Find and Fix

The annual physical exam has never been productive from a health point of view. It contributed to the medical practice economic model and it gave people a sense of security. When the "recognize and respond" phase of medical care reached a point of diminishing returns there was need to develop a new philosophy. The "find and fix" phase of medical care based upon early detection and secondary prevention has yielded some health benefits but it is early and the learning curve is steep. The future promises the possibility of more cost effective programs. Meanwhile, community and public health based upon primary prevention for populations offers promise for cost effective improvement in health and deserves more attention. This will be disruptive to the medical care model but 30% of medical care may produce no health benefit and at least half of the health problems requiring medical care can be prevented. It appears reasonable to reduce the quantitative expansion of medical care and emphasize more focused qualitative medical care. This represents a change in mind-set and it will result in a transformation for society. There may be no time that society needed it more.