Prevention: A Century of Change
- Tom A. Elasy, MD, MPH, Editor-in-Chief
In the early part of the 20th century, a periodic health exam for prevention purposes became widespread. The notion of seeing your doctor on a regular basis, as a checkup, somehow gained acceptance during an era when most still believed “if it ain't broken, don't fix it.”
The American Medical Association (AMA) endorsed this prevention exam mindset in 1922, in part because life insurance policyholders who had this exam had a decrease in mortality: a classic example of selection bias.
Two Canadians, Frame and Carlson, wrote one of the first critical reviews of a component of prevention—screening—in 1975.1 What followed, in the form of a Canadian Task Force on the Periodic Health Exam (1979) and, a decade later, a U.S. Preventive Task Force on the Periodic Health Exam (1989), was a flurry of analysis about the quality and quantity of information and recommendations that …
