Duke primary care specialists J. Brinkley Sugg, RN, FNP, Scott Joy, MD, and William Hebda, MD, answer a few questions about primary care.

J. Brinkley Sugg, RN, FNP

What do most people misunderstand about preventive medicine?

Sugg: Many patients believe that if they don’t feel bad, if they don’t have a family history, or if they don’t have any symptoms, then there is no need to do anything.

Hebda: Some people are afraid that if they go looking for “trouble,” they might find it. I tell them that yes, we might find a problem, but that is why we do it -- if we catch it early, we can usually take care of the problem without too much trouble.

Scott Joy, MDJoy: Most people think that prevention is more complex and time-consuming than it really is. Exercise, mammograms, colonoscopies, vaccines -- these are not complicated or flashy, but they are crucial to maintaining health.

What makes preventive care worth it?

Joy: Every dollar that is spent on preventive care saves about two to three dollars in medical costs over the long term. As a patient, how do you want to spend your money -- with prevention now, or with procedures or surgeries later on?

William Hebda, MDHebda: It’s the same reason we change the oil in our Toyota. Do we treat our car better than we treat ourselves?

Sugg: Preventive care is the cheapest, most effective, and most reliable way to maximize your ability to enjoy the things in life that truly matter to you -- whether that’s your family, career, faith, hobbies, or just being alive and well.

Will genomics play a role in preventive medicine?

Joy: It already is. Genetic testing that is currently available allows us to identify patients who are at higher risk for developing conditions such as diabetes, heart disease, and breast and prostate cancers.

Sugg: Genomics has the potential to “customize” preventive medicine for patients. We know a lot about preventive care by looking at large populations; genomics can provide a more sophisticated way to zoom in on specific individuals who are identified as being at higher risk.

Hebda: But it’s important to remember that environmental influences still play an important role. For example, your genes may show a risk for heart problems, but if you exercise and eat healthy foods and avoid cigarette smoke, you will mitigate or lower your risk.