Prescription for Health: Changing Primary Care Practice to Foster Healthy Behaviors

It is well proven that 4 health risk behaviors – smoking tobacco, risky alcohol consumption, unhealthy diet and physical inactivity – cause premature disease, disability and death and massively increase the fiscal burden of health care. What has not been well known is whether systematically applied techniques in contemporary primary care practice can stimulate and assist patients to modify or abort their risky behaviors. This information deficit must be corrected so that both private insures and government payers will have a fiscal interest in funding office based preventive strategies.

Prescription for Health (P4H) addresses this challenge directly. Each of the Round 1 P4H papers addresses 2 or more of these risky behaviors. Taken together, they demonstrate that innovative strategies can be effective with feasible modifications in existing primary care practices. They show that a variety of techniques succeed in many diverse demographic and fiscal primary care settings. Moreover, many of the projects prove their success by using both practice and existing community based resources.

Even more exciting is the prospect that Round 2 P4H research just getting underway in 10 practice based primary care networks around the country will examine more comprehensive preventive care management strategies for all 4 risky behaviors. By using many common patient selection and program evaluation methods, these projects will learn more about which techniques work best, both in general and in specific populations. Further, analysis by a health economist will identify preliminary information about the incremental cost of the interventions in the existing practice setting.

At a time when we intuitively “know” that modifying these behaviors will both improve health and reduce costs, P4H is leading the way to learning what works and how to incorporate it in the existing and future primary care practice settings. Kudos!

Morris B. Mellion, M. D. Associate Medical Director, Blue Cross and Blue Shield Association; Past President, American Academy of Family Physicians

Competing interests:   None declared