It should not be but that is all I see happen.
This is partly because we have very limited understanding of what we are doing, so don't make interventions until the situation is life-threatening. There is some wisdom in that, but the real solution is to gain understanding so that other options make sense.
I don't want to hijack this thread for a personal dispute with Dr. Edwards, particularly since it is not he himself who is the target of my ire. If I had a condition where he had direct professional experience I would probably be glad to have his advice as a practical matter. What bothers me is the belief that current understanding is acceptable, with only some small details to fill in. From personal experience I know that professionals operating with defective models of what they are doing can kill people, and I'm not demonizing the medical profession, I learned this in a very different context. I also have strong reason to believe current models are seriously defective, to the extent of omitting a wide range of fundamental questions. There are large professional blind spots in things I've mentioned like dynamic variation and signalling. There is now a substantial literature on biological signalling, dynamics and system theory, but this scarcely has any impact on the practice of medicine, and little impact on medical research. I keep seeing the same obviously defective models in publications, reviews and textbooks. A surprising number of professionals actually believe them.
The progress he cites on the practice of treating RA is real, but deserves more scrutiny. About half the change has come by eliminating practices that were harmful. Positive changes have been introduced at about the rate of one per decade. Current best practice still fails one of my tests because it does not scale. This is not something that medical professionals are likely to think about
per se.
Experience with the transition from propeller-driven aircraft to spacecraft, or from vacuum tubes (valves) to VLSI, gives me a different perspective, and that is only the hardware. In my own lifetime I have recapitulated essentially the entire history of computation.
Understanding of information as a
Ding an sich has been more important than the touted changes in hardware. I have repeatedly seen ideas reimplemented using new means of fabrication. (Changes in implementation have come so fast that we have largely given up on introducing new acronyms like ULSI or MOSFET. They don't last long enough to catch on before they are superseded.) Medicine has recently received more solid information than was previously available in the entire history of the subject. So far, there is little idea what to do with this.
We tend to think that we can go on the way we have been forever. We forget the cumulative effect of changes already in progress. Video and the Internet now mean we live in glass houses, compared to past civilizations. We tend to forget that more people are looking in than out. The current refugee crisis is an example of the problem of extending our comfortable bubble to accommodate others. Even small expansions involve crises. We are still arguing about how to pay for the last expansion.
If we don't deal with the problem of scaling medicine and some other important aspects of convenient modern life in this century it is very likely the civilization we have built will be torn apart. I don't like the idea of a comfortable elite living in well-fortified castles as a future. Nor is bringing everyone down to a common level of misery attractive. We've already been there and done that, about 1,000 years ago.
(Do you suspect I've been reading about the condition of "jolly old England" leading up to 1066?)