Not Too Much, Not Too Little

by Dr. Gail Amundson, Quality Quest for Health

Keeping up-to-date on preventive care screenings and immunizations is one way to take care of your health, but it can be challenging to get preventive care “just right.”

Studies show that very few Americans receive all of the important preventive services they need. The number of people who are “up-to-date” may be as low as five percent—just one in 20! Other studies show that many Americans receive more services than they need. In some cases, lots more.

How can both be true?

Some tests are done too often. “Physicians do too many Pap tests” reads the headline about a new study examining if doctors are following the recommended guidelines. In the case of Pap tests, they are not! Fully two-thirds got it wrong—and continue to recommend annual Pap tests. All guidelines recommend Pap tests once every three years unless a woman has a history of abnormal tests. Most do not.

Pap tests work really well. They save lives. Pap tests pick up early changes that can be treated before cancer develops. But once every three years provides plenty of time, because cervical cancer takes at least 10 years to develop. Almost all cases of advanced cervical cancer are among women who don’t get Pap tests or who haven’t had a test in a long time.

Annual Pap tests are a waste of women’s time and a waste of money. Not getting Pap tests puts women at risk of dying from cervical cancer. Preventive care should be “just right.”

Preventive care is a moving target. What an individual needs changes as he or she gets older. What men need and what women need may overlap, but clearly, not completely. And family history as well as one’s own personal history may change standard recommendations.

What seems like it should be simple can be very confusing.

You can use the Quality Quest Adult Preventive Care Calculator at qualityquest.org to learn what preventive services are “just right” for you—and recommend it to your employees, family members and friends. Just type in your age and gender and click the submit button. You will then see a list of recommended services that can be printed and taken to your next doctor's appointment to discuss with your physician.

The calculator is for adults 18 years of age and older. The recommended services are based on the Adult Preventive Care Guidelines from the Institute for Clinical Systems Improvement and the United States Preventive Care Task Force. The calculator is for people at average risk, which is most people. People with certain personal or family histories or with a chronic condition such as diabetes or heart, kidney or lung disease will need more services, or they may need the standard services more often. Your doctor can help you determine if the standard recommendations need to be changed for you. iBi