• James W Mold, Darren A DeWalt, and F Daniel Duffy.
• From the University of Oklahoma Health Sciences Center, Chapel Hill, NC (JWM); Division of General Medicine and Clinical Epidemiology, University of North Carolina School of Medicine, Chapel Hill, (DAD); Internal Medicine and Medical Informatics, University of Oklahoma-Tulsa School of Community Medicine, Tulsa (FDD). jameswmold@gmail.com.
• J Am Board Fam Med. 2023 Apr 3; 36 (2): 333338333-338.

AbstractPrevention does not fit well within our problem-oriented medical paradigm in which the focus is on curing or ameliorating existing diseases. It is easier and more satisfying to solve existing problems than it is to advise and motivate patients to implement measures to prevent future problems that may or may not occur. Clinician motivation is further diminished by the time required to help people make lifestyle changes, the low reimbursement rate, and the fact that the benefits, if any, are often not apparent for years. Typical patient panel sizes make it difficult to provide all of the recommended disease-oriented preventive services and to also address the social and lifestyle factors that can impact future health problems. One solution to this square peg-round hole mismatch is to focus on the goals, life extension and prevention of future disabilities.© Copyright by the American Board of Family Medicine.

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