A Personalized Health Enhancement Program



A Personalized Health Enhancement Program

HealthTrends is a unique health promotion and disease prevention program that distinguishes itself from other health appraisals by computer- tracking the changes in your health over a period of years and alerting you when you be come at risk for a disease.

Close monitoring of such parameters as blood chemistries, diet, exercise level and life habits will be the key to discovering abnormal trends in your health.

From these tests, recommendations are made that should prevent many diseases and disabilities. These recommendations might include dietary modification, weight reduction, specific physical activities and/ or life-style changes. Implementation of recommended changes has the bonus effect of making you feel more energetic, alert, and productive.


The Initial HealthTrends visit consists of:

  • A complete medical history and physical by a physician.
  • 26 blood tests including HDL and LDL cholesterol, blood sugar, and thyroid
  • A urinalysis.
  • A stool check for bowel cancer (if over 40 years of age).
  • An extensive health questionnaire, food log and life stress-event test.
  • Optional testing includes:
    Electrocardiogram (ECG) , mammogram; pap smear, and additional blood tests as indicated.


The follow-up HealthTrends visit consists of:

  • A review of the physical, blood and urinalysis tests.
  • Multiple computer printouts which detail your good and bad health practices, disease risks, early cancer warning signs, your ideal body weight, and a stress report. Explanatory information accompanies each printout.
  • A diet analysis summarizing the sodium , potassium, cholesterol, saturated fat, and total calorie content of your diet and recommending the optimal caloric requirements for your stature.
  • An exercise prescription, tailored to your age and activity level.
  • For patients over 35, a cardiovascular risk assessment.


Annual testing is essential:

  • All this information is incorporated into a chart which is yours to keep and bring back yearly with each HealthTrends visit. At that time, the entire process will be repeated.
  • As time passes, we will accumulate enough of a database to make a graphic depiction of your changing health patterns. We will then make recommendations that, if followed, should reverse your disease risks and eliminate a future need for medicine.
  • A summary letter will highlight the information provided to you.
  • Cost: $195.00 (Medicare and private insurance accepted).


HealthTrends was created by:

Sanford J. Brown M.D. in accordance with his belief in preventive medicine. Dr. Brown is a family physician and founder of the Mendocino Foundation for Health Education.

As well as assessing individual well-being, health screening of employee groups is available for employers concerned with promoting wellness in the workplace.

For more information or to schedule an appointment call 707 964-9168, or fax 707 964-7243

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    Reprinted from Medical Economics, June, 1991

    How I Make the Annual Physical Really Worthwhile

    By Sanford J. Brown M.D.


The Doc chops wood to stay healthyA lot of people have never felt the need for an ongoing relationship with a physician. If you're like me, you see such people only occasionally- when they have flu, a sore throat, a sprained ankle. Or they may come to you one time and next time go to another doctor or the ER. But I've developed a program that involves them when they're well and helps keep them that way. Furthermore, they begin to think of me as their doctor, the person they can turn to when they do get sick.

Some of my regular patients who've often frustrated me by not taking care of themselves have also joined the program. Both groups are seeking preventive care. I've wanted to provide it since medical school, but until nine years ago, I never took the time to figure out how.

I call my program HealthTrends, and you could apply something like it to your practice. It has certainly rewarded me, both professionally and financially. And I think it's paying off for the participants in better health and reduced healthcare costs.

For 12 of my 20 years in practice, I did the usual: reminded patients to get their tetanus boosters, flu shots, Paps, mammograms, and so on. I diplomatically suggested that obese patients lose weight, that smokers desist, hypertensives avoid salt, and couch potatoes get up and exercise. I put up posters promoting breast-feeding, and auto safety for infant and child passengers.

I went further. Even before going to medical school, I'd published cartoon coloring books on such health problems as lead poisoning and sickle-cell anemia. So I wrote and illustrated a publication for my patients on the need for childhood immunizations. I distributed a quarterly newsletter. Some patients responded to one thing or another. Most didn't. And none of my efforts reached any non-patients.

Finally, I realized that to have an impact I needed a coherent plan that would monitor patient compliance and progress, and keep the participants committed to their own good health.

The personal computer, I decided, not only was good for billing and sending timely reminders, but could also be used for patient education. It was ideal for keeping track of changes in people's health. Therefore, I'd base my program on the computer.

If the computer was to be the skeleton of my plan, what would flesh it out? Here, it suddenly occurred to me, was a sound use for the annual physical. For years, I'd felt the routine yearly exam cost more than it was worth. But now I saw a reason for the annual exam-to monitor changes in people's health, as well as how their lifestyles affect their well-being.

The main question was whether people would be willing to pay for the kind of exam I was proposing. I soon found out: They certainly would. A lot of people don't know if their cholesterol, blood sugar, or blood pressure is too high. They have only a vague idea what they should weigh. They think they should be more active physically, but don't know the best kind of exercise. They wonder how the stress in their lives is affecting their health, and what to do about it. They want to know the health effects of what they eat. And they can't remember when they had their last hands-on physical. HealthTrends is designed to give them answers.

Its core is a computer-scored health-risk analysis. Before the patient comes in, he fills out a questionnaire that includes 102 questions on current and past medical history, additional questions on 43 stressful events that may have occurred during the past year, and a daily food log.

I charge $195 for the program, including an hour-long history and physical, with all testing appropriate to the patient's age, sex, and race. That fee also covers a 10- to 15-minute follow-up consultation, but not such optional tests as an ECG, mammogram, Pap smear, or lab tests beyond the cbc, urinalysis, stool guiac, and Chem 19. (The ECG, urinalysis, Pap smear, and stool guiac are done in-office.) There's also an optional physical-fitness test carried out by a physical therapist. Patients don't mind paying for the additional tests if I prescribe them.

Altogether, 150 variables are covered by the questionnaire and physical. The patient gets a 5- to 15-page computer printout detailing his favorable and unfavorable health factors, good and bad health practices, cancer risks and warning signs, a mean projected life expectancy, and 10-year mortality risk tables.

There are other printouts, which I developed from medical-education modules on hypertension and diabetes. These let us calculate ideal body weight, caloric requirements, and cardiovascular risks. The computer programs also analyze diet and generate an exercise prescription.

The printouts, along with explanatory flyers, go into a folder that the patient keeps. I write a covering letter summarizing the results of the physical exam and laboratory tests and concluding with suggestions for better health. The participant never has an excuse for not remembering what the doctor said; it's all there, including answers to the questions he was afraid to ask.

In the 12 months ending in August 1988, 80 people went through the program. There were 180 last year. At the present rate, there'll be more than 200 this year. About half of those who've entered the program in one year have returned the next. Nearly all of those who've done a second year have come back for the third exam.

New people enter nearly every week. They're recruited by word of mouth, from occasional talks I give, from our explanatory brochure, or from hearing my explanation when they come as new patients with episodic illnesses.

I developed the computer programs for all this, and I'm now creating a program to track trends by showing the participants the changing risk factors for any disease for which they have greater- than-average 10-year mortality risk. Thus we're beginning to make use of the 150 variables stored on each participant each year.

If a participant's health-risk analysis indicates he stands an increased chance of dying from an auto accident, for instance, my new program will go into his personal data base and pull out the factors responsible-the number of miles he drives each year, the percentage of time he wears his seat belt, the number of drinks he consumes each week. Some causes of mortality, such as atherosclerotic heart disease, have as many as 20 major and minor risk factors. A participant's risk factors are presented in graphic form, and in the follow-up session I stress the ones that the person could modify.

Participants range in age from 22 to 80 and include many Medicare patients. Where health insurers allow clients a yearly physical, I do a HealthTrends physical. In other cases, a diagnosis requires a comprehensive physical. And many of our patients pay for HealthTrends themselves, seeing it as low-cost health insurance.

Some participants who are employers ask me to put their workers through the program as a preventive measure. Each employee gets an individual assessment, and the employer receives an overall picture of the health of the workforce. This helps in directing health education to areas of real need. If employees score well, the employer will have an argument for reduced health insurance premiums.

One of my greatest satisfactions with the program comes when people actually change their habits. Occasionally a patient I haven't seen since the last annual exam comes back having lost 40 or 50 pounds. When I ask what inspired him, he replies that HealthTrends did: "I got tired of having my weight keep coming up as a risk factor."

I've always been drawn to health education and preventive medicine. Now I enjoy dealing with people who want to know how to remain healthy.

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