Records and prevention for the beginner.

'"THE importance of preventive care1 and good rec-^ ords2 in contemporary general practice is reflected in the aims of vocational training schemes.3 New princi¬ pals, fresh from their trainee year, may encounter frustration in these areas because their new partners do not share the same priorities. The aim of this study was to determine how much improvement to clinical records and preventive care a principal could reasonably carry out during his first year in practice. Method The study period of 12 months started on 1 March 1981. The author's first month in practice (February 1981) was excluded as a settling-in period. The practice comprises three full-time principals, a practice sister (part-time) and secretarial staff who work from private premises in an urban area in north Kent and serve a combined list of 7,000 patients. However, the partners are working towards a system of personal lists and only patients on the author's list were included in the study, although he saw many of his partners' patients over the year. During the study year the author's list grew from 1,800 to 1,980 patients. Clinical notes were put in chronological order and the patient's history was summarized on one side of an FP7A form. Repeat prescriptions were written on an FP7B form.4 Contraceptive advice was noted on a specially designed card. For a short diagnostic index, separate pages of a loose-leaf file were headed with 18 of the major chronic conditions.for example, diabetes, hypertension. The patient's name was written on the appropriate sheet when a diagnosis had been entered on the FP7A summary card mentioned above. A rubber stamp was made for printing a six-item list in the margin of the reverse side of the summary card: blood pressure, smoking, weight, dietary roughage, rubella status, cervical smear.5 Details were recorded on the same sheet, together with the date: blood pressure and weight were measured and advice was given on smoking and dietary roughage. Female patients in the age range 20-64 years were referred to the practice sister for a cervical smear if they had not had one in the previous five years. Girls aged 10-14 years who had not received rubella immunization were referred to the practice sister, and young women (14-35 years of age) whose rubella immunity was in doubt were referred for laboratory tests. The number of patients seen, their age, sex and details of preventive measures were recorded separately at …