The Wall Street Journal Health Blog today posted a couple of articles (here and here) on the costs and the effectiveness of preventative medicine in the US and Germany. The articles outline that despite their high costs, preventative medicine programs do not actually help to prevent any disease such as colon or breast cancer. In fact the article on Germany, based on research by the German magazine Der Spiegel, claims that the only people who benefit from the screenings are the doctors who are paid fees to perform the test. For example, there are no randomized trials (the gold standard for medicine) demonstrating benefits for patients who under go regular colonoscopies. In the US researchers looked at a prevention program performed with 200, 000 Medicare participants. They found that it didn’t improve patient’s health and it didn’t result in fewer doctor and hospital visits and therefore less cost.
For anyone who came to our dinner event last March these articles shouldn’t come as a suprise. Preventative medicine is a misnomer. It doesn’t actually prevent anything. You could have a colonoscopy every single day for a year, but doing so would not lower your chances of getting colon cancer. Preventative medicine is really early detection and screening. It simply tells you if you already have the problem (this is an important role but it clouds the issue in peoples minds). True preventative medicine is all about the lifestyle choices you make. Each one of us has the keys to determine if we develop or don’t develop any of these chronic diseases such as heart disease and cancer. We should be (and do in our office) advocating lifestyle intervention; that is the key to making America (and Germany) healthy, and in the process saving billions of dollars, not costly screening tests.