The Bale/Doneen Method was developed by Bradley Bale, MD and Amy Doneen, ARNP for the prevention of heart attacks and ischemic strokes. This method is now being integrated into primary care clinics and specialty clinics around the nation. The Bale/Doneen Method delivers evidence-based medical care using a system anchored in the disease of atherosclerosis rather than the standard practice of basing care solely on risk factors. Decisions for assessment and treatment are based on the presence of atherosclerosis and the impact on the atherosclerotic process.

There are six basic elements to the method:

1. Education:
   Every patient is informed about the disease state of atherosclerosis and is taught that a thrombus actually blocks the flow of blood in most heart attacks and ischemic strokes.
2. Disease:
   Each patient is evaluated for the presence of atherosclerosis or an accelerated atherosclerotic process, using non-invasive office based techniques to find asymptomatic vascular disease. Additionally, all patients are monitored annually with a carotid intima-media thickness test to follow the atherosclerotic disease over time in the individual patient.
3. Inflammation:
   Biomarkers are utilized to routinely assess and monitor the inflammatory state of the vascular system.
4. Root Causes:
   The root cause or causes of the atherosclerotic process are uncovered and then aggressively managed.
5. Optimal Goals:
   Therapeutic targets are set based on peer-reviewed, reliable research and guidelines.  Our goals are aggressive in an attempt to
   minimize risk. As a result, they often go beyond the values set for the standard of care.
6. Genetics:
   Genetic information is obtained on patients to aid in the assessment of their CV risk and to help guide therapy.  This allows for a very personalized
   approach to maintain health and wellness.  This aspect is rapidly expanding, affording the opportunity to continually enhance individualized management.