Preventative Care in Medicineby Nirupama Shankar, PT, MHS | September 28, 2008
Medicine and health care are classified into various categories based on different specifying criteria. One of the classifications is a distinction on the basis of preventative and curative care: primary, secondary and tertiary cares. Primary care occurs when lifestyle modification behaviors are taught and encouraged in order to maintain a state of good health before disease occurs. Secondary care is provided after a disease has occurred, with a view to prevent progression into a disability. Tertiary prevention occurs after a disability has occurred, to improve function through rehabilitation.
I believe that primary care is the most important of the three, because it tackles issues at a very early stage, and may actually decrease onset of certain diseases and also prevent disease progression. Primary care is also cheap and easy to implement. Costs are significantly less for community education programs than treatment through surgery and hospitalization. This approach to healthcare is more socially responsible and economically viable. It is particularly important in the USA because many diseases are a result of faulty lifestyle choices that may be modified with proper education and awareness. For example, diabetes, obesity, heart disease and stroke have a strong correlation with modifiable behavior such as smoking, heavy alcohol consumption, fatty diet and sedentary lifestyle.
Both consumers and providers in the field of healthcare have a responsibility towards making healthcare delivery efficient and cost effective. As consumers we can make regular appointments for screening programs (such as physicals, dental work-up, eye-exams, cervical screening, etc.) that will facilitate early diagnosis and detection of disease (if present). As providers, we can hold more public health service workshops, screening programs, health education programs, and community based classes in varied settings to spread awareness about good health practices. This approach has been evaluated in many countries and literature suggests that it has been successful in decreasing smoking, encouraging women to get regular mammograms, and bringing about changes in diet and exercise levels.
It is heartening to see many professions (dentists, physical therapists, nurses) have already taken on these roles. Even as consumers we can encourage our friends and family to take this approach to healthcare — we will contribute to our own wellness and also make a difference in the big picture of healthcare.
McKenzie JF, Neiger BL, Smelter JL (2005). Planning, Implementing, and Evaluating Health Promotion Programs. 4th ed. San Francisco, CA: Pearson Benjamin Cummings.
J PROCHASKA, W VELICER, C REDDING, J ROSSI, M GOLDSTEIN, J DEPUE, G GREENE, S ROSSI, X SUN, J FAVA (2005). Stage-based expert systems to guide a population of primary care patients to quit smoking, eat healthier, prevent skin cancer, and receive regular mammograms Preventive Medicine, 41 (2), 406-416 DOI: 10.1016/j.ypmed.2004.09.050
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