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Quaternary prevention


The quaternary prevention, concept coined by the Belgian general practitioner Marc Jamoulle, are the actions taken to identify a patient at risk of overmedicalisation, to protect them from new medical invasion, and to suggest interventions which are ethically acceptable.

Quaternary prevention is the set of health activities to mitigate or avoid the consequences of unnecessary or excessive intervention of the health system.

Social credit that legitimizes medical intervention may be damaged if doctors do not prevent unnecessary medical activity and its consequences. Quaternary prevention should take precedence over any alternative preventive, diagnostic and therapeutic, as dictated by the principle of primum non nocere.

Main idea: to avoid patient overdiagnosis and overtreatment.

Use: During all the episode of care (preclinical and clinical period).

It's the "actions taken to identify patients at risk of overtreatment, to protect them from new medical procedures and ethically acceptable alternative to suggest". The concept is included in WONCA's Dictionary of General and Family Medicine.

To do quaternary prevention is to say “no” to many considerably indecent proposals, and to offer prudent and scientific alternatives (“ethics of negation”, “ethics of ignorance sharing”). To do quaternary prevention is to exchange the fear exploited by healthcare malice for the feeling of knowing that what matters is the quality of life.

The intent of quaternary prevention is not to eliminate but rather to moderate the medicalization of the daily life, since a part of the aforementioned medicalization is not directly related to the medical intervention and has to do with social, cultural and psychologic reasons. Quaternary prevention is only about avoiding or palliating the medical part of the medicalization of the daily life.

To do quaternary prevention in clinical encounters is to comply with the scientific goal of Medicine, which aims for “the maximum quality with the minimum quantity, as close to the patient as possible”.

“To prevent is better than healing, when preventing is less harmful than healing”. To engage into quaternary prevention is to avoid the unnecessary curative and preventive activities. Every doctor-patient encounter should include quaternary prevention in order to avoid/limit the damage caused by the activity of the health system. To do it is to enforce the old motto primum non nocere.


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Wikipedia

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