Prevention versus screening

What is prevention? The standard of care for preventive medicine specialists in conventional medicine is determined by the USPSTF (The US preventive services task force), which is an independent panel of experts in primary care (like internists, pediatricians, gynecologists, etc). The USPSTF determines when screening exams are necessary, which medications to take for prevention, and how to counsel patients.

The USPSTF comes up with guidelines based on a review of the scientific evidence, and publishes them in the form of “recommendation statements”. For example, the USPSTF determines at what age mammograms, physical exams, DEXA scans, blood tests, etc., are necessary. These are called “screening” tests because they are done for virtually every person of the recommended age and gender. The hope is that by screening millions of people, we can catch a few people who might actually have a certain disease (and thereby save lives).

Is this prevention? Screening exams, by definition, find people who actually have disease. A mammogram, for example, shows when a woman actually has breast cancer, it does not show that a woman might develop breast cancer in a few years. And it certainly doesn’t tell people how to prevent a disease from occurring in the first place.

Why is this important? Naturopathic physicians are experts in prevention, not screening (though we do a lot of that too). We want to work with our patients years before they get cancer, to talk about how to prevent it to begin with, not how to treat it when they already have it! We want to work with our patients to figure out the cause of their high blood pressure or high cholesterol, not just give them a drug to lower it.

Naturopathic physicians are the true preventive services task force! (We should get some fancy uniforms or something)