Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: America Needs More Preventative Medicine

Category: Access To Children's Health Care


In the present medical climate, prevention is about the least costly overall in medical care. In other words, the big fees go to doing procedures and performing expensive high technological medical feats. Unfortunately, very small fees are paid for a doctor sitting face to face with patients and teaching them how to prevent long term complications from diabetes, high blood pressure, heart disease, obesity or any other disease. A pediatricians' time with new mothers and fathers, teaching them about their child's normal growth and development with anticipatory guidance for the milestones the child might go through and safety precautions to take at each age, is also poorly funded. Consequently, many pediatricians, family doctors and internists have to see more patients at a faster rate just to cover their malpractice insurance and overhead when they would prefer to spend more time with each patient teaching and providing good medical care.

Health and Human Resources Secretary, Louis Sullivan, recently told graduates of the University of North Dakota that this is the biggest challenge facing America's doctors. As an example, he cited Japan which has healthier people than America even though we spend twice as much of our gross national product for medical care. They, however, do a much better job on preventive care.

One example is that they provide prenatal care in the first trimester for 98% of the pregnant women in their society. This compares with only 75% of our American women getting prenatal care in the first trimester.

With the current 12% (and rising fast) GNP spent on medical care, we must do something to provide better and more effective preventive care in our system. We must put incentives into the system and adjust the payment scale for preventive care services to be more in line with other medical charges.

We must, as a society, change so many of our unhealthy life styles that require very expensive long term medical care to reverse. I agree with Dr. Sullivan that our priorities are skewed in America and I hope the next generation of physicians will reverse this. We must all encourage less smoking, drinking, fast driving, drugs, promiscuous multi-partner sex and a dozen other unsafe practices which are all too common in our society. Only when we begin to do this will we begin to see a lower infant mortality rate in line with all of the other modern countries in the world and lower heart and cancer rates in line with so many other poorer countries which do a better job in overall medical care.