To the Editor.—
Sheagren et al are to be congratulated for their recent article1 describing a problem- and risk-oriented database! Their model shows that a preventive encounter may be as challenging as a diagnostic one, something we have recognized for a long time.Since 1983, the focus in the periodic examinations of our executive health program has shifted from disease orientation ("documentation of demise") to an emphasis on prevention through risk identification. A patient-completed prevention-oriented questionnaire developed for that program now enjoys use as an intake instrument in many of our medical clinics. The development of that questionnaire was a lesson in itself, heightening our awareness of the myriad risks that lurk in patients' environments, medical experiences, life-styles, and family closets. The questionnaire is not perfect, and already needs updating, but is taking us in the right direction.A healthy emphasis (pun intended) on these issues is also found
Gutknecht DR. Reorganizing the Database: Prevention Through Risk Identification. Arch Intern Med. 1991;151(7):1454–1458. doi:10.1001/archinte.1991.00400070196032
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