Preventive medicine is very difficult to define and today it is no longer acceptable to think simply in terms of preventing the occurrence of specific disease processes. With current trends to whole-person health there is a more holistic approach which involves a more positive approach to preventive health care. Most people understand preventive medicine in terms of public health activities such as immunization for children, the control of fresh water supplies, safe sewage disposal, an assurance that foods and drugs are safe and the detection and control of infectious diseases. These activities are routinely and effectively carried out by local health authorities in most western countries, and we tend to take them for granted. Today we face new problems of prevention, with chronic diseases and self-induced environmental hazards causing a substantial proportion of all illnesses and deaths.

Partly because of the way that preventive medicine has grown out of public health and sanitation and partly because of the way that health care is centered on after-the-fact Procedures, preventive medicine is poorly regarded within medical and health circles and most doctors simply pay lip-service to the concept. This statement is borne out by the fact that only 4 per cent of the total US medical expenditure goes on prevention and only 1.5 per cent of all that country’s doctors are involved in full-time preventive medicine! The figures are not much better in other western countries. The influence of preventive medicine is also obstructed by the fact that it needs little that modern technology has to offer and therefore appears to be outdated and simplistic. All of this limits its appeal to those doctors and other health-care professionals who are looking for drama in medicine rather than what is best for society as a whole.

Unfortunately, prevention also tends to be handicapped in another way. Because of the difficulties already mentioned those who do go into it become so frustrated at the small resources and slow progress that they tend to become somewhat evangelical in their zeal to get things changed, so that they alienate even some potential allies. As one expert put it: ‘If there is one thing more difficult than submitting oneself to a regime, it is refraining from imposing it on other people’


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