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Preventive Care

One of the best aspects of health care reform is it starts to emphasize prevention - Anne Wojcicki

 

"Today, when a tremendous range of health information is at our fingertips, we need to make sure we are grounding medical decisions and choices on the best available knowledge and fact. While some home remedies can be harmless—an apple a day or chicken soup for a cold certainly do no harm–some folk remedies and urban myths can be harmful. Preventive actions such as improved diet and moderate levels of exercise have been shown to be effective in helping head off illnesses from heart disease to diabetes.

As a primary-care physician who also has served in the U.S. Public Health Service corps, I can tell you that avoiding what’s good for you is embedded in the lifestyles of many Americans. It explains public fascination with another TV phenomenon, “The Biggest Loser,” which celebrates both extraordinary weight gain and equally extraordinary weight loss.

But I also worry about the other end of the spectrum–people who put too much stock in preventive care. They believe if they only “live right” they’ll never get sick, never suffer or live with, or die from a serious condition.

How many times have you heard someone say, “Can you believe it? Sally has just been diagnosed with lung cancer. But she never smoked a cigarette in her life!”

In fact, 10-15% of lung-cancer deaths in the U.S. are not related to smoking. The risk of heart disease can be reduced by preventive health care, but we’re a long way from eliminating it. Vaccines are hardly 100% effective but important preventive measures that lower our risk of illness–people should get their children (and themselves) vaccinated and should get annual flu shots.

While preventive health care is essential, it’s not the answer to everything. There will always be serious or chronic illnesses that require high costly treatments, medical/surgical specialists, and resource-intensive health care institutions. Thinking that prevention is the answer to all our health-care woes can put in jeopardy the major investments – both public and private – that are needed to maintain the infrastructure of our nation’s entire health care system.

Medical schools and teaching hospitals are a prime example. They disproportionately care for the sickest and poorest patients; they train most of our health care workforce, and they are the bedrock of biomedical research. They are the safety net, the nation’s standby capacity when man-made or natural disaster strikes. In fact, 44 of the nation’s 48 designated Ebola treatment centers are major academic medical centers.

But sometimes when funding is tight, public and private investment is framed in terms of primary and preventive health care versus tertiary and quaternary health care. But such a dichotomy couldn’t be further from the truth. We need both."

Source: Atul Grover, The Danger of Over-Emphasizing Preventive Health Care, The Wall Street Journal, February 19, 2015.


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