The Age of Diagnosis: When Labels Lie

We’re living in what Suzanne O’Sullivan calls The Age of Diagnosis. And it’s a bloody accurate description of the landscape right now — a landscape full of labels, full of certainty, and increasingly devoid of nuance.

This isn’t a review of the book, not really. It’s a reflection — sparked by it, echoing it, tangled in it. It’s also a warning.

Because as a GP, and as a human who’s done a fair bit of unravelling and re-ravelling himself, I’m seeing something dangerous taking root.

We’re not just diagnosing more.

We’re diagnosing worse.

What is Overdiagnosis (and Why Should You Care)?

Overdiagnosis isn’t just an academic term. It’s not a theoretical concern. It’s happening, and it’s harming people.

The concept is simple: a person receives a diagnosis that doesn’t help them — and may, in fact, make things worse.

Worse how?

• It shapes their identity around illness.

• It narrows their path to recovery.

• It locks them out of better options.

• It tells them they’re broken, when they’re maybe not.

And I say this not to deny suffering — far from it. The suffering is real. The experiences are real. But the labels we give suffering? That’s where things get slippery.

Science is Slow. TikTok is Not.

There’s a whole generation now being diagnosed by collective consciousness. Online spaces are full of “aha” moments — reels, tweets, group posts — where symptoms are clustered and a diagnosis offered like a balm.

But diagnoses used to follow evidence. Now? Evidence is scrambling to catch up with the vibe.

Conditions — particularly complex, chronic, medically unexplained ones — are now self-defined by communities before they’re ever defined in journals. Long COVID is just one example. There are dozens more.

This isn’t inherently bad. Lived experience matters. But when collective storytelling replaces clinical scrutiny, we get into dangerous territory.

Medical Advocacy or Medical Evangelism?

The problem is — and this is where it gets gnarly — a lot of these “conditions” exist in tight clusters. You know the ones. You see them constantly in general practice. You mention one, and the rest arrive like clingy mates at a pub.

There are entire movements built around reinforcing diagnoses — not solving them. Movements that resist nuance, reject evidence, and profit from identity over insight.

And when researchers probe too deeply, especially into the psychosocial roots of these conditions, they get threats. Real ones.

That’s not advocacy. That’s a cult.

And it’s strangling honest science.

The Diagnosis You Want vs. The One You Need

Here’s the part that gets me called every -ist under the sun.

Not all suffering needs a diagnosis.

Not every symptom cluster needs a label.

And not every label helps.

Sometimes — often — the most honest response is: “I don’t know. Yet.”

Maybe your fatigue isn’t a rare gene defect. Maybe it’s burnout, undernourishment, and chronic stress.

Maybe it’s perimenopause. Maybe it’s trauma.

Maybe it’s five years of unmet need and no vegetables.

And maybe — just maybe — it’s okay to hold space for that without forcing a label.

When Diagnosis Does Harm

Overmedicalisation is what happens when the process of being a patient becomes more important than the process of getting better.

• It’s when someone can’t get physio because their rare diagnosis now excludes them from normal care pathways.

• It’s when mental health is ignored because “it’s all physical”.

• It’s when B12 jabs are demanded with normal labs because someone saw it on a reel.

I get it. People are desperate for answers. A diagnosis feels like an anchor.

But some anchors don’t hold.

Some just drag you further down.

The System is Losing the Fight

Doctors are losing this battle.

GPs are drowning in pre-diagnosed cases. Consults where the diagnosis is already made — by Google, by TikTok, by a group chat, by a supplement seller.

If I push back? I’m gaslighting. I’m lazy. I’m dismissive.

I’m the reason people hate doctors.

And sure, sometimes we get it wrong.

But I’ll take my boring, cautious, fallible medicine over someone else’s monetised certainty every time.

So What Do We Do?

We need to:

• Fund research into medically unexplained symptoms

• Accept that “we don’t know yet” is a valid, often wise, diagnosis

• Support people without labelling them prematurely

• Spot when identity is shaped by illness, not in spite of it

• Back clinicians who hold the line with curious skepticism

• Name the nocebo effect for what it is — powerful, and underappreciated

• Stop treating “psychosomatic” like a slur — it’s not. It’s human.

In the End: Mess Needs Holding, Not Labelling

I’ve had too many consults recently where I’ve tried to do the right thing and been met with hostility.

Maybe I’m tired. Maybe I’m jaded.

But maybe I’m just sick of watching people suffer more because they were told a label would fix everything.

Diagnosis isn’t always the answer.

Sometimes it’s the problem.

And we owe it to our patients to know the bloody difference.

Stay Messy

—DW