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The Case for Preventive Care

 

As the American Healthcare system becomes increasingly overburdened it is becoming apparent that expansion may not be possible, or even the best option. As a greater number of Americans get sick year after year, it’s not feasible to simply build more hospitals and train more practitioners. We have to get to the root and ask what’s causing more Americans to get sick. Then we must work to begin implementing changes that alleviate those causes. Some of the causes are societal and environmental, and are beyond the scope of a doctor’s influence, though they can lobby and engage in activism towards a goal, but it falls outside of their practice. What doctors can influence however is the extent to which they engage in preventive care.


Preventive care is any type of care that prevents disease down the road. It includes things like blood pressure, diabetes, and cholesterol tests; vaccinations; cancer screenings; diagnostic tests to measure well-being; and a host of other treatment plans that aim to maintain healthy homeostasis1. Even the government recognizes the merit in increasing preventive care measures. HHS’s Healthy People 2030 objective2 enumerates a list of goals they’re working towards in concert with the healthcare field, among them, increasing community health services, screenings, and routine visits as well as data markers like prevalence of heart disease and diabetes.


However, barriers to preventative care exist, things like scheduling, availability, transportation constraints, and lack of awareness. Healthcare providers can begin to alleviate those in certain ways, but the burden is not entirely theirs. Dr. Haya Rubin, in a review published in The Journal of General Internal Medicine details certain strategies to alleviate barriers to preventive care3. It’s a useful read, and it details key points like bundling emergency visits with pap smears and better coding practices. One key idea it presents is utilizing non-fasting results in blood screens, which can still be useful, to increase testing compliance.


Dr. Rubin presents this evaluation that I think is helpful for framing ways to incorporate preventive care into your practice, which will in turn begin to ameliorate certain burdens befalling the healthcare system at large:


“To choose interventions to improve guideline adherence and to understand whether they will succeed or fail in specific settings, it is useful to consider which types of barriers are prevalent and which barriers each intervention does or does not overcome. As primary care providers, barriers to our adherence fall into the three general areas of awareness, agreement, and ability.4 In turn, features of our practices and organizations, our patients and their communities can affect barriers in each of these areas. Which barriers to guideline-adherent preventive care are most prominent and how are these barriers to each intervention overcome3?”

 

 

Written by Jeremiah Ockunzzi, courtesy of Dr. Bart Rademaker, MD.

 

 

1) https://www.hhs.gov/healthcare/about-the-aca/preventive-care/index.html

2) https://health.gov/healthypeople/objectives-and-data/browse-objectives/preventive-care#:~:text=Barriers%20include%20cost%2C%20not%20having,awareness%20about%20recommended%20preventive%20services.&text=Teaching%20people%20about%20the%20importance,more%20people%20get%20recommended%20services.

3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495466/

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