My 2 cents’ worth is that nowluke seems to me to have provided an accurate and expert description of the current reasoning for the current approach. As posted and noted earlier:
The opinion of a "specialist" is the lowest evidentiary weight in clinical decision making.
That is a manifestation of an important concept that was new to me: I’ve learnt that there’s a willie-wagging hierarchy in medicine. Apparently, there’s a causal link between a person’s compliance or otherwise with a medical standard and the recognised comparative length, in the medical hierarchy, of the willie of a medical professional expressing an opinion about the person’s compliance. Go figure.
I have an appointment with someone whom, I’m advised, has the largest willie in the hierarchy. I’m looking forward to getting the person’s opinion and the reasons for it.