Most people go to their doctor when they’re ill. I prefer to see patients when they’re feeling healthy. That way, I can identify any early signs of underlying medical issues. If so, most of the time the problem is preventable and even treatable before any long-term damage occurs. Yet this concept—the practice of preventive medicine—is still not widely known by patients or supported among mainstream primary care settings.
The U.S. Preventative Services Task Force is trying to help fix that. The Task Force makes recommendations about which preventive services, such as screenings, counseling services or preventive medications, should be incorporated routinely into primary medical care. In theory, the guidelines based on a collection of analysis seem on track; however, in practicality, they don’t often work because they fail to consider the individual perspective.
I know that no test is perfect. But when you test over time, you can get a better understanding of the trends and know what to look for. That’s where 40 years of experience and expertise at Cooper Clinic makes all of the difference. There are two Task Force guidelines that I specifically take issue with.
My father and preventive medicine pioneer, Dr. Kenneth H. Cooper, was the first physician to use treadmill stress testing in Dallas. Since then, Cooper Clinic recommends an exercise stress test beginning at age 40, a decade earlier than the Task Force advises. Why? Very often the first symptom of heart disease is a heart attack. The stress test is a reliable way to look for underlying problems with the heart, values, and blood flow. Plus it tells us a person’s fitness level, which is a contributing factor to overall health.
Another test we recommend for male patients, opposite the Task Force, is prostate-specific antigen (PSA) testing. For men, this is an important preventive tool to evaluate prostate health and determine the risk of cancer. Prostate cancer is the No. 2 cancer killer in men. And since PSA testing has been available, there has been a 25 percent reduction in annual prostate cancer deaths in men in the United States. I recommend PSA testing for my patients on an individual basis, and for many of my patients, the result has been early detection of cancer.
Ultimately, preventive testing is about finding disease early when it’s most treatable. It not only saves lives, but also has the potential to save our country millions of dollars.
My father says an annual comprehensive physical exam is the best health insurance you can buy. It’s time for all Americans and primary medical practices to take a new look at preventive medicine.
Tyler C. Cooper, MD, MPH, is CEO of Cooper Aerobics Enterprises.