I imagine that this gray area is where a lot of "unnecessary surgery" comes from. The vast majority of people have no medical need for circumcision (but some do

I imagine that this gray area is where a lot of "unnecessary surgery" comes from. The vast majority of people have no medical need for circumcision (but some do). A lot of people don't need their wisdom teeth removed (but many probably should). You might need a filling eventually (just not now). Where do you draw the line, in a world where setting up studies to find conclusive evidence for binary medical decision-making ("Should this ever be done in the presence of x, or should it never be done?") is hard enough? I had two surgeries in 2019; in both cases the consulting doctor told me that it was 50/50 if I actually needed them or if they'd actually fix the issues that might have been associated with them. One was a pretty smashing success, the other (ironically more expensive) one was a 4-figure wash that had the surgeon dodging my inquiries as to what went wrong. Unfortunately, it turns out that medical decision-making entails taking a holistic view of the situation and giving advice that the doctor then has to take responsibility for. Good luck achieving that on a systemic level within the ever-dysfunctional structure of American healthcare.