Rather, these recommendations encompass those preventive services that have been examined by the Task Force and that have been shown to have satisfactory evidence of clinical effectiveness, based on the methodology discussed in the preceding chapter. At the same time, the preventive interventions listed are not exhaustive. Preventive services listed in each table are not necessarily recommended at every periodic visit. For example, although sigmoidoscopy is recommended for persons age 50 and over, it is not recommended annually even though periodic visits in this age group may occur once a year. The Task Force has not attempted to design a periodicity schedule for health supervision visits because for many interventions, evidence of an optimal periodicity is lacking.
Health maintenance needs to be considered at every visit.
For patients with limited access to care, the illness visit may provide the only realistic opportunity to discuss prevention. It is recognized that busy clinicians may not be able to perform all recommended preventive services during a single clinical encounter. Indeed, it is not clear that such a grouping is either necessary or clinically effective. If a sparser, evidence-based protocol is used, health maintenance can frequently be done during acute visits. Patients suffering from an acute illness or injury, however, may not be receptive to some preventive interventions.