FEED-BACK.COM E-ZINE
July / August 2009
Volume 12 Issue 4
Preventive Medicine: Potential Impacts
Along with "increasing competition, providing more choices, and keeping the insurance companies honest," the current version of Health Care Reform Act legislation emphasizes "preventive medicine" as a means for improving quality of care.[1] Preventive medicine is a legitimate discipline according to journals and professional organizations. Other individuals and groups question its validity. The following overview summarizes some recently published material.
Components & Proponents
While preventive medicine may seem like a new concept, one organization proves otherwise. The American College of Preventive Medicine (ACPM) was founded in 1954 as a national professional society of physicians. Among its 2,000 members are board-certified doctors in preventive medicine and other disciplines (primary care, public health, research, etc.). The 5,000 member American College of Occupational and Environmental Medicine (ACOEM) promotes worker health through clinical care, education, preventive medicine, and research.
Screening and early detection of disease are major components of preventive medicine, along with promotion of lifestyle changes to reduce patients' risk of long-term medical problems. Topics covered in the June 2009 issue of the American Journal of Preventive Medicine provide some examples:
- Diagnostic and other impacts of fecal occult blood tests
- Mammography screenings
- Motivational smoking cessation interventions
- Multimodal mammography reminder methods.
Assessments & Outlook
Practical application may be hard to justify, since large-scale screening can generate significant false result rates that require expensive follow-up testing.[2] Others question whether the combination of health information technology (HIT), coordinated care for patients with multiple chronic conditions, and wellness programs in the Health Care Reform Act will more effectively control costs than the current fee-based model. Potential benefits of all three components have not yet been demonstrated.[3]
Based on recent history, population dynamics are likely to outpace adoption of HIT. Despite government incentives and promotion, cost is a major barrier. Some analysts suggest that over the next ten years, one-third of physicians will not have installed HIT systems.[4]
According to the Centers for Medicare and Medicaid Services, national health spending was projected to be $2.4 trillion in 2008 and forecast to grow more rapidly than the gross domestic product through 2009. If the current trend continues, national health expenditures are forecast to reach $4.4 trillion by 2018.[5]
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[1] "Statement by the President on the Health Care Reform Legislation Introduced in the House Today," Health Reform 2009, July 14, 2009 [Robert Wood Johnson Foundation].
[2] "The Preventive Medicine Con,", DocIsInBlog.com, July 17, 2009.
[3] "Electronic Record-keeping Wellness Programs and Care Coordination,", The Concord Coalition, June 15, 2009.
[4] Ibid.
[5] "National Health Expenditure Projections, 2008-2018," Centers for Medicare and Medicaid Services, 2008.
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