Do you know that one simple step could save 100,000 lives? Research shows that if 90 percent of adults were to receive an annual wellness visit and their age-appropriate health screenings, 100,000 Americans would avoid a preventable death every year. So why aren’t more Americans seeking and receiving these services? Benjamin Franklin’s adage that “an ounce of prevention is worth a pound of cure” is of no comfort to patients with high deductibles, co-insurance, and co-payments who must choose between their health and other pressing financial concerns. In fact, high out-of-pocket cost is the number one reason patients do not seek regular health care — preventive or otherwise. The Centers for Disease Control and Prevention estimates that fewer than half of Americans older than 65, and fewer than a quarter of adults between age 50-64 have received the recommended level of preventive health services – immunizations, cancer and cardiovascular screenings, smoking cessation advice and counseling on daily use of aspirin among other services. But in spite of the high out-of pocket costs, 82 percent of adults went to the doctor at least once in 2012. Why didn’t 82 percent of adults receive the recommended preventive health screenings? The answer is best illustrated using the case of a patient, Mr. K. Mr. K, like most Americans, had been accustomed to seeing his primary care physician for an annual physical. He had borderline blood pressure, high cholesterol, and arthritis. Mrs. K would accompany her husband on the visits and bring a list of concerns to review with the doctor. Despite their efforts to come prepared, it always seemed their list was not completely addressed in the annual 30-minute visit. Then one day in September, Mr. K saw blood in the toilet bowl. An urgent colonoscopy revealed a large tumor in his colon. Mr. K was 67 and now diagnosed with metastatic colon cancer — a terrible disease that could have been prevented. Despite seeing a doctor annually for the past 10 years, he was never counseled to undergo a colon cancer screening. How did this happen? Mr. K’s case, unfortunately, is not unique nor is it an indictment of his primary care physician. The problem is that the annual physical is simply inadequate for many patients. While compressed visit times share part of the blame, I believe it is the emphasis on curative medicine during the traditional annual physical that causes less pressing preventive medicine to be overlooked and unaddressed. The promotion of the “annual wellness visit” is a response by insurance companies and health care providers to address our past failures at delivering preventive medicine. Since 2011, Medicare beneficiaries have had access to an annual wellness visit and other preventive services with no out-of-pocket cost. And after Jan. 1, all health care plans must now cover a common set of preventive health services, including an annual wellness visit, at no cost to patients. Parents are well accustomed to taking their children to the pediatrician for an annual “well child visit” and told to return as needed for “sick visits.” The same holds true for adults. The annual wellness visit is the time to update all of your recommended cancer screenings, immunizations, cardiovascular and bone density screenings, as well as discuss changes you can make in your lifestyle to improve your health. So don’t wait until you feel bad to see your doctor. Scheduling a wellness visit today is a simple and free step that can have an outsized impact on your future health. Mark M. Ryan is a practicing internist in the Primary Care Division of Woodlands Medical Specialists in Pensacola.
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