Clinical Preventive Medicine
- LAST REVIEWED: 26 January 2022
- LAST MODIFIED: 30 September 2013
- DOI: 10.1093/obo/9780199756797-0117
- LAST REVIEWED: 26 January 2022
- LAST MODIFIED: 30 September 2013
- DOI: 10.1093/obo/9780199756797-0117
The clinical practice of preventive medicine has long been the dream of many who have believed that its promise is too great to ignore. But the actual history of clinical preventive medicine has been much more complex, and often much less rewarding, than these dreamers anticipated. Humanitarians have believed that its promise was in preventing, delaying, decreasing, or eliminating the pain and suffering that accompanies most morbid conditions, while government officials, insurance executives, and economists have more often focused on the potential cost savings it appears to promise. In the journey toward that promise, clinical preventive medicine has gone through several evolutionary changes as it rather unsuccessfully has attempted to define and promote itself in a more attractive and convincing manner to the practicing clinician. Three major complications have hampered its progress and acceptance in the medical community. First, the attractive insinuation that clinical preventive medicine would lead to cost savings has put it in the unenviable position of being measured and judged solely by its economic benefits, a disadvantage not shared with most other clinical modalities. When those savings have not been forthcoming, or when they have not been as great as expected, the medical community and health-care payers have been quick to discount its value. Second, unlike many bodies of medical knowledge that fall cleanly under the purview of a specific medical specialty, the practice of clinical preventive medicine intersects with the practice of almost all of the recognized medical specialties as well as with many other professional fields, both clinical and nonclinical, outside medicine. The knowledge, skills, and competencies required to practice clinical preventive medicine are oftentimes intensive, both in acquisition and provision (e.g., counseling and patient education), and they are either poorly remunerated or may be better provided by ancillary staff, such as nurses, dietitians, exercise physiologists, or behavioral scientists. Defining the unique and appropriate role of the physician in clinical prevention continues to be a point of deep debate and discussion in the medical community. A transformational change in this area may be occurring, however, as a growing number of physicians who claim to be practicing what is being called “lifestyle medicine” take on and greatly expand the scope of what has traditionally been called the practice of clinical preventive medicine. And finally, those who practice alternative and complementary medicine have been very successful in capturing and proclaiming the promise of clinical prevention to the media and lay public while often neglecting or bypassing the rigor required to ensure that their practices are based on scientific evidence.
The sweep of clinical preventive medicine is well represented by the works given here. Stokes, et al. 1982 defines the terms that are used in the field and describes the general concepts on which the field has been built, defining clinical preventive medicine as “those personal health services, provided within the context of clinical medicine,” by which health is maintained and disease risk and untimely death are reduced. The extent of preventable disease and death in the United States is described in McGinnis and Foege 1993 in a novel and thought-provoking manner, and the seminal works Frame and Carlson 1975 and Breslow and Somers 1977 establish guidelines and schedules to formalize the periodic health examination, in a move away from the traditional annual physical examination. Canadian Task Force on the Periodic Health Examination 1979 took this field to new levels of scientific rigor by setting strict standards for the acceptability of various levels of evidence and utilizing a meticulous methodology in reviewing an increasing list of suggested and recommended screening tests. All subsequent activities of the US Preventive Services Task Force, the Canadian Task Force on Preventive Health Care, and the numerous specialty association guideline production committees truly stand on the shoulders of the original work of the Canadian Task Force on the Periodic Health Examination.
Breslow, Lester, and Anne R. Somers. 1977. The lifetime health-monitoring program: A practical approach to preventive medicine. New England Journal of Medicine 296.11: 601–608.
This article further refined recommendations for ethical periodic screening examinations, and added more economical insights into the evidence on which those recommendations were based.
Canadian Task Force on the Periodic Health Examination. 1979. The periodic health examination. Canadian Medical Association Journal 121.9: 1193–1254.
This article exponentially expanded the scope of services reviewed and recommended, and it established the “most rigorous, detailed and comprehensive evaluation of the periodic health examination to date.” It also refined the definitions used in the field, and it set detailed criteria for the assessment of potentially preventable conditions that are the basis of all further work in this area.
Canadian Task Force on Preventive Health Care.
The site of the reconstituted Canadian Task Force, with additional interventions reviewed and updates refining the work of the first group.
Frame, Paul S., and Stephen J. Carlson. 1975. A critical review of periodic health screening using specific screening criteria. Part 1: Selected diseases of respiratory, cardiovascular, and central nervous systems. Journal of Family Practice 2.1: 29–36.
First of four articles that reviewed the literature on the periodic health screening up to this point, and that redefined it on a scientifically sound basis. Defined the criteria needed to justify screening programs, and formulated recommendations based on those criteria. Series continued in the Journal of Family Practice 2.2: 123–129 (Part 2: Selected Endocrine, Metabolic, and Gastrointestinal Diseases); 2.3: 189–194 (Part 3: Selected Diseases of the Genitourinary System); and 2.4: 283–289 (Part 4: Selected Miscellaneous Diseases).
McGinnis, J. Michael, and William H. Foege. 1993. Actual causes of death in the United States. Journal of the American Medical Association 270.18: 2207–2212.
Creatively moved behind the leading cause of death indicators to focus on the true or “actual” causes of those deaths, thus opening a new vista on how such deaths might be prevented.
Stokes, Joseph, III, Jay Noren, and Sidney Shindell. 1982. Definition of terms and concepts applicable to clinical preventive medicine. Journal of Community Health 8.1: 33–41.
This article by a committee of the American Teachers of Preventive Medicine Foundation helped set the stage for clinical preventive medicine by clarifying the definitions and terms that are used in the field.
US Preventive Services Task Force.
This site continues the work of the original task force by updating recommendations based on new information and by increasing the number of interventions reviewed.
US Preventive Services Task Force. 1989. Guide to clinical preventive services: An assessment of the effectiveness of 169 interventions. Baltimore: Williams & Wilkins.
Working on the foundation set by the Canadian Task Force on the Periodic Health Examination, this guide expanded the number of interventions reviewed and formalized the evidence-based criteria needed for such a review.
Users without a subscription are not able to see the full content on this page. Please subscribe or login.
How to Subscribe
Oxford Bibliographies Online is available by subscription and perpetual access to institutions. For more information or to contact an Oxford Sales Representative click here.
- Access to Health Care
- Action Research
- Active Aging
- Active Living
- Adolescent Health, Socioeconomic Inequalities in
- Adolescent Risk-Taking Behavior in the United States
- Advocacy, Public Health
- Agricultural Safety and Public Health
- Air Quality: Health Effects
- Air Quality: Indoor Health Effects
- Alcohol Availability and Violence
- Alternative Research Designs
- Ambient Air Quality Standards and Guidelines
- American Perspectives on Chronic Disease and Control
- Antimicrobial Resistance (AMR)
- Arts in Health
- Asthma in Children
- Asthma, Work-Related
- Attachment as a Health Determinant
- Behavior Change Theory in Health Education and Promotion
- Behavioral Risk Factor Surveillance
- Bicycling and Cycling Safety
- Birth and Death Registration
- Birth Cohort Studies
- Board of Health
- Built Environment and Health, The
- Business and Corporate Practices
- Cancer Communication Strategies in North America
- Cancer Prevention
- Cancer Screening
- Capacity Building
- Capacity Building for NCDs in LMICs
- Capacity-Building for Applied Public Health in LMIC: A US ...
- Cardiovascular Health and Disease
- Child Labor
- Child Maltreatment
- Children, Air Pollution and
- Children, Injury Risk-Taking Behaviors in
- Children, Obesity in
- Citizen Advisory Boards
- Climate Change and Human Health
- Climate Change: Institutional Response
- Clinical Preventive Medicine
- Community Air Pollution
- Community Development
- Community Gardens
- Community Health Assessment
- Community Health Interventions
- Community Partnerships and Coalitions
- Community-Based Participatory Research
- Complexity and Systems Theory
- Cultural Safety
- Culture and Public Health
- Definition of Health
- Dental Public Health
- Design and Health
- Dietary Guidelines
- Directions in Global Public Health Graduate Education
- Driving and Public Health
- Ecological Approaches
- Enabling Factors
- Environmental Health, Pediatric
- Environmental Laws
- Environmental Protection Agency
- Ethics of Public Health
- Evidence-Based Pediatric Dentistry
- Evidence-Based Public Health Practice
- Family Planning Services and Birth Control
- Food Safety
- Food Security and Food Banks
- Food Systems
- Frail Elderly
- Functional Literacy
- Genomics, Public Health
- Geographic Information Systems
- Geography and Health
- Global Health
- Global Health Diplomacy
- Global Health Promotion
- Global Health Security
- Guide to Community Preventive Services, The
- Health Administration
- Health Communication
- Health Disparities
- Health Education
- Health Impact Assessment
- Health in All Policies
- Health in All Policies in European Countries
- Health Literacy
- Health Literacy and Non-Communicable Diseases
- Health Measurement Scales
- Health Planning
- Health Promoting Hospitals
- Health Promotion
- Health Promotion Foundations
- Health Promotion Workforce Capacity
- Health Promotion Workforce Capacity
- Health Systems of Low and Middle-Income Countries, The
- Healthy People Initiative
- Healthy Public Policy
- Hepatitis C
- High Risk Prevention Strategies
- Human Rights, Health and
- Human Sexuality and Sexual Health: A Western Perspective
- IANPHI and National Public Health Institutes
- Immigrant Populations
- Immunization and Pneumococcal Infection
- Immunization in Pregnancy
- Indigenous Peoples, Public Health and
- Indigenous Populations of North America, Australasia, and ...
- Indoor Air Quality Guidelines
- Infant Mortality
- Internet Applications in Promoting Health Behavior
- Intersectoral Action
- Intersectoral Strategies in Low - Middle Income Countries ...
- Justice, Social
- Knowledge Translation and Exchange
- Knowledge Utilization and Exchange
- Law of Public Health in the United States
- Media Advocacy
- Mental Health
- Mental Health Promotion
- Migrant Health
- Migrant Worker Health
- Motor Vehicle Injury Prevention
- Multi-Drug-Resistant Tuberculosis
- National Association of Local Boards of Health
- National Public Health Institutions
- Needs Assessment
- Needs Assessments in International Disasters and Emergenci...
- Obesity Prevention
- Occupational Cancers
- Occupational Exposure to Benzene
- Occupational Exposure to Erionite
- Occupational Safety and Health
- Occupational Safety and Health Administration (OSHA)
- Oral Health Equity for Minority Populations in the United ...
- Ottawa Charter
- Parenting and Work
- Parenting Skills and Capacity
- Participatory Action Research
- Patient Decision Making
- Pesticide Exposure and Pesticide Health Effects
- Physical Activity and Exercise
- Physical Activity Promotion
- Polio Eradication in Pakistan
- Population Aging
- Population Determinants of Unhealthy Foods and Beverages
- Population Health Objectives and Targets
- Precautionary Principle
- Prenatal Health
- Program Evaluation in American Health Education
- Program Planning and Evaluation
- Public Health, History of
- Public Health Surveillance
- Public-Private Partnerships in Public Health Research and ...
- Public-Private Partnerships to Prevent and Manage Obesity ...
- Quantitative Microbial Risk Assessment
- Racism as a Structural Determinant of Health
- Radiological and Nuclear Emergencies
- Randomized Controlled Trials
- Real World Evaluation Strategies
- Reducing Obesity-Related Health Disparities in Hispanic an...
- Research Integrity in Public Health
- Resilient Health Systems
- Rural Health in the United States
- Safety, Patient
- School Health Programs in the Pacific Region
- Sex Education in HIV/AIDS Prevention
- Skin Cancer Prevention
- Smoking Cessation
- Social Determinants of Health
- Social Epidemiology
- Social Marketing
- Statistics in Public Health
- STI Networks, Patterns, and Control Strategies
- Sustainable Development Goals
- Systems in the United States, Public Health
- Systems Modeling and Big Data for Non-Communicable Disease...
- Systems Theory in Public Health
- Traditional, Complementary, Alternative, and Integrative M...
- Translation of Science to Practice and Policy
- Traumatic Stress and Post-Traumatic Stress Disorder
- Tuberculosis among Adults and the Determinants of Health
- UK Public Health Systems
- Unintentional Injury Prevention
- Urban Health
- Vaccination, Mandatory
- Vaccine Hesitancy
- Violence Prevention
- Water Quality
- Water Quality and Water-Related Disease
- Weight Management in US Occupational Settings
- Welfare States, Public Health and Health Inequalities
- Worksite Health Promotion
- World Health Organization (WHO)