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Tuesday, October 14, 2008

Prevention: The Best Medicine?

Last week’s New York Times contained an interesting essay called “Campaign Myth: Prevention as Cure-All.” The piece, written by H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice in Hanover, N.H. and the author of “Should I be Tested For Cancer? Maybe Not and Here’s Why,” argues that while Barack Obama and John McCain are both championing prevention and wellness as part of their presidential campaigns, it actually may not be the best medicine—or health care policy.

A few interesting quotes:
“The term 'preventative medicine'” no longer means what it used to: Keeping people well by promoting healthy habits, like exercising, eating a balanced diet and not smoking. To their credit, both candidates ardently support that approach.

"But the medical model for prevention has become less about health promotion and more about early diagnosis… It boils down to encouraging the well to have themselves tested to make sure they are not sick. And that approach doesn’t save money; it costs money…

"Early diagnosis may help some, but it undoubtedly leads others to be treated for “diseases” that would never have bothered them. That’s called over diagnosis.”
The article goes on to detail how screening and testing a growing number of people for conditions like cancer, heart disease, diabetes and osteoporosis leads to more people being classified as “at risk,” and perhaps receiving treatments or therapies they may not need.

For those of us in the corporate wellness world, who are constantly trying to define “prevention” and improve our program offerings, the essay is definitely worth a read.

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