What is Preventive Medicine?
As a primary care doctor, I believe in prevention. I want you to be well and to stay away from doctors as much as possible. Given this fact, there are two main goals of prevention:
- To stack the odds in your favor as much as possible. The best prevention possible means we are doing everything we know to do to prevent a problem. This requires both your cooperation with my recommendations and my knowledge of what to do in the first place. As time goes by, this will be the part of the website that changes the most. Up until now I've had to wait for the cars to break down before I took care of them; now I can keep things running smoothly all along.
- To make potentially big problems into small ones. Once a person has a problem (diabetes, for example), the goal is to have them live their life with as few problems from diabetes as possible. Getting older is a problem we all face, and the goal is to keep people acting and feeling young as long as possible.
Know Your Risk
One of the first things every person needs to do for prevention is to know their risk. We get far more bang for the buck when we prevent something that's likely to happen. If you life in Florida, you do things to prevent damage from Hurricanes, not earthquakes. But if you live in California, you don't care about Hurricanes, instead focusing on earthquakes. Here are the main things that determine your risk:
Heredity (meaning immediate family) - Certain diseases tend to run in families and so a family history increases your risk of getting them. The most significant of these diseases are:
Coronary Heart disease - such as heart attacks.
The closer the relative and the younger the age of disease, the higher the risk. Having a father with a heart attack at age 40 puts you at significant risk. Having an uncle who had one at 90 doesn't.
This is pretty much the same as coronary heart disease, but it is a little less strongly inherited (probably because it nearly always happens at older age than heart attacks).
Not all cancers are equal in this. Most cancers are only a small part heredity, with three notable exceptions:
- Breast cancer - some forms of breast cancer are strongly hereditary, especially those happening at a younger age.
- Prostate cancer - Having a family member with prostate cancer under the age of 65 increases your risk (if you are a man, obviously).
- Colon Cancer - A family member with colon cancer or pre-cancerous polyps is a significant risk factor of this deadly cancer.
Adult onset diabetes (Type 2) is strongly hereditary, and there are definite steps you can do to prevent this.
In women, an immediate family member with osteoporosis significantly increases that risk in them.
Who you are as a person (things you can't control) greatly determine your risk in certain areas:
- Age - some things are much more common in young people (cervical and testicular cancer, for example), while many other things are common as you age.
- Sex - Obviously you can't have problems with organs you don't own, but there are other ways sex affects risk. Women are more likely to have osteoporosis, for example, while men tend to have heart attacks at younger ages.
- Race - Various ethnicities are more likely to have certain diseases.
This is what we tend to harp on the most because it is most under our control, but it's also what we feel most guilty about.
- Smoking - Don't smoke. Take up a safer hobby, like juggling acid-filled balloons or canyon jumping. Smokers are more likely to die from all sorts of things, but you probably already knew that.
- Alcohol - in moderation, alcohol is actually probably beneficial. But done in excess, it greatly lowers a person's life expectancy.
- Exercise - Moderate exercise lets you live longer than being a couch potato.
- Diet - Obesity is "epidemic" now for one main reason: food is cheap. Eating a healthy diet may be more expensive in the short-run, but it is much cheaper in the long-run.
- Other Diseases - Diabetes raises a person's risk of a heart attack, as does high blood pressure. People with thyroid disorders are more likely to have osteoporosis.
Act now and Pay Less Later
Once you know your risk, and once we determine what we can do to reduce that risk, the only thing left to do is to do what's needed. Here are the most common diseases we work to prevent, with links to further explanations of what can be done to prevent them.
- Heart attack (and stroke)
- Breast Cancer
- Prostate Cancer
- Colon Cancer
- Lung Cancer
- Cervical Cancer
- Pneumococcal Infection
- Zoster (Shingles)
- Pertussis (Whooping Cough)
- Accident Prevention
Here are some common things that may be beneficial prevent disease. Please note that there is significant controversy regarding some of these, and none are appropriate for everyone:
- Quitting (or cutting down) Smoking
- Moderate Exercise
- Keeping near a good body weight
- Control cholesterol
- Drinking in moderation
- Eat better foods
- Control Blood Pressure
- Keep diabetes well controlled
- Heart Calcium Scores
- Take Aspirin
- Pap Smears
- PSA blood Testing
- Hemoccult (hidden blood) testing
- Bone Density Testing
- Pneumococcal Vaccine
- Influenza Vaccine
- Tetanus Vaccine
- Pertussis Vaccine