Treating the Cause

Preventive services are generally not recommended or adopted unless they are cost-effective in the population in which they are to be implemented. Since preventive services accrue their benefit primarily by reducing costs from morbidity and mortality, this cost-effectiveness criteria is reasonable. Treatment services, on the other hand, are recommended and adopted when there is an evidence-based medical indication for treatment. The presence of morbidity constitutes a sufficient medical indication for applying an intervention proven to improve, reverse or ameliorate the disease or its symptoms. Costs play a very different role in determining treatment services as opposed to preventive services. This difference is poorly understood as it pertains to the practice of clinical LM, and the confusion is inappropriately limiting the application of proven lifestyle interventions in the treatment of patients with existing disease.