The 21st century was supposed to be the age of clarity in medicine. We now have advanced imaging, predictive algorithms, genetic risk scores, and wearables that can track heart rhythms in real time. And yet, patients are more confused and more anxious than ever.
Why?
Because modern medicine has confused data with understanding, and testing with care.
At the heart of this crisis is a quiet revolution in how medicine is practiced—one that Dr. Andrew Rudin, MD, a nationally recognized cardiologist, has watched unfold over decades. His conclusion is both simple and sobering: “We’re chasing certainty with tools that can’t deliver it. And the more we test, the more we feed the illusion—at the cost of real care.”
Technology Without Judgment
Medical technology has become astonishingly powerful. CT scans can spot minute coronary calcifications. AI can flag irregular heart rhythms before a patient feels a flutter. Lab panels now come back with dozens of biomarkers, each with its own complex range.
And yet, says Dr. Rudin, “Every tool is only as good as the judgment behind it.” Without a clear clinical question—without context—technology becomes noise.
That noise leads to false alarms, incidental findings, and test cascades that send patients spiraling into a system more prepared to act than to pause.
The Cultural Pressure to Know Everything
Underlying this overreliance on diagnostics is a cultural myth: that with enough information, we can control the future. We test not because a symptom demands it, but because we want reassurance. We scan not because of risk, but because we fear regret.
“People don’t come in asking if they’re sick,” says Dr. Rudin. “They come in asking if they’re about to be. That’s not a clinical question—it’s an existential one.”
This anxiety is compounded by the commercialization of health. Direct-to-consumer tests promise early detection. Ads suggest that only the paranoid survive. The result? A society where silence from the body feels suspicious, and health is seen not as a baseline—but as a mystery waiting to be unraveled.
When Medicine Stops Listening
Dr. Rudin argues that when tests replace dialogue, patients suffer. “We used to sit and talk,” he says. “Now we click and scan.”
This shift affects more than outcomes—it erodes the relationship at the core of good care. A rushed test offers a result; a thoughtful conversation offers context, perspective, and peace of mind.
What’s worse, overtesting can sometimes create disease:
- An unnecessary stress test leads to an unnecessary cath.
- A borderline lab result prompts a medication with side effects.
- A benign mass becomes a surgical target simply because it was found.
“In cardiology,” says Rudin, “we see this all the time. You test the wrong patient, you find the wrong problem, and you intervene in ways that don’t help—but feel necessary.”
Toward a Culture of Clinical Maturity
So how do we fix it?
Dr. Rudin doesn’t suggest abandoning technology—far from it. But he believes that medicine must grow into its tools. That means cultivating:
- Clinical restraint: Knowing when not to test is as vital as knowing when to act.
- Patient education: Reassuring someone that no test is needed can be more powerful than ordering one.
- Systemic alignment: Incentives must reward thoughtful care, not throughput and documentation.
- Tolerance of uncertainty: Good medicine accepts that not every question needs an answer today.
“Wisdom in medicine isn’t about eliminating doubt,” Rudin says. “It’s about knowing which doubts we can live with.”
Final Thoughts: Back to the Bedside
At a time when health feels increasingly abstract—numbers, scans, scores—Dr. Andrew Rudin, MD, urges us to return to something simpler, and more radical: presence.
Presence with the patient. Presence with the question. Presence with the limits of what we know, and the courage to say, “Let’s wait. Let’s listen. Let’s not overreach.”
Because the ultimate test of a good clinician isn’t how many diagnostics they order—it’s how wisely they use them.