Is clinical prevention better than cure?
Juan Gérvas, Royal
Lancet 2008 Viewpoint
www.thelancet.com Vol. 372 - December 6, 2008
Website: www.thelancet.com [Subscription required]
“…….In wealthy countries, the focus of clinical care is changing from cure to prevention, to anticipate future diseases in currently healthy individuals. We review the challenges that clinicians face, such as: prevention can cause harm; predicting the benefit of preventive activities for the individual, as opposed to the group, can be difficult; prevention is not of equal value to everyone; and prevention is beginning to take priority over treatment.
Clinicians need to be vigilant to avoid colluding with those who have vested interests in some preventive activities.
Finding the right balance between prevention and treatment is a daily challenge. Many reasons exist for the increased emphasis on prevention, including the identification of risk factors for disease, increased social expectations of a long and healthy life, and collusion of many commercial and professional interests in profiting from the creation of new markets:1–3 the social, professional, and financial rewards for prevention can be considerable.
In clinical care, treatments are intended to cure or alleviate symptoms and signs. By contrast, prevention is done to ward off something in the future. Clinical prevention, including immunisation and lifestyle advice, is an important and positive component of almost every clinical visit. However, with increasing responsibility for specific populations and recognition of the many diverse influences on the occurrence and progression of illness, the concepts underlying prevention have become muddled….”
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