The Utility or Futility Principle

Doctors are taught from day one: Never order a test unless the result will change what you do next.

This is clinical utility, and it's one of the most useful mental models I've ever borrowed from medicine.

Before ordering any test, a doctor asks: "Will this result change my management of the patient?"

If the answer is no, they skip it entirely.

This might frustrate you as a patient.

You want thoroughness. You want certainty.

But here's the disconnect: while you see peace of mind, your doctor sees information that won't change the treatment plan.

More testing isn't always better care. Each test carries costs - financial, yes, but also false positives, unnecessary follow-ups, and potential harm.

In systems with finite resources, tests that don't change outcomes take resources from patients who truly need them.

We operate under the same constraints in our own lives.

You and I have finite time, mental resource, and physical resource.

In the medical world, a test is either an instrument of Utility (it changes the treatment) or an exercise in Futility (it provides more information but changes nothing).

I've lived in that futility zone more times than I'd like to admit.

Watching a sixth video on productivity systems when I knew what I needed to do. Seeking another opinion on a decision I'd already made, just to delay the discomfort of commitment.

So now I apply what I call The Utility or Futility Principle: If the information won't change my next action, pursuing it is futile.

Before starting any task, I ask myself: "Will this result actually change what I do next?"

If the answer is no, I stop.

Doctors don't order tests that won't change treatment. Not because they're careless, but because they respect what's finite.

Our time. Our energy. Our life.

If you aren't achieving utility, you're actively engaging in futility.

What are you doing that changes nothing?

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