Clinical Preventive Medicine
Clinical Preventive Medicine: Causing More Identity Crisis for Preventive Medicine or Helping to Manage the Crisis
In their article entitled “Preventive Medicine’s Identity Crisis” Jung and Lushniak1 eloquently addressed a long-lasting discussion on the identity of the specialty of preventive medicine (PM). In 2011, the identity crisis in the PM field became more acute for PM residency training programs when the Accreditation Council for Graduate Medical Education required all PM residents to have a minimum of 2 months direct patient care experience during each year of the program.2Author Response to “Clinical Preventive Medicine: Causing More Identity Crisis for Preventive Medicine or Helping to Manage the Crisis”
We agree with Drs. Hatef and Lam,1 who commented on our recent article, “Preventive Medicine’s Identity Crisis,”2 on a number of counts, first and foremost that preventive medicine is a clinical specialty—our practitioners are trained as clinicians and are fully capable of providing clinical care, whether preventive or acute. More importantly, they remind us that there has always been a clinical component of public health, from sexually transmitted disease clinics to provision of directly observed tuberculosis therapy, and these clinical services are unlikely to become unnecessary in the future.Letter Regarding the Impact of U.S. Preventive Services Task Force Recommendations in Breast Cancer Screening Trends
Dehkordy et al.1 performed an analysis of 4 years of data from the Behavioral Risk Factor Surveillance Survey (BRFSS) comparing screening mammography rates prior to and after the U.S. Preventive Services Task Force’s (USPSTF’s) 2009 revisions to its breast cancer screening guidelines, which withdrew recommendations that women aged 40−49 years have biennial mammograms.2 Dehkordy and colleagues’ analysis finds that mammography screening rates decreased from 2007 to 2012, whereas screening initiation rates at age 40 years increased during that period.Early Prevention and Screening of Cervical Cancer in a Developing Country
We have read with much interest an article recently published by Ekwueme et al.1 about the impact of the National Breast and Cervical Cancer Early Detection Program on cervical cancer mortality among uninsured low-income women in the U.S. Cervical cancer is a relevant issue in Peru, owing to its high incidence and mortality rate when compared with other countries.2 Despite being a fully preventable cancer with a clearly known pathogen, its early prevention and detection remains a problem in Peru, which is worsened by poverty conditions and inadequate access to health care, as well as unequal distribution of health workers among the country’s different regions.Early Prevention and Screening of Cervical Cancer in a Developing Country—Reply
Drs. Carvallo-Michelena and Rojas-Dominguez describe the importance of documenting the impact of cervical cancer screening programs and the relevance of impact measurement to low- and middle-income countries (LMICs) like Peru.Medical Student–Led Community Cooking Classes: A Novel Preventive Medicine Model That’s Easy to Swallow
The obesity epidemic and increasing rates of associated chronic diseases highlight the need for physician competency in clinical nutrition. The importance of this issue notwithstanding, only 19% of graduating U.S. medical students report readiness to offer adequate nutritional education to patients despite its demonstrated efficacy.1,2 Tulane University School of Medicine created The Goldring Center for Culinary Medicine as the world’s first known medical school–based teaching kitchen led by a physician and trained chef with a dedicated associated research team for monitoring outcomes.U.S. Preventive Services Task Force Diabetes Screening
To the Editor: In a recent AJPM article, Casagrande and colleagues1 attempt to make a case for altering the diabetes screening recommendation by the U.S. Preventive Services Task Force (USPSTF) based on the current recommendation’s low sensitivity in detecting previously undetected type 2 diabetes and other cardiovascular disease (CVD) risk factors that have a high prevalence in those with undetected diabetes. Although test sensitivity is one criterion to consider in assessing screening tests, it is not the most important.Newborn Screening in Jamaica: Inaccurate Reference
The current newborn screening program for sickle cell disease in Jamaica started in 1995 and encompasses three main hospitals on the island, which are responsible for ∼43% of births islandwide. Our paper titled “Newborn Sickle Cell Disease Screening: the Jamaican Experience (1995–2000)”1 was designed to evaluate this program and made comparisons with the well-known Jamaican Sickle Cell Cohort Study (JSCCS).2,3 It discussed the comprehensive care program allowed by screening, including early-life interventions such as penicillin prophylaxis from age 4 months as well as pneumococcal vaccination at age 4 years and general health maintenance measures (e.g., education, counseling, and nutrition).
