In a provocative piece, Slate magazine’s Darshak Sanghavi writes about “tiered medicine” and proposes that clinical protocols be titrated to patient capacity. This again approaches the notion of “Goldilocks” medicine we spouse in Minimally Disruptive Medicine. We have also discussed the need to have guidelines that appreciate this issue and that perhaps efficacy may need to have a secondary priority, particularly among patients who are overwhelmed with multiple chronic conditions.