatment can result from treating problems that weren’t problems in the first place.
“We don’t talk enough about the emotional burden,” says Andrew Rudin, MD. “Once a patient hears that something is abnormal—even if it’s clinically insignificant—it changes how they feel about their body, their health, and their future.”
Why It Happens
There are a lot of reasons we’ve landed here:
- Doctors are afraid of missing something. In a system that’s increasingly litigious, ordering more tests can feel like protection.
- Patients expect answers. We live in a culture that values certainty, and testing offers the illusion of control.
- Technology is available. With advanced imaging and detailed lab panels readily accessible, it’s easy to default to ordering rather than observing.
- Time is limited. It takes longer to explain why a test isn’t needed than to just order it.
Dr. Rudin admits the system itself doesn’t always make the right choice easy. “It’s faster to click the order button than to have a conversation. But fast doesn’t mean better. And often, it’s the slow, thoughtful approach that protects the patient.”
Rethinking What “Good Care” Really Means
So what’s the alternative? According to Andrew Rudin, MD, it’s not about doing less—it’s about doing what’s right.
That means:
- Only ordering tests when the results will change the plan.
- Taking time to do a thorough physical exam and history before jumping to technology.
- Having open, honest conversations with patients about the risks and benefits of testing.
- Encouraging questions, rather than treating diagnostic decisions as automatic.
In his practice, Dr. Rudin uses what he calls a “diagnostic pause.” Before any test is ordered, he asks: “What am I looking for? Will it change what I do next? Is this the safest, most reasonable choice for this patient right now?”
It’s a simple checklist—but it’s changed how he practices medicine.
“Sometimes the most compassionate thing you can do is not order a test,” says Andrew Rudin, MD. “It’s taking the time to explain, to reassure, to watch. That’s what real care looks like.”
What Patients Can Do
If you’re a patient, you don’t need a medical degree to take an active role in your care. Here are a few questions you can ask when a test is recommended:
- What are we looking for?
- What are the risks of this test?
- What happens if it’s normal? What if it’s not?
- Could we wait and see?
- Are there other ways to approach this?
These questions don’t mean you’re challenging your doctor—they mean you’re participating in your own healthcare. And good doctors, like Dr. Rudin, welcome that.
“Patients deserve to understand their choices,” he says. “Most people want to do what’s best for their health. They just need someone to help them weigh the options honestly.”
The Takeaway: Thoughtfulness Is the New Thorough
The best healthcare doesn’t always mean doing more. Sometimes, it means doing less—with intention, care, and wisdom. As diagnostic tools become more powerful, it’s more important than ever to use them with purpose.
Doctors like Andrew Rudin, MD are helping lead that change—bringing medicine back to what it’s meant to be: not a race for answers, but a relationship rooted in trust, reason, and kindness.
So next time you find yourself in a doctor’s office, wondering whether that extra test is really necessary, remember this:
You can ask. You can wait. And sometimes, the smartest test is no test at all.