Basically the title. Was reminded of this when I saw Jakob's Coros data which clearly did not divide zones by his true max. I have seen so many athletes and coaches prescribing training based on heart rate, but using the 220 - age formula instead of actually testing for max HR (which can vary wildly, especially for elite athletes). Heart rate training is flawed as it is but basing it on the formula has got to be one of the worst ways to gauge effort out there.
Anecdotal, but I remember my college coach telling me to slow down on tempos because my heart rate would push into the 180s, when I had a lab-tested max of 214. Meanwhile one of my teammates would consistently be in the 150s-160s at the same paces, but would lose to me in every race. Maddening.