As a public health professional, the emphasis on preventive care is important. It remains to be seen what the Affordable Care Act (ACA) can achieve in regards to preventive care. Currently, the ACA requires most health plans to cover a set of preventive services like shots and screening tests at no cost to the insured. While these services are important, there are larger, societal issues that prevent society from embracing prevention care. First, the United States (U.S.) health care system resembles a disease repair system. This system will continue to inflate health care costs if prevention is not emphasized, starting with medical school training.
Unhealthy diets and physical inactivity are key risk factors for the major non-communicable diseases such as cardiovascular diseases, cancer, and diabetes. If there is to be a shift in focus from curative to preventive care, the medical school curriculum must include nutrition and physical activity education to reduce disease burden. Here are some statistics on the impact of chronic disease as measured by financial cost, mortality and morbidity:
- In 2011, chronic illnesses account for 84 percent of overall costs among the entire population, not only of the elderly.
- The U.S. has the third largest number of confirmed diabetes cases in the world.
- Heart disease is the leading cause of death for both men and women. More than half of the deaths due to heart disease in 2009 were from the male population.
- In 2010, nearly 575,000 people died of cancer, and more than 1.45 million people had a diagnosis of cancer.
During focus groups, medical students have expressed that lifestyle counseling is an important, societal and personal obligation. However, as they move from training in basic science to clinical rotations, facing more time constraints and stressors, they become less willing to attend lifestyle classes. Medical schools can incorporate these classes into the required curriculum to train students in lifestyle counseling. This change in curricula content will expand the breadth and depth of subject matter that emphasize the importance of preventive care. As a global society, the U.S. can emulate countries that are taking unique approaches in medical education. For instance, University of Kwa-Zulu Natal (UKZN) in Durban, South Africa, is expanding its approach to the HIV/AIDS epidemic. The university has packaged a series of workshops called “Me and HIV,” to enhance sensitivity about HIV/AIDS among health workers. These workshops examine the myths, realities, attitudes and perceptions of HIV/AIDS, prevention strategies and how to help people learn to live with their condition.
Emphasizing the importance of preventive care through medical school is crucial in creating sustainable prevention-oriented physician practices. The role of the physician is vital since patients cite their physician most often as the one who influenced them to make a health behavioral change. Medical schools need to change the way they approach medical education by including preventive care training sessions in clinical rotations. This investment will increase the quality of preventive care in medical education. In the U.S., the correlation between preventive care training and non-communicable diseases is particularly important. If prevention is emphasized in medical education, people will live healthier lives and health care costs will decrease.