There are many ways in which cult medicine believers try to insinuate themselves into the health care system. As Dr. Gorski has pointed out, “prevention” is one of their metaphorical feet in the door. The cult medicine literature often says things like, “mainstream medicine is fine for treating acute illness, but what we do is prevention.” What they often leave out is the question of what “prevention” means, what the data on prevention is, and how to properly approach prevention. It’s likely that one of my co-editors will touch on this topic in a bit more detail, but let me give you an introduction to the topic of prevention.
Prevention is usually divided into three types: primary, secondary, and tertiary.
Primary prevention refers to the prevention of diseases and conditions before their biological onset. Examples of our most successful primary prevention interventions are clean water/sewerage and, ironically, vaccination. I say “ironically” of course because so many of the altmed folks who talk about prevention are anti-vaccine.
Secondary prevention refers to the search for diseases that have not yet progressed to the point of causing overt disease, and intervening to prevent overt disease. This includes things like Pap smears, which look for early cervical cancers (which could have been primarily prevented by vaccination), mammography, which looks for early breast tumors, and colonoscopy, which looks for early colonic neoplasms. Secondary prevention is sometimes used synonymously with “screening”.
Tertiary prevention refers to the prevention of progression of and complications from existing disease. For example, retinal and foot exams in diabetics prevent blindness and amputation very effectively.