Search

Tetanus is a rare disease in the United States, which predominantly affects the elderly and who have a lower prevalence of tetanus immunity compared with younger age groups. A large proportion of the elderly have not received primary immunization for tetanus and do not receive recommended tetanus booster immunizations. Although expert panels support immunization of all persons, without an upper age limit, physicians either are unaware of or do not act on recommendations to immunize the elderly. Improved education of physicians and patients, emphasizing a case-finding approach, may reduce the number of tetanus cases in the elderly. Studies are needed to find ways to improve tetanus immunity in the elderly.

Once a major part of medical practice, physician house calls have declined in frequency over the years. Recently, it has been suggested that house calls are increasing. This study examined the current self-reported house call practices among recent graduates of family practice residency programs in the United States. A questionnaire was mailed to a cross-sectional, random national sample of 301 family physicians who are members of the American Academy of Family Physicians and who completed a residency between 1981 and 1986. There was a 66% response rate to three mailings, with 197 questionnaires analyzed. Sixty-two percent of the physicians reported they were making house calls. The majority (53%) made less than one house call per month. Fewer than 15% made house calls on a weekly basis. There was a downward trend by residency year in the percentage of physicians making house calls when comparing graduates from 1981 to 1986. House calls do not appear to be a significant part of the practice of young family physicians.