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An effective office organization for screening and follow-up of hypertensives can be simple. The physician must first adopt a policy of regularly taking blood pressures of patients who attend for any reason. Notations on the outside of the chart are a visible record and reminder. A tickler file with 12 monthly divisions provides an efficient follow-up system. There are no ethical barriers to instituting this approach.

To explore the association of monilia in infants and their mothers, the office charts of 45 mother-infant pairs were reviewed. There was a significant association (p

The Total Design Method (TDM) as offered by D.A. Dillman promises "guaranteed" 80% return rates for mail and telephone surveys. In a survey conducted in London, Ontario, a booklet-type questionnaire, introductory letter, return postcard and return stamped envelope were mailed to 185 family physicians. Non-responders were followed up one week after the initial mail-out with a reminder postcard, and three and seven weeks after the initial mail-out with replacement questionnaires. A return rate of 92.8% proved that the method was highly successful. The TDM is based on sound research principles and confirms that when attention is paid to administrative detail, high response rates can be achieved from difficult subjects.

As the initial step of a large randomized trial to test a new strategy of caring for hypertensive patients, the state of blood pressure screening was studied in 34 community-based family practices in southwestern Ontario. The charts of all active adult patients, 20-65 years of age, were reviewed.At least one blood pressure reading was recorded in the last five years for 71% of the 40,453 patients. The proportion of patients screened increased with age; in each age group, a greater proportion of females than males had been screened. Overall, 8.9% of males and 9.6% of females were labelled hypertensive. The rate of patients so labelled increased with age to a maximum of 30% of the 55-65 age group. More than 50% of patients with diastolic pressures over 105 mm Hg were not taking hypotensive drugs.

The defining features of family medicine as described in the literature have important ethical implications. In an attempt to study the day-to-day practice of family physicians regarding these ethical issues, a 28-item questionnaire was sent to 95 part-time and 17 full-time family physician teachers associated with the University of Western Ontario's Department of Family Medicine. Of the 112 questionnaires mailed out, 97 were returned for a response rate of 86.6 percent. There was a significant spread of answers, suggesting there is no uniform opinion in the sample population. The findings suggest that there are important differences between the description of family medicine in the literature and what the family physicians in this study do in their day-to-day practice. The family physicians in this study, while prepared to coerce patients, were not prepared to discharge from their practices patients who were noncompliant. Physician age is an important variable in some ethical decisions, but not in others.

At a time of controversy about the appropriate use of obstetric ultrasound, this study explores the effect of availability on ultrasound use. Using a historical cohort design with chart review, pregnancy ultrasound rates were compared between two teaching family-medical centres, one with on-site ultrasound facilities and one without. Pregnant patients at the centre with on-site facilities (n=23) were 2.2 times more likely (p