Coordinating Preventive Medicine in Patients With Inflammatory Bowel Disease: Whose Responsibility Is It Anyway?

Preventive medicine was a concept developed in the early 1970s in response to demands to control medical costs, as well as to improve the value, quality, and outcomes of health care delivery.1 The goals of this concept were to protect, promote, and maintain the health and well-being of patients, while preventing disease, disability, and premature death. The responsibility of health promotion and disease prevention fell on the patient's primary care physician who was able to stratify preventive measures based on the risk factors and existing diseases. Primary disease prevention is given to an asymptomatic individual (eg, immunization), secondary prevention is the treatment given to patients who already have developed risk factors or preclinical disease (eg, mammography), and tertiary prevention is targeted to symptomatic patients (eg, treatment of increased lipids in a patient who has had a myocardial infarct).