<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>specialist</author><text>Periodic baseline tests are The Correct Answer™. To establish individual patient normals.&lt;p&gt;Can&amp;#x27;t manage what we don&amp;#x27;t measure.&lt;p&gt;Attention should focus on &lt;i&gt;what&amp;#x27;s changed&lt;/i&gt;. Instead of playing 20 Questions for each new problem. [1]&lt;p&gt;High LDL? Well, it&amp;#x27;s always been high, and stable. We don&amp;#x27;t have to treat it.&lt;p&gt;Bone spurs (on spine)? Well, most everyone has them and they&amp;#x27;re not bothering you.&lt;p&gt;Oh, new sciatica symptoms? Hmmm, looks like you&amp;#x27;ve got a new bone spur which &lt;i&gt;may&lt;/i&gt; be impinging. Let&amp;#x27;s try some PT, get you a standup desk for work, and reassess in 6 months.&lt;p&gt;Etc.&lt;p&gt;--&lt;p&gt;Concern trolls claim more testing begets false negatives, begetting unnecessary treatment, which has its own risks.&lt;p&gt;Fine. Change healthcare from transactional to relational. Change from our current fee-for-service to continuity-of-care (or capitation, prevention, whatever we end up calling it).&lt;p&gt;Like u&amp;#x2F;JumpCrisscross says elsethread, only treat anomalous results per new symptoms.&lt;p&gt;I believe periodic baselines with regular checkups would &lt;i&gt;reduce&lt;/i&gt; testing and unnecessary treatments, overall.&lt;p&gt;--&lt;p&gt;[1] Monitoring, logging, anomaly detection, and RCA... Starting to sound suspiciously like engineering and operations. Of course, some orgs treat each incident as unforeseen one-offs, aka The Condi Rice Defense™. But high functioning teams plan ahead.</text><parent_chain><item><author>lazystar</author><text>I had a similar mindset as you describe here - but I no longer agree after experiencing long covid.  My experience with long covid was made easier because of historical lab data from bloodwork tests that were taken pre-covid when I was a healthy 30 y&amp;#x2F;o white male.  After suffering for months from (what I now know was) long covid, I went in for a checkup for some help.&lt;p&gt;The blood test comparison of healthy me to sick me was invaluable, because the healthy tests established a baseline of my system at peak condition.</text></item><item><author>arcticbull</author><text>The issue isn&amp;#x27;t really that they&amp;#x27;re expensive - they are, they shouldn&amp;#x27;t be. Proactive access to care is good.&lt;p&gt;The article kind of hints at this, but it comes down to Bayes theorem [1]. The general population has a relatively low incidence of disease, so even tests that are fairly reliable in a population with a high incidence of disease become super inaccurate when applied to the general population.&lt;p&gt;Worse, false positives generally - especially in the US, due to high financial liability risk - end up involving expensive, invasive medical follow-up tests, and the probability of a false positive multiplied by the risk of the exploratory procedures outweighs a later diagnosis.&lt;p&gt;No wonder annual physicals don&amp;#x27;t do much good.&lt;p&gt;High-risk people should get periodic tests for the things they&amp;#x27;re at risk of, and people should be in a position to report issues they discover in the course of their lives. However testing otherwise-healthy people for things they probably don&amp;#x27;t have isn&amp;#x27;t likely to yield good results no matter how good the test. It&amp;#x27;s just math.&lt;p&gt;[1] &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Bayes%27_theorem&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Bayes%27_theorem&lt;/a&gt;</text></item><item><author>siliconc0w</author><text>Just had a recent physical - I got a low value for a test and it kicked off more tests, a visit to a specialist, more tests and no conclusion besides &amp;#x27;let&amp;#x27;s wait and see&amp;#x27; which I could have done without draining my HSA.  If the price of care was reasonable, sure, let&amp;#x27;s be proactive but because PCPs don&amp;#x27;t really seem to do anything but refer you to a specialist and any visit to a specialist + tests will immediately trigger thousands of dollars in bills, even if you&amp;#x27;re insured you&amp;#x27;re going be paying your deductible plus like 10-30% after that.&lt;p&gt;I got a random lab bill for like $650 (discounted from $2500) and in the follow up visit everyone agreed that was high but no could explain why it was that expensive - medicare&amp;#x27;s fee schedule has the same code costing $90.  Until we stop this madness of providers basically charging whatever opaque negotiated random amount they want to insurers who then pass that down to charge payers after collecting a % the prices are just going to continue to go up and the broken medical system will stay fucked - with the consequence that the economics aren&amp;#x27;t going to make sense to seek proactive care.</text></item></parent_chain></comment><story><title>TV doctors say annual checkups save lives – real doctors call bullshit (2016)</title><url>https://www.vox.com/science-and-health/2016/9/26/13029358/annual-physical-tv-doctors-america</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>ck425</author><text>Sounds like you&amp;#x27;re over it now, any idea what helped? I also developed long covid as a healthy 30 y&amp;#x2F;o white male, but haven&amp;#x27;t been able to kick it after 8 months.</text><parent_chain><item><author>lazystar</author><text>I had a similar mindset as you describe here - but I no longer agree after experiencing long covid.  My experience with long covid was made easier because of historical lab data from bloodwork tests that were taken pre-covid when I was a healthy 30 y&amp;#x2F;o white male.  After suffering for months from (what I now know was) long covid, I went in for a checkup for some help.&lt;p&gt;The blood test comparison of healthy me to sick me was invaluable, because the healthy tests established a baseline of my system at peak condition.</text></item><item><author>arcticbull</author><text>The issue isn&amp;#x27;t really that they&amp;#x27;re expensive - they are, they shouldn&amp;#x27;t be. Proactive access to care is good.&lt;p&gt;The article kind of hints at this, but it comes down to Bayes theorem [1]. The general population has a relatively low incidence of disease, so even tests that are fairly reliable in a population with a high incidence of disease become super inaccurate when applied to the general population.&lt;p&gt;Worse, false positives generally - especially in the US, due to high financial liability risk - end up involving expensive, invasive medical follow-up tests, and the probability of a false positive multiplied by the risk of the exploratory procedures outweighs a later diagnosis.&lt;p&gt;No wonder annual physicals don&amp;#x27;t do much good.&lt;p&gt;High-risk people should get periodic tests for the things they&amp;#x27;re at risk of, and people should be in a position to report issues they discover in the course of their lives. However testing otherwise-healthy people for things they probably don&amp;#x27;t have isn&amp;#x27;t likely to yield good results no matter how good the test. It&amp;#x27;s just math.&lt;p&gt;[1] &lt;a href=&quot;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Bayes%27_theorem&quot; rel=&quot;nofollow&quot;&gt;https:&amp;#x2F;&amp;#x2F;en.wikipedia.org&amp;#x2F;wiki&amp;#x2F;Bayes%27_theorem&lt;/a&gt;</text></item><item><author>siliconc0w</author><text>Just had a recent physical - I got a low value for a test and it kicked off more tests, a visit to a specialist, more tests and no conclusion besides &amp;#x27;let&amp;#x27;s wait and see&amp;#x27; which I could have done without draining my HSA.  If the price of care was reasonable, sure, let&amp;#x27;s be proactive but because PCPs don&amp;#x27;t really seem to do anything but refer you to a specialist and any visit to a specialist + tests will immediately trigger thousands of dollars in bills, even if you&amp;#x27;re insured you&amp;#x27;re going be paying your deductible plus like 10-30% after that.&lt;p&gt;I got a random lab bill for like $650 (discounted from $2500) and in the follow up visit everyone agreed that was high but no could explain why it was that expensive - medicare&amp;#x27;s fee schedule has the same code costing $90.  Until we stop this madness of providers basically charging whatever opaque negotiated random amount they want to insurers who then pass that down to charge payers after collecting a % the prices are just going to continue to go up and the broken medical system will stay fucked - with the consequence that the economics aren&amp;#x27;t going to make sense to seek proactive care.</text></item></parent_chain></comment><story><title>TV doctors say annual checkups save lives – real doctors call bullshit (2016)</title><url>https://www.vox.com/science-and-health/2016/9/26/13029358/annual-physical-tv-doctors-america</url></story>