What Your Doctor Means When They Say "Everything Looks Normal"
After more than a decade in primary care, there's a pattern I've seen again and again.
Patients are told their labs are "normal." Their exams are reassuring. Nothing is technically wrong.
And still, something doesn't feel right.
A good friend and I were having pizza and wine recently and decompressing while our kids were running circles around us. She pulled up a message from her recent physical with her primary care doctor.
Her labs had been reviewed. The note read: "Cholesterol a little high, but overall everything looks good. See you next year."
She looked at me, confused. "What do I do with this?" she asked.
Unfortunately, this is incredibly common. And honestly, as a physician, I know I've sent messages like this myself in the past. Traditional medical care does many things very well. It treats acute illness, manages chronic disease, and follows evidence-based guidelines developed for large populations. Where it often struggles is in the gray zone. That space between "healthy" and "sick" is where early risk and subtle physiologic changes live. This is also where we need to do better.
This is where the idea of personalized, precision-based medicine becomes important.
For my friend, that does not mean panic or aggressive treatment. It means asking better questions. What is the significance of her elevated cholesterol in the context of her overall cardiovascular risk? Does she have a family history of heart disease? Would advanced lipid testing, such as apolipoprotein B or lipoprotein(a), help clarify her longer-term risk? Most importantly, what is the right plan for her?
Despite how it is sometimes portrayed, personalized medicine is not about ordering every possible test or chasing perfect numbers. It is not about optimization for optimization's sake. At its core, it is about using your individual context, including your medical history, physiology, family risk, and patterns over time, to make thoughtful and intentional decisions.
