Preventive Medicine Partners with Medscape Medscape by exo78698

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									                     Preventive Medicine Partners with Medscape
                                    Medscape article by
                          Robert G. Harmon, MD, MPH, FACPM
                   President, American College of Preventive Medicine
                                        Sept. 2, 2004


       I am pleased to launch the first of many Medscape articles to come on the subject
of preventive medicine. The writers will be members and fellows from the American
College of Preventive Medicine (ACPM), a national medical specialty founded in 1954.
ACPM actively promotes the practice, teaching and research agenda of preventive
medicine. ACPM’s members are committed to preventing disease and promoting the
health of the individual, the community and the nation.

       ACPM’s members, who specialize in either occupational medicine, general
preventive medicine/public health, or aerospace medicine, hold clinical, research,
teaching, administrative and leadership positions in public agencies, managed care
organization, industry, the military and academia. ACPM works closely with many
governmental and non-governmental agencies to strengthen the practice of preventive
medicine, including the Centers for Disease Control and Prevention, the Agency for
Toxic Substances and Disease Registry, theHealth Resources and Services
Administration and the National Institutes of Health.
       Preventive medicine is becoming more and more prominent. Never has there been
more attention by the public, the media, government, health professionals, and health
plans focused on prevention. My main complaint is that too many people are still saying
“preventative medicine.” Please help me to educate the world that the extra “ta,” although
in the dictionary as an alternate spelling, is not needed.
       The Internet has become an exciting means of informing consumers, clinicians,
and others about prevention, self care, and evidence-based tools such as the Guides to
Clinical and Community Preventive Services. Prevention and self care books, magazines,
and newsletters continue to sell well and enjoy large readerships.




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       National organizations such as the American Cancer Society and the American
Heart Association, although often devoted to a single disease or system, are promoting
preventive medicine in a big way. National measures, standards and goals such as
Healthy People 2010 and the Health Employer Data and Information Set (HEDIS) have
focused enormous attention on preventive medicine. What gets measured gets managed,
so metrics such as immunization and mammography rates are often in the news.
       The Partnership for Prevention (www.prevent.org) has produced ground-breaking,
widely acclaimed studies about evidence-based priorities in preventive services and
policy interventions. Even cure-oriented subspecialists are beginning to appreciate the
value of prevention, spurred on by the tertiary prevention practiced in disease
management programs.
       Let’s have some fun and look ahead to the year 2010 and at “A day in the life of
Dr. I. M. Wired”…
   •   He’s board certified in family and preventive medicine. The latter credential came
       from a part time MPH and preventive medicine residency with rotations in a local
       health department, health plan, biotechnology startup, and employer health
       promotion program
   •   He works part of his time in a totally automated group practice, including an
       electronic health record, which is available to each patient via a secure Internet II
       web site. The automation was subsidized by fee bonuses from all payers.
   •   His first four hours of the day are spent on e-mail, phone, and interactive TV with
       patients and other health professionals. His patients all have access to telephone
       triage and Internet health information. All of these services are reimbursed by all
       payers.
   •   His next two hours are spent seeing patients. The electronic health record is
       always available on his wireless personal digital assistant, which also has the
       latest evidence-based practice guidelines, medication lists, and can transmit
       electronic prescriptions and other orders. All patients are prescreened, have
       completed an annual health risk appraisal, are counseled about self care, and are
       followed up with other professionals, whose services are also reimbursed by all
       payers.


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   •   His last two hours are spent working with teams on community prevention
       projects sponsored by his specialty society (ACPM) and a coalition of health
       plans, hospitals, government agencies, universities, employers, non-profit
       organizations, etc.
   •   His free time after work is spent working out at a community facility with his
       family
   •   The interesting thing is that all of Dr. Wired’s activities are in practice somewhere
       in the US today. The problem is that they’re not very prevalent.
   So here is my bigger vision for the year 2010.
   •   The consumer is the most important part of the health system. Everything else is
       there to serve the needs of the person and the family.
   •   Preventive medicine is one of the fastest-growing and most popular medical
       specialties in the US.
   •   PM specialists are on the cutting edge of new trends, including biotechnology,
       genomics, disease management, quality improvement, health informatics, e-
       Health, pharmacoepidemiology, health services research and health systems
       reform.
   •   All US residents have health insurance and access to quality health care that
       focuses on health promotion.
   •   Physicians spend at least one-third of their working time on primary, secondary,
       and tertiary preventive care, most of it with teams of other health professionals
   •   At least one-third of the NIH research budget is devoted to primary and secondary
       prevention research, much of it at the new National Institute for Health
       Promotion. Meanwhile, the prevention research and demonstration budgets at
       AHRQ, CDC and HRSA have grown as fast as NIH’s.
   •   Health plans, employers, government and consumers spend at least one-third of
       their health dollars on clinical and community preventive services, including
       health promotion, using evidence-based guidelines.
   •   Most of the Healthy People 2010 objectives are achieved
       To accomplish these goals will require a lot of new thinking and willingness to
change. And I don’t mean Dilbert’s quote. He said, “Change is good. You go first!”


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       With the renewed dedication and commitment of you—Medscape’s dedicated
readers --this vision can become reality. Thanks for opportunity to share this with you.




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