Health care is like auto repair more than it is like purchasing an auto; you were born with this vehicle. I don't understand enough about cars to decide if I sh

Health care is like auto repair more than it is like purchasing an auto; you were born with this vehicle. I don't understand enough about cars to decide if I should buy Fuel Additive X that's being heavily marketed. Whether I buy it or not is pretty unimportant, because it's just for my car. If someone is trying to sell me an angioplasty, how am I supposed to decide for myself if I need it? Unfortunately, guessing wrong about the necessity of an invasive procedure is more risky than choosing the wrong fuel additive. No consumer guide can answer that question - and if it can, it can just label itself "medical school" and I'll respect that. Let's say that some guide says "angioplasty does not reduce mortality except in the setting of unstable angina or myocardial infarction, so don't get it." The doctor could come back and say, "yeah, but you have diabetes and that guide didn't look at studies with patients with diabetes." (Stuff like this is true and critically important to understanding clinical trials.) Or maybe you have atypical vascular architecture so the guides don't address that. I'm basically trying to get at clinical equipoise. Clinical equipoise occurs more often than you might think; it's a time where well-meaning doctors can disagree with one another because there is not specific enough data (or none at all) to answer the question at hand. I don't see a guide handling that. (Note that I'm saying nothing about whether or not patients can choose physicians intelligently - I think they do it quite well via word of mouth - but I'm referring specifically to the consumption of medical care like medicines and procedures.)