Altman, Lawrence K. "A Profession Divided Is Finding It Hard to Teach Prevention," New
York Times 14 August 1990, p. C3.
The medical profession, it is here reported, is divided between those who are clinicians and
focused on dealing with disease and those focused on prevention and the maintenance of health.
Promoters of health are interested in changing the focus on disease but the going is rough for
several reasons identified here: 1) insurance coverage is for "treatments" given not for prevention
counselling; 2) medical education does not stress prevention but stresses curing illness; 3)
historically, people go to physicians for aches and pains but only recently for shots and
counselling. However, there are forces at work to change this: the costs of medical care are such
that something has to be done. Emphasis on prevention is one of those things. The problem with
preventive medicine is that it is not professionally "in" as a concern.
In medical academics, research is the pathways to success. In medical testing (the national tests)
only 1 in 12 sections concerned prevention. Faculty at medical schools resist change and will not
accept a new emphasis on preventive medicine.
The article ends with this point: there is no immediate payoff for the expert in preventive
medicine. The physician can see of paralytic walk, the nearly dead patient revive, and the sick
cured. The expert in preventive medicine has no such glory. (Yet, heroics in prevention is not
unknown. One of my heroes is Joe Goldberg and his variety of prevention was certainly not
without heroics, real heroics.)