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[The Prevention Visit: a health check advocated by the Dutch College of General Practitioners]
1Nederlands Interdisciplinair Demografisch Instituut (NIDI), Den Haag, the Netherlands. bonneux@nidi.nl
Abstract:
The practice guideline 'The Prevention Visit' by the Dutch College of General Practitioners utilises a questionnaire and derived risk score related to age, sex, BMI, smoking status and a few more but minor determinants to assess the absolute risk of cardiovascular disease, diabetes and chronic kidney disease. According to this test, all persons over 65 are at risk. The description of the health problem addressed is limited to unfounded speculations on unhealthy lifestyles. Except for smoking cessation and blood pressure reduction, the proposed interventions lack evidence of effectiveness. The undesirable or harmful side effects of advice and treatments, particularly the overtreatment of elderly persons, are not discussed. This prevention visit is therefore an emanation of the culture of fear: health experts exaggerating health problems. In doing so, they transform the basic human fear of ageing and death into seemingly objective 'risks' that need 'treatments'.
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