What is preventative medical care and how can it help lower health care costs on the front lines of medicine?
Preventative medical care can take many forms. It can be identification and treatment of medical conditions such as high blood pressure and diabetes before complications of these common diseases develop. Identifying these conditions early helps to decrease costs of caring for the most severe complications such as heart and kidney disease. But in addition to this type of preventative medicine, there are preventative measures that can decrease the costs of surgical care as well.
Cancer screenings are the perfect example of a way to help decrease surgical costs. Breast cancer screening with mammogram not only saves lives and increases the survival of breast cancer patients. It helps identify the cancer at an earlier stage where treatments can be less invasive both before and after surgery. Aggressive skin cancer surveillance and mole removal can help identify pre-cancerous skin lesions and avoid larger more expensive surgical treatments. And colonoscopy as a screening tool can identify polyps before they become colon cancer. This can save health care dollars by avoiding surgery and/or post-operative treatments. There are other examples beyond cancer screenings.
Hernia repair is one of the most common operations performed by general surgeons. Surgical repair of a hernia accomplishes relief of often painful symptoms, but more importantly it prevents costly complications. When a hernia is repaired as a day surgery, the patient goes home the same day and has a fairly rapid return to work and daily activities. If complications of a hernia develop such as incarceration or strangulated bowel, it will generally require an emergency operation and a hospital stay increasing costs tremendously. The most common general surgical operation is perhaps the best example of how waiting for complications can increase costs.
Gallstones are common and laparoscopic removal of the gallbladder is the most common operation performed by general surgeons. If it is performed electively the results are 95-98% resolution of symptoms and rapid return to work activities. But like hernias the gallbladder can present with severe disease and complications that can increase costs. If infection in the gallbladder, cholecystitis develops, the operation is harder and the patient generally requires admission to the hospital. When complications such as infection develop, the operation is more likely to have to be done with an open incision. Identifying patients with symptomatic gallbladder disease and removing the gallbladder before complications develop is one of the best ways to keep costs of surgical care down.
So as we move forward with whatever our system of health care looks like, it is important to remember that preventative medical and surgical care is one of the simplest ways to help contain and decrease costs. Often procedures and screenings are weeded out as an unnecessary expense. It is important for patients to realize that many procedures help identify treatable conditions and can tremendously decrease the costs of health care.
Scott R. McDearmont, MD, FACS
Highland Village, TX
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