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Prevention

The New Health Paradigm

DISEASE MANAGEMENT Volume 4, Number 2, 2001
E.J. BalbonaMD


The New Paradigm


In medical school we were taught that the point at which a patient needed our help was with the onset of symptomatic disease.


Today we know better....


Physicians are increasingly cognizant of the limitations of the current disease-focused paradigm. Growing dissatisfaction with the status-quo creates a unique opportunity to revolutionize and improve our model of medical care.


Standard medical practices consist almost entirely of palliation, care that is not curative and will not correct the underlying disease process. This how we as profession respond to cardiovascular disease, osteoporosis, arthritis, diabetes, and a host of other medical conditions. To be blunt, this approach is fundamentally flawed. Despite arguments to the contrary, late stage intervention such as heart bypass surgery, joint replacements, organ transplants, and so forth, represent examples of the utter failure of modern medicine to prevent or cure disease.


Our fixation with this mode of medicine management does nothing to lower the incidence of the disease in question. Thus, the next cohort in the population is ultimately destined to suffer in an identical way, from the identical disease. These healthy "appearing" pre-symptomatic individuals hold little interest for the health­ care bureaucracy and are essentially doomed to suffer the same devastating and costly complications as those who came before them.


Is it really revolutionary to suggest that the best care we can provide is to care enough to never allow our patients to become ill in the first place?


After the initial discovery of individuals who were destined to become ill at some point in the future, the consequences of the disease (such as death) can be dramatically altered. This argument can be made for cardiovascular disease, osteoporosis, diabetes, and cancer.  Identification of the individuals at risk rather than the risk factors after disease is well established.  


Is this a better way to practice medicine?  The answer... is YES.


In the not so distant future physicians will aggressively seek out and proactively prevent disease. They will take a new interest in the objective analysis of health status and provide guidance for wellness management. Advances in medical technology and our understanding of the human genome will only accelerate this process. Politicians, employers, insurers, and physicians will accept the fact that the illness that never occurs is the one that has received optimal care.



This is the new medical paradigm. 

With it we have the opportunity to create a future of
better health for generations to come.



Eduardo J Balbona M.D.