The Worried Well - Where Do I Fit Now?

I have spent twenty five years around New Zealand healthcare, in general practice, in plastic surgery, in cosmetic medicine, in primary care and medical technology, and I still cannot quite work out where a patient like me belongs.

I am not sick. I have no diagnosis pulling me toward a specialist and no acute problem sending me to my GP. What I am is curious, engaged and willing to go looking for answers about my own body before anyone tells me to. In the industry we have a name for this. I am the worried well.

What being worried well actually looks like

It does not look like hypochondria and it does not look like health anxiety in the clinical sense. It looks like wanting to know whether my iron sits at an acceptable 25 or a genuinely optimal 100, and wanting a full picture rather than a single line on a lab report that says normal. It looks like asking for a DEXA scan, a calcium score, a VO2 max test, a full body MRI, tumor markers, a colonoscopy, an echo, a stress test, even a vision and dental check, not because something is wrong but because I want to know before something is.

Overseas, that curiosity gets met without friction. I can fly to Seoul or Kuala Lumpur, walk into a clinic and have an entire day of comprehensive testing booked, run and reported back to me in language I actually understand, no referral required and no explanation expected. Here in New Zealand the same request is often met with a different opening question, not how can we get this sorted but why do you want that done.

I understand why. Resourcing is real, funding models are built around acute need rather than optimisation and every GP I have worked alongside is already stretched thin. But I have also sat in enough of these clinics, on both sides of the desk, to see how exhausting this shift has become for clinicians, and how little space there currently is for a patient who wants a conversation about optimal rather than a conversation about normal.

The patient walking in has already done the research

I am not the only one showing up like this anymore. More than forty million people worldwide now turn to ChatGPT every day for health information, and just over half of patients say they use AI to research their own conditions before they ever see a clinician. Patients are arriving at appointments having already run their results through ChatGPT, quoting a TikTok surgeon's baseline bloodwork or armed with a supplement stack recommended on a podcast. Whether that information is right or wrong, it changes the entire dynamic of the consultation. The patient is no longer walking in blank. They are walking in with an opinion and an expectation that the clinician will either confirm it or explain, clearly and credibly, why it is wrong.

Trust in that information is not straightforward either. Most patients say they trust the AI generated answers they are given, yet the vast majority still expect their own doctor to be checking that information against a trusted source before acting on it. Clinicians feel that tension too, with the great majority saying they always or often validate AI generated health information themselves, wary of the bias and inaccuracy that can sit inside a confident sounding answer. So the patient walking in armed with a chatbot's opinion is not necessarily looking to bypass their GP. In most cases they still want a human checking the machine, they simply expect that human to be current enough to do it credibly.

That is a genuinely difficult needle to thread. Shut the conversation down and the patient feels dismissed, and often simply leaves to find someone who will listen. Agree too readily and the clinician risks handing over their own clinical authority to an algorithm that was never in the room and never took a history. Neither reaction protects the patient. What protects them is a clinician who can sit confidently between the two, informed enough to meet the AI-armed patient on their own ground and still willing to say, honestly, when the answer is more nuanced than a chatbot suggests.

Where the worried well seem to be heading

My honest read, having watched this from inside the industry for a long time now, is that general practice is quietly splitting into two very different jobs. One is acute and complex care, the genuine emergencies, the undiagnosed symptoms, the conditions that need continuity and judgement built over years of knowing a patient. The other is proactive, preventive, optimisation focused care, the exact territory the worried well are drawn to.

That second category is increasingly being met somewhere else entirely. Longevity clinics, executive health programmes and direct to consumer testing platforms are being built specifically to say yes to the DEXA, the calcium score, the full panel, without the friction of justifying the request. It is a reasonable fit on both sides. The programme gets a self selected, highly engaged, fee paying patient who does not need convincing to show up or follow through, and general practice is relieved of a category of demand it was never resourced to carry in the first place.

The risk sitting underneath that split is what falls through the gap between the two systems. A programme built to optimise a healthy person is very good at exactly that. It is not necessarily built to catch the thing that looks like nothing until it suddenly is not, which is where continuity and clinical judgement matter most and where a longstanding GP relationship still earns its place. It is also worth saying that clinicians themselves are wary of leaning too heavily on any of this. A large majority of physicians worry that regular AI use could erode their own diagnostic instincts over time, the clinical equivalent of losing your sense of direction once you stop reading a map. That caution is a good thing. It is exactly why the human in the room, not the programme and not the chatbot, still needs to be the one making the final call.

So where do I actually fit

Honestly, I am not entirely sure yet, and I suspect I am not alone in that. What I do know is that the clinics coping best with patients like me are not the ones dismissing AI informed requests outright, and they are not the ones capitulating to every test a patient asks for either. They are the ones who have deliberately trained their staff and clinicians to redirect these conversations with confidence, to meet curiosity with information rather than resistance, and to know when optimisation genuinely belongs in general practice and when it belongs somewhere purpose built for exactly that.

Maybe that is not a loss for anyone. Maybe it is simply how the cards fall, with patients like me eventually finding the provider actually suited to what we are after, and general practice free to focus on the patients who need it most urgently. I would love to hear how this is landing from the other side of the desk, because from where I am sitting, the shape of the system is already changing, whether or not anyone has decided what it should become.