We have set a high standard of evidence for the evaluation ofpreventive services to be widely used. Cost is one reason. Sinceeveryone is a candidate for preventive services, the aggregatecost is high. Professional ethics is another reason. By seekingout a physician, a sick patient initiates an episode of care.The physician's responsibility is to help, not to guaranteea good outcome. The obligation is more stringent when a physicianmakes a recommendation to a healthy person: the physician mustbe sure that the benefits exceed the harm (primum non nocere).For example, screening for a disease . . . [Full Text of this Article]
History and Physical Examination
Disease Prevention in Low-Risk Patients
Blood-Pressure Measurement
Breast Examination by a Physician
Serum Cholesterol
Mammography
Cervical Cytologic Screening
Vaccination
Counseling
Current Controversies
Screening for Breast Cancer
Screening for Colon Cancer
Screening for Prostate Cancer
Screening for Hypercholesterolemia
Hormone Replacement
Conclusions
Source Information
The author is a member of the U.S. Preventive Services Task Force and has served on the Clinical Efficacy Assessment Subcommittee of the American College of Physicians. This article represents the author's views and not the views of these organizations.
From the Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, where reprint requests should be addressed to Dr. Sox.
References
Related Letters:
Preventive Health Services
Catalona W. J., Bialor B. D., Wachtel T. J., Fagan M. J., Atkins C. D., Cappuccio J., Phatak P., Sox H. C.
Extract |
Full Text
N Engl J Med 1994;
331:1156-1158, Oct 27, 1994.
Correspondence
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