Preventive care is any medical service which protects against health emergencies. These types of services include dental cleaning, well-woman appointment, and annuals physicals. Some medicine such as allergic reaction, contraception, and immunization are preventive. Screening such as a test for colonoscopies, high cholesterol, skin cancer is preventive measures which are effective. The main purpose of the preventive measure is to ensure that people stay healthy. The idea is to nip illnesses in the bud before they turn catastrophic to humans. Also, preventive care ensure people are productive by ensuring they are healthy even when they grow old. Most people do not realize that the cost of healthcare is the first cause of bankruptcy in America. Many people end up spending most of their savings to provide health care for themselves or their loved ones. It is always cheaper to prevent a disease than to cure it. However, most of the population are ignorant about these facts, and they end up being culprits of ignorance. This paper highlights the significance of preventive care, types of prevention services, current preventive practices, and evidence that support the effectiveness of preventative services.
Types of Prevention
Clinical preventive medicines are a kind of preventive care model that maintains and promotes health and suppress risk factors which cause injury or disease. Table 1 depicts three types of preventive medicine. According to Lee, Friderici, Stefan, & Rothberg, (2014) primary prevention is the behavior or action which does not permit an adverse event or a disease to occur. Secondary prevention is the detecting of a condition or disease early which is in an asymptomatic stage so that treatment can block or delay the symptoms to occur. Example of secondary prevention includes screening for diseases such as cancer, tumor, and cholesterol. According to Drost et al., (2018) tertiary prevention attempts to prevent a clinical disease that is in existence. An example of tertiary prevention is cardiac rehabilitation program that is used to prevent myocardial infarction from occurring.
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If primary prevention is successful the prevalence of disease decreases. However, in contrast, Secondary prevention detects the disease early so that it can be treated ( Siu, 2016) . Similarly, tertiary prevention tries to prevent the disease that is already established.
Evidence Supporting Prevention
Since the turn of the century, the leading cause of death among the human population has changed immensely, and it is depicted in (Table 2). Chronic disease has become the new threats which are a shift from acute diseases. The most chronic disease currently is because of people’s lifestyle. The burden of suffering from the “real” cause of death has been portrayed in ( Table 3 ). Close of 400, 000 individuals succumb from tobacco-related illness annually ( Drost et al., 2018) . Whereas, physical activity pattern and unhealthy nutrition are responsible for approximately 300,000 yearly deaths of America population. Most of these deaths can be delayed or prevented through primary prevention activities. Correspondingly, some disease that are caused by these factors can be diagnosed and treated at its infancy through screening.
The prevention of morbidity and mortality caused by certain health condition has made huge progress over the last half a century. The main credit for the decline is the decrease in acute infectious diseases which was deliberately increasing secondary diseases. The introduction of immunization has helped eliminate these diseases due to proper documentation of most of the notorious diseases like mumps, the most recent Haemophilus influenza , diphtheria, rubella, and measles (Lee, Friderici, Stefan, & Rothberg, 2014). Since the mid-1970s stroke has dropped by over 60% due to the early detection and treatment of the disease, and they also managed and controlled untreated hypertension hence reducing its spreading ( Drost et al., 2018) . Also, medical personnel over the past 30 years have improved the detection and treatment of hypertension drastically. Many people nowadays benefit from hypertension treatment although early detection is not present. However, the medics have confirmed the rise of hypertension infection in the recent past.
Over the last two decades, the mortality deaths from coronary heart disease have decreased by 50% ( Siu, 2016) . The improvement of coronary artery treatment is attributed to this drop since bypass graft procedures, emergency responses services, and coronary health care unit has improved over the past years. Similarly, this big drop of early coronary disease is attributed to the change of lifestyle of a bigger portion of people especially the people who indulge in smoking and the drop of high levels of total cholesterol serum in the general population (Bansal et al., 2018). The reduction of risk factor profiles and improved treatment across America has resulted in the recent decline of the coronary disease.
During the period from 1970 to 1994, the cancer mortality rate in the United States has risen by over 6%, and the treatment offered against this disease does little or no overall effect after its infection ( Siu, 2016) . And any drop of cancer deaths across the country is accredited to a probable drop of new lung cancer infections which was one of the primary cancers. This decrease comes from the drop of men smoking prevalence which is in the primary level of cancer infection and the increase of women undertaking cervical screening (the Papanicolaou test) frequently as a secondary cancer infection level (Bansal et al., 2018). Due to lack of substantial overall decline in cancer mortality over the years, many national have resolved to a new suggestion which requires a realignment of their emphasis from seeking a cure to putting much effort in prevention of new infection.
The recent years have realized more certain association of behavior with the factor risks tied together with other diseases and injuries. The regular ever-increasing recognition on the available preventive measures focuses on improving everyone’s health throughout the country at all time (Bansal et al., 2018). However, medical practitioners have failed to prove the preventive service program is effective considering the current life quality and mortality and morbidity. According to Siu (2016), in 1975, they reviewed the systematics used in screening while in the periodic medical health examination which utilizes a specified method. The tests performed annually by using many traditional formulas and procedures proved to be unreliable and faulty hence it could not be justified. They tried presenting screening flow sheet which presented recommendation within a certain period. On health promotion and disease prevention, Surgeon General presented a report in 1979 which gave the status of the state-of-the-art up ( Drost et al., 2018) . The report seeks to outline a report on a case of more attention to certain diseases prevention criteria while promoting health improvement in various areas. The Canadian task force came up with a landmark study which focuses on the Periodic Health Examination in different areas which may help in developing quality data used in the evaluation of individual components found in the periodic of the health examination.
The US Preventive Services Task Force published a review in the Guide to Clinical Preventive Services after using data obtained from the Canadian Task Force that was being used as supportive evidence ( Siu, 2016) . The review publication was reviewed and the second edition was published in 1996 ( Drost et al., 2018) . Based on the effectiveness of screening and counseling interventions, data was collected and set as a criterion for quality evaluation for more than 70 conditions and illness. The intervention used in addressing the patients acted as a major principle of the US Task Force while handling vital personal health practices in medical facilities (Bansal et al., 2018). This intervention requires patients to take responsibility for their health hence giving medical practitioners time to put their efforts in providing the required counsel together with appropriate resources.
It is the responsibility and opportunity of every clinician to find and deliver preventive services, specifically to those with limited care access. When ordering a selective test of a certain type of services and preventive services, clinicians are encouraged to be selective (Bansal et al., 2018). The selection includes different types of traditional periodic health examinations which remains unproven due to its ineffectiveness ( Drost et al., 2018) . Certain expensive screening tests could result in damage or harm to people having further treatments and diagnosis. The book Guide to Clinical Preventive Services presents the medical practitioners with outlines of quality evidences with different evidence interventions with helps physicians to identify and determine the state of their patients through the screening procedures conducted together with counseling services which provide people with other options to be put into considerations in the risk factor profile of a patient.
There must be a review of the physical examination components which is contained in the health examination ( Siu, 2016) . Little supportive evidence is relevant to the routine components. Also, all the presented evidence is probably a negative one; it might have a particular individual benefiting through the physical discovery with pretty much little evidence of giving a significant overall effect to everyone around.
The meta-analysis of 74 studies helped in the determination of patient effect in counseling and education ( Drost et al., 2018) . All behavioral groups depicted a beneficial effect which includes alcohol abuse, nutrition, smoking, other preventable behaviors and the control of wealth.
With certain preventive interventions like the mammographic screening used for screening for breast cancer should be affordable ( Siu, 2016) . Their some programs that help women desist from smoking while pregnant, attending all the immunizations and wearing safety helmets when using a bicycle to save money which amounts to $14 when issuing some of the immunization.
Current Preventive Practices
Apparently, the majority of the physicians have embraced the preventive care model; they have started to practice it to help in preventing and managing certain conditions or diseases. According to Maurice & Abouassaly, (2014), most physicians have commenced recommending health promotion counseling and assessment, immunizations, and screening tests. However, the recommendation done by physicians falls short of the expected guidelines. According to Bellet, Woodnutt, Green & Kaler, (2015) most physicians who recommend preventive care model are young, subspecialists, generalists and residency trained within their specialty. In America, physicians should agree with the guidelines of screening practices and the American Cancer Society. The numbers of physicians who embrace this guideline are increasing ( Drost et al., 2018) . However, the method used to recommend preventive care model to the patients is inadequate. Physicians recommend a preventive care model to the patients, and they do not offer adequate counseling to the patients of the importance of embracing preventive care model. Majority of physicians inquire about smoking habits; however, they spend little time to counsel the patient to quit smoking. Similarly, few physicians address smoking and nutrition; they do not go an extra mile to advise individual on healthy living. According to Bansal et al., (2018), less preventive care is efficient. Physicians do not do enough with counseling as a way of engaging the patients.
There are several reasons why a preventive care model is not widely praised. These include health system barriers, patient barriers, and physician barriers, these reasons are highlighted in ( Table 4 ). Majority of physicians believe that preventive service is crucial that recommending them in their practice ( Siu, 2016) . Along with reasons in Table 4, this can be because of lack of confidence in the ability to change the behavior of the patient and counsel, views that promoting preventive medicine is outside the role of physicians and the perception that patients will not likely follow recommendations.
Also, the patient gender and income disparities may impact the individuals who access or receive preventive care model. Physicians are less likely to discuss smoking with high-income earners and exercising with low-income earners ( Drost et al., 2018) . Male physicians are less likely than their female counterparts to recommend pap and screening mammography for their female patients ( Bellet, Woodnutt, Green, & Kaler, 2015) . This is because female physicians report that they are comfortable in administering breast examinations or Pap.
People have a certain misconception about prevention care model. Some individuals have the perception that the more test they undergo, the less likely will they fall sick ( Siu, 2016) . For instance, electron-beam computed tomography used for the screen for coronary heart disease and quantifying coronary calcification has gain popularity, and advertising for its test is contributing to the perception of engrained effectiveness
The belief that the more screening a person undergoes, the better is coupled with the perception that technology is efficient in preventing certain disorders or diseases. People are willing to embrace sophisticated screening tests, miracle diets, and dietary supplements and other alternative preventive practices without any benefit that is documented yet they tend to ignore preventatives such as abstaining from tobacco and regular exercising which have documented benefits. According to Bansal et al. (2018), one in three adults observed the recommended five servings of vegetables and fruits daily, 60 percent of Americans do not exercise and 23 percent of America population smoke tobacco. The statistics show how unhealthy the population of America is yet people want to look for shortcuts in undocumented preventive care models that have no documented benefit.
Undergoing screening on a regular basis or altering change habit requires more effort from the patient, who will be unwilling to commit to preventive care if it is uncomfortable and costly, or if the patient is unsure if the model will be beneficial ( Drost et al., 2018) . Beneficial changes in the occurrence of some behaviors which are risky in general population like smoking have occurred progressively, confirming the difficulty in ensuring sustained health behavior is upheld.
Reimbursement for medical care can influence clinical practice immensely including preventive care model. Presently, reimbursement for preventive services differs but it is poor, especially reimbursement of health promotion services (Bansal et al., 2018). So far, evidence suggests that offering preventive services for beneficiaries of medical care will result in modest health benefit at no extra cost ( Siu, 2016) . In contrast, the cost to the society will be significant if some interventions were utilized maximumly, for instance, screening mammography in young women. This stressed the need to carefully evaluate data regarding cost and evidence for effectiveness before recommending regular screening test.
Conclusively, preventive care model continues to grow. However, physicians should put more to enhance preventive care model among the general population. Physicians should step up and be involved in the life of the patients by advising them about healthy living. Similarly, the general population at large should embrace and absorb advice physicians give them since the recommendations given by them have documented benefits. The advertisement on sophisticated screening tests, miracle diets, and dietary supplements is a mere lie since it has no approved documented benefits. To change the attitude of physicians, the general population should embrace the preventive care model and heed the advice of physicians; this will make them responsible since they will be satisfied that their services are appreciated. Also, the government should incorporate the preventive care model into Medicare so that the general population receives this service at no cost; this will encourage many individuals to seek preventative services.
References
Bansal, S., Pecina, J. L., Merry, S. P., Kennel, K. A., Maxson, J., Quigg, S., & Thacher, T. D. (2015). US Preventative Services Task Force FRAX threshold has a low sensitivity to detect osteoporosis in women ages 50–64 years. Osteoporosis International, 26(4), 1429-1433.
Bellet, C., Woodnutt, J., Green, L. E., & Kaler, J. (2015). Preventative services offered by veterinarians on sheep farms in England and Wales: Opinions and drivers for proactive flock health planning. Preventive veterinary medicine , 122 (4), 381-388.
Drost, F. J., Rannikko, A., Valdagni, R., Pickles, T., Kakehi, Y., Roobol, M., & PRIAS-study group. (2018). PD20-02 CAN ACTIVE SURVEILLANCE REALLY REDUCE THE HARMS OF PSA TESTING, LIKE THE US PREVENTATIVE SERVICES TASK FORCE CURRENTLY SUGGESTS? THE PRIAS-STUDY IMPLICATES CAUTION. The Journal of Urology , 199 (4), e401-e402.
Lee, S. Y., Friderici, J., Stefan, M. S., & Rothberg, M. B. (2014). Impact of the 2008 US preventative services task force recommendation on frequency of prostate‐specific antigen screening in older men. Journal of the American Geriatrics Society, 62(10), 1912-1915.
Maurice, M. J., & Abouassaly, R. (2014). Patient opinions on prostate cancer screening are swayed by the United States Preventative Services Task Force recommendations. Urology, 84(2), 295-299.
Perez, T. Y., Danzig, M. R., Ghandour, R. A., Badani, K. K., Benson, M. C., & McKiernan, J. M. (2015). Impact of the 2012 United States Preventive Services Task Force statement on prostate-specific antigen screening: analysis of urologic and primary care practices. Urology , 85 (1), 85-91.
Siu, A. L. (2016). US Preventative Services Task Force (USPSTF). Screening for Depression in Adults. JAMA J Am Med Assoc , 315 , 380-387.
