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February 3, 1993

Preventive Medicine for Our Ailing Health Care System

Author Affiliations

From the Department of Medicine, Harvard Medical School and Massachusetts General Hospital, Boston, and Department of Medicine, VA Medical Center, Brockton/West Roxbury, Mass.

JAMA. 1993;269(5):616-618. doi:10.1001/jama.1993.03500050094032

AS THE national debate about our health care system intensifies, it is timely to raise some important issues that should be seriously considered. I refer to the need for more preventive medicine, which should be part of the national debate, but with other basic problems may be passed over in the haste to deal just with cost issues. My aim is not to review the potential health benefits of preventive medicine but to indicate how health promotion should be an essential ingredient combined with curative medicine to create a comprehensive health care system. Although preventive medicine is not solely the domain of physicians, physicians should lead its practice. Preventive cardiology will be considered because heart disease continues to be the leading cause of premature death in our society, because the current practice of cardiology is a major item in our health costs, and because much is known about how to