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Reorganizing the Database: Prevention Through Risk Identification

David R. Gutknecht, MD
Arch Intern Med. 1991;151(7):1454-1458. doi:10.1001/archinte.1991.00400070196032.
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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


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