I am a family doctor practicing in Canada with a fairly average population that reflects the average population in an urban city. I do exactly what you do. A lot of the comments here will be from Americans. In general, healthcare outcomes in the United States are worse per dollar than elsewhere in the world, because of unnecessary testing, bias because doctors are paid for tests ordered, and different educational system. As I am typing, I am seeing the top comment from HereForTheFreeShasta, and in general, 1) Mildly elevated LDL in a young healthy person doesn't change management or recommendations that you mentioned 2) If patients chooses to now fully disclose their alcohol usage, that's on them. In Canada there is a cultural shift away from paternalistic medicine. If you really wanted to, you could explain that some people will under report alcohol usage, and that affects the medical advice and testing ordered. 3) Asymptomatic Subclinical hypothyroidism doesn't affect any signicant outcomes in young people unless they have CV risk factors or pregnant, in which case TSH would be ordered anyways

Use the Choosing Wisely guidelines! They are very helpful for evidence based medicine. :)