A checkup checklist to make sure you’re protected
Americans will go to great lengths to protect themselves from medical risks -- even when the level of risk is unclear or unproven. The threat of mad cow disease drives some people to boycott beef, pesticide concerns lead others to eat only organic foods, and fears about vaccine safety prevent some parents from immunizing their children.
Ironically, some of these same people fail to act against serious, and well-documented, medical risks.
Two-thirds of adult men and women skip preventive measures that could protect them against colorectal cancer, for example. One in every three women ignores the screening recommendations for breast cancer. And one in five women miss Pap smears that could identify cervical cancer in a curable stage.
Cost is one reason. When people are feeling well, it’s hard to persuade them that they should pay for a test that might not find a problem. And many health plans have either stopped paying for preventive tests and services or cut back on coverage.
Physicians bear some responsibility also. Increasingly pressed for time, they’re forced to prioritize what they do during an office visit. Preventive interventions typically take a back seat to more immediate problems.
Further, doctors and patients have lacked clear-cut evidence about which preventive tests and services are most cost-effective and which provide the most health benefits. Until now. A new study funded by the Centers for Disease Control and Prevention ranks preventive services based on the specific effect that each can have on a patient’s health. The study was just released in the American Journal of Preventive Medicine, and it offers a plan of action to anyone who strives for good health -- but doesn’t know where to begin.
“We’ve tried to identify the most important things patients can get from their doctors,” says study coauthor Ashley Coffield, a health services researcher.
Only interventions performed in medical settings and with well-proven benefits were examined.
“Although the findings of the study are largely directed at healthcare providers, consumers can use them to be proactive with their doctor,” Coffield says.
For children, immunizations top the list. Currently licensed vaccines have proved highly protective and, despite alarmist messages to the contrary, the risks associated with their use are quite small.
For adults, discussing daily aspirin use with their physician is rated one of the most beneficial. Among men 40 and older and women 50 and older, low-dose aspirin therapy can dramatically reduce the risk of cardiovascular events such as heart attacks.
Blood pressure and cholesterol screenings also top the list of most beneficial preventive interventions. Identifying and treating high blood pressure and lipid disorders can significantly lower the risk of coronary heart disease and stroke.
A little further down the list come Pap smears and mammograms for women, and flu shots and colorectal cancer screening for all adults 50 and older. A complete ranking of services is available online at www.prevent.org/content/view/50/101.
Ultimately, getting your doctor to order the appropriate preventive tests and treatments is only half the battle. The other half is to live a healthy lifestyle, which includes eating right and exercising regularly. Although less dramatic than a meat boycott and less politically correct than an organic diet, you don’t need your doctor’s permission to do it -- and there is clear scientific proof that it works.
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Dr. Valerie Ulene is a board-certified specialist in preventive medicine practicing in Los Angeles. She can be reached at themd@att.net. The MD appears the first Monday of the month.
