“What does preventive medicine mean to you?” We ask this question to every one of our guests on the podcast for a reason. Why? Preventive medicine, in my opinion does not have one definition, and is highly dependent on the context and the individual. Despite how individual a definition might be, there are still overarching concepts and ideas that may be seen as all-encompassing. In this article, I discuss those overarching concepts that I believe make up what preventive medicine should be.
Idea 1: Absolute Prevention Isn’t Possible. Do What You Can, Leave the Rest To Chance
Preventive medicine is actually a very misleading name and sets false expectations for many. Prevention to most people means absolute avoidance of whatever disease or situation might be in mind. For example, we use seatbelts in rollercoasters to prevent falling out of them during a loop. Luckily, this prevention works 100% of the time. However, when it comes to diseases and other health related circumstances, it isn’t realistic to ever say we can avoid anything completely. All we can do is try to reduce the risk of whatever might be in mind. A good example of this is trying to avoid lung cancer by not smoking as much as we’d like to think this is a 100% way to avoid lung cancer this is simply not the case.
The “Risk Reduction Podcast” doesn’t have quite the same ring to it, but the idea stands that we cannot prevent everything and must do what we can in our power while leaving the rest up to chance or any ideas of the supernatural. Sometimes, no matter to what lengths someone might go to, bad things happen. Children get cancer, triathletes suffer heart attacks, healthy people might end up sick for no reason whatsoever. Therefore, I emphasize this concept in every podcast when appropriate – do what you can and don’t worry about the rest.
Idea 2: Prevention Is for Everyone Regardless of Circumstance
There are multiple levels of prevention outside of absolute avoidance. Primary, secondary, tertiary, and even quaternary prevention are all still considered “prevention” even though after primary one technically does have some level of disease. Primary prevention refers to what we’ve been talking about – absolute avoidance. Secondary prevention is screening for disease in those with disease but who might not be experiencing symptoms to reduce the risk for progression. Tertiary prevention deals with improving symptoms in those with known symptomatic disease, and lastly quaternary prevention is reducing the risk for over-treatment by various medicines and interventions. As you can see there are many types of prevention!
Primary prevention is what we typically consider the “ideal” but by no means is it a failure if one develops disease or is found to have disease through screening. We should not be equating the development of medical conditions to moral failure. For one reason or another, life happens and there may be nothing that could have been done to prevent disease progression or that could have been done for further risk reduction. See idea 1!
In this sense, there’s more to prevention than remaining disease free and prevention can be practiced in any situation or circumstance. Even in advanced and terminal cancers, quaternary prevention can be practiced improving quality of life as described in our more recent episodes. Prevention is about improving quality of life whether that means remaining disease free or reducing the risk of worsening disease.
Idea 3: Everyone’s Reason for Prevention is Different
We are all different and have what we like to call on the podcast “allowances.” We all have different goals, motives, ideologies, circumstances, etc. All of us want to remain disease free in an ideal world, which unfortunately isn’t possible, but have varying images of why we want to remain healthy. For some health means participating in triathlons, for some it means being able to go about their day with no bodily issues, and for others they might just want to be healthy enough to play with their grandchildren.
Rather than focusing on health for the sake of health or prevention for the sake of prevention, I always stress purpose on the podcast. The why. Why do you want to remain healthy? Purpose defines action and with a clear reason for remaining in a particular level of health, behavior follows. Being able to lift a grandchild might be a very strong motivator for an older individual to engage in resistance training; however, this goal might not suffice for a young triathlete. Thus, risk reduction becomes a product of a process rather than an abstract ideal and much easier to follow.
Idea 4: Prevention Isn’t Complicated.
When people think about “practicing prevention” or improving their health they think about things they must add. They think about adding exercise, adding to one’s nutrition plan, purchasing supplements, and generally strengthening their resolve. The result – a complex list of daily practices that ends up becoming a stressor. However, outside of following the guidelines set forth by professional societies surrounding nutrition and exercise, there isn’t necessarily much more to add outside of special circumstances. Sure, if you aren’t meeting the current guidelines for 300 minutes of moderate intensity cardio per week addition is warranted. However, going from 300 minutes to say 500 or 600 does not guarantee “additional prevention.”
Why? Why do we have a burning desire to add to our increasingly complex regiments? Addition makes us feel actively in control and actively working towards prevention. However, subtraction and conscious omissions may also provide a similar feeling once cognizant that addition does not guarantee further benefits. You don’t need to supplement with anything outside of those with medical needs, you don’t need to do more cardio or training sessions to further reduce your risk, you don’t need to add meditation to your routine if you find no benefit. Don’t overcomplicate things and possibly add additional stressors to your life if unnecessary. You don’t always have to add.
Prevention Summed Up
What is preventive medicine? Well, based on these 4 ideas the definition varies based on the individual. In general, preventive medicine is about doing what you can within reasonable measures to reduce your risk of disease to live the life you want to live and engage in the activities you want to. Prevention is not about chasing esoteric therapies, health obsessive behaviors, or strictly for the healthy. This is preventive medicine and the lens I try frame every conversation through that we have with the various experts that come on the show.