Presidential address: preventive medical practice

Area of Science:

• Public Health
• Preventive Medicine
• Medical Education

Background:

• National programs show a consensus on the need for preventive services.
• Physician provision of preventive services is declining.
• Factors like specialization and practice organization influence preventive service delivery.

Purpose of the Study:

• To examine physician performance in delivering preventive services.
• To identify factors affecting the volume of preventive services provided.
• To discuss implications for medical education in prevention.

Main Methods:

• Review of national programs and effective preventive activities.
• Analysis of factors related to the volume of preventive services.
• Discussion of educational implications.

Main Results:

• Physician delivery of preventive services is decreasing.
• Organized primary care settings with multidisciplinary teams are effective.
• Current preventive practices are suboptimal, despite known effective interventions.
• Consumer and physician education programs can improve performance.

Conclusions:

• Medical education must better prepare physicians in preventive medicine.
• Optimizing practice organization and payment models can enhance preventive care.
• National and community efforts are needed to boost preventive service utilization.