I hear this phrase a lot in my practice and although it always gives me a smile, it also leaves me wondering if we can do something different to change people’s perception about preventive healthcare. Anyway, where did this phrase come from? I looked it up and it turns out that the present-day wording began in the early 1970’s and it was popularized by T. Bert Lance, the Director of management and budget in Jimmy Carter’s 1977 administration when he was quoted saying that he can save uncle Sam billions if he can get the government to adopt a simple motto: “if it ain’t broke, don’t fix it.”
It seems that Mr. Lance never heard of “ Live sensibly- among a thousand people, only one dies a natural death, the rest succumb to irrational modes of living” a famous Maimonides saying back in the 12th century, or that an ounce of prevention is worth a pound of cure.
Most people would prefer never to contract a disease or if they cannot avoid an illness, they prefer that it be caught early and stamped out before it causes them any harm. And that’s the whole idea of prevention. So to accomplish this, people without specific complaints undergo interventions to identify and modify risk factors, to avoid the onset of disease, or to find disease early in its course so that early treatment prevents sickness. Types of clinical prevention include immunizations that start since infancy, screening for cancers or high blood pressure, counseling about quitting smoking or taking an aspirin in high risk people to prevent heart attacks and strokes.
I’ll give a specific example which is screening for colon cancer. Although it is the second most commonly diagnosed cancer in women and third most common in men, and it causes around 600,000 deaths yearly and it has been proven that checking stools for blood or doing scopes reduce mortality, people are still very reluctant to address it. I have to admit that around 1250 scopes have to be performed to prevent one colon cancer death but think about it like getting insurance to your car, or house, or like giving your kids immunizations. It’s a risk you’re taking, but it’s a one that can kill you!