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The Power of Prevention

Author: Kirk Pappas, M.D.
February, 2015 Issue

Take a deep breath and look in the mirror: Where are you with your own prevention?

Just last week, I was speaking with one of my colleagues—one of our newest family medicine physicians—who’s so young that I’m old enough to be his father (but that’s a story for another column). He’s so happy and enthusiastic to care for all of his patients, including many, many new ones.
He related a story of a brand new patient to his practice who’d been without health care for more than 10 years. Now, he has health care through the Affordable Care Act and Covered California. At his initial visit, given his age, his new doctor ordered a few tests and a screening test for colon cancer. The test was found to be positive and, after colonoscopy, a localized cancerous lesion was removed completely.
We know this lesion had a fixed percentage chance of spreading each year it wasn’t found. No one actually knows how long the cancerous polyp had been there, including the patient.
Now take a deep breath and look in the mirror: Where are you with your own prevention?
The numbers are clear. For each of the common prevention tests, there are obvious benefits. For large communities such as our own county, we can do the math. We can study vast populations of patients screened (as we do at Kaiser Permanente with the help of our complete electronic medical record system) and then set goals to screen everyone. We can also know how many lives we can save.
This is part of what inspired my new colleague—setting goals for all of our patients. We know in our county that there are many thousands more people with access to health care and prevention than there was a year or two ago, just like my colleague’s patient.
The math is also clear for thousands of other people with new coverage. And it’s equally clear for the hundreds of thousands who have coverage already, some of whom are reading this (you know who you are).
• For every 900 women who are eligible to be screened for breast cancer, we can save a life.
• For every 1,100 women who are eligible to be screened for cervical cancer, we can save a life.
• For every 700 men and women who are eligible to be screened for colon cancer, we can save a life.
If there are, as some estimate, 50,000 more people in our North Bay counties with coverage in 2014 and another 30,000 or so possible in 2015, then you can do some quick math and see the value for all of us as a community.
Many, many lives will be saved. Maybe some of your own family members who now have access to care.
For those of you who smoke, or if you have a loved one who smokes, we only have to get 18 people to quit to save a life.
Some prevention seems less dramatic. For example, did you get a flu shot this year? If you didn’t, you’re taking a risk of getting sick. Someone might say, “Well, if it happens to me, then shame on me.” That’s one viewpoint, but we know that in communities around us, there are now epidemics of disease that can be prevented with vaccination. When one doesn’t vaccinate, he or she puts others at risk—including those who didn’t have the choice to refuse vaccination, or perhaps who haven’t received theirs yet. (See “The Vaccination Debate” for more information on this topic.)
Please take an opportunity to watch this two-minute video, titled “Protect Yourself and Your Family with the Flu Vaccine,” which provides insights into the reasons why it’s so important to get vaccinated.
With the Affordable Care Act and all of those fellow North Bay residents eligible for care, we all have a lot of work to do. Yet none of us in health care can do it completely for you. Each of you reading this needs to reach out to your personal physician about prevention.
For those of you who are Kaiser Permanente members, you can download the KP Preventive Care App for iPhone, iPad or Android. It's a health reminder app that gives you one less thing to think about when it comes to managing your health. With it, you can receive preventive health alerts and appointment reminders for you and your family, email your doctor (or your family’s personal doctors) with non-urgent messages, and more.
Perhaps your life—or that of a loved one—is counting on it. Be well.
Kirk Pappas, M.D., is a board certified physical medicine and rehabilitation doctor. He’s the physician-in-chief of the Kaiser Permanente Medical Center in Santa Rosa.


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