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Goal-Oriented Prevention: How to Fit a Square Peg into a Round Hole
James W Mold1, Darren A DeWalt2, F Daniel Duffy2
1From the University of Oklahoma Health Sciences Center, Chapel Hill, NC (JWM); Division of General Medicine and Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill, (DAD); Internal Medicine and Medical Informatics, University of Oklahoma-Tulsa School of Community Medicine, Tulsa (FDD). jameswmold@gmail.com.
Journal of the American Board of Family Medicine : JABFM
|March 3, 2023
Summary
Preventive medicine faces challenges in the current problem-focused healthcare system, impacting clinician motivation and patient adherence. Shifting focus to life extension and disability prevention offers a more effective approach to proactive health.
Area of Science:
- Public Health and Preventive Medicine
- Healthcare Systems Analysis
- Medical Education and Practice
Background:
- The current medical paradigm prioritizes treating existing diseases over preventing future health issues.
- Clinician motivation for preventive care is hindered by time constraints, low reimbursement, and delayed benefit realization.
- Large patient panels complicate the delivery of preventive services and lifestyle counseling.
Purpose of the Study:
- To address the mismatch between preventive care needs and the existing problem-oriented medical model.
- To explore alternative frameworks for motivating clinicians and patients towards preventive health measures.
- To reframe the goals of prevention towards tangible outcomes like life extension and disability prevention.
Main Methods:
- Conceptual analysis of the current medical paradigm's limitations regarding prevention.
- Exploration of motivational factors for clinicians and patients in adopting preventive strategies.
- Proposal of a goal-oriented approach focusing on life extension and disability prevention.
Main Results:
- The problem-oriented medical model presents significant barriers to effective preventive care implementation.
- Clinician and patient engagement in prevention is challenged by practical and systemic factors.
- Reframing prevention goals toward life extension and disability prevention offers a promising solution.
Conclusions:
- A paradigm shift is necessary to integrate prevention more effectively into healthcare.
- Focusing on life extension and disability prevention can enhance the appeal and efficacy of preventive medicine.
- This approach can better align with both clinician and patient objectives for long-term health and well-being.
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