Preventative care is disappearing

When you visit your family doctor, there are usually two agendas that require consideration. The first is the problem you’ve planned to discuss. The second is the wide array of topics that your doctor likely has on the preventive medicine agenda that you may not have considered at all.

These topics include:

• Update meds and lab work.

• Update complete immunization status.

• Update any new allergies/reactions.

• Update over-the-counter meds.

• Check new/unseen skin lesions for cancer.

• Update bone densities, Pap smears, breast exams (men too), pelvic exam, mammograms, sleep apnea review, prostate exams, PSA review, colonoscopies, etc.

• Review of health promotion issues like proper diet, ideal weight, stop smoking, exercise prescription, drug and alcohol abuse, dental and eye care, socialization and mental health, sleep history, etc.

In another era, over a number of visits or on a general health review, this material would optimistically be covered. But what family doc now has the time, the inclination, or the payment schedule to achieve this end, and record it? Probably close to no one.

As one of my family-doc colleagues recently lamented: “Traditional anticipatory care is going the way of the dodo bird.”

What a loss. It diminishes the quality of care across the board. Who even notices?

Neil Finnie, MD (retired GP) Victoria