There is an underlying conflict between the perspectives on preventive care that applies to medicine and beyond. Dr. Attia is basically saying that he can beat the house. That is, he's saying that even for broad-based screening techniques that haven't proven effective at the population level, he can do better at the individual level, by picking the right patient, the right tests, at the right time.

This may be true, but it's increasingly not how medicine is practiced. A lot of what we're doing now is guideline-based care. We follow flowcharts based on standard criteria. I've heard the term "personalized medicine" thrown around by a few intellectuals, but it's not what I see in practice.

For the patient, the question is, can a real doctor give you better care than a cookie cutter approach? For the physician, the question is whether we'll be made obsolete.