Preventive or Prospective Medicine

Simple logic suggests that it takes more sense to prevent illness than to deal with it through episodic health (medical) care.  This philosophy characterizes preventive or prospective medicine.  Unfortunately, however, many physicians say they have little time to practice preventive medicine because of the large number of episodically sick people who fill their offices every day.

When physicians do practice preventive or prospective medicine, they first attempt to determine their patient’s level of risk for developing particular conditions.  They make this assessment by identifying risk factors (and high-risk health behaviors) with a variety of observational techniques and screening tests, some of which may be invasive (taking tissues from the body such as a biopsy or blood draw).  Additionally, an important tool in assessing risk is an accurate family health history, something that over one-third of all adults cannot adequately provide to their health care providers.

Once they have identified levels of risk in patients, health practitioners try to lower those risk levels through patient education, lifestyle modification, and when necessary, medical intervention.  Continued compliance on the part of the patients will result in a lower level of risk that will continue over the years.  Note that preventive medicine is guided by practitioners, and patients are expected to be compliant with the direction they are given.

Although preventive medical care appears to be a much more sensible approach than episodic care in reducing morbidity and mortality, third-party payers (insurance plans) traditionally have not provided coverage for these services.  Managed health care plans that earn a profit by preventing sickness, such as health maintenance organizations, or HMOs should be much more receptive to the concept and practice of preventive medicine.