Feasibility and usefulness of family record cards in general practice

In order to determine the feasibility of family record cards in general practice a research secretary created cards for 1825 households from a practice of 10 600 patients. The capital cost was pound108 and the time taken by the secretary was 1638 hours, which is equivalent to a wage of pound1330 for a maximum grade secretary, assuming a 70% rebate paid by the family practitioner committee. Approximately six and a half hours of receptionist/secretarial time are needed each week to maintain the system. The doctors spent a mean of three minutes checking and completing the initial update of each card.Before the cards were introduced, most information about families was held in the doctors' heads, and little was written in the records even though the doctors considered family information relevant in 33% of consultations. After the introduction of family record cards the doctors had access to reasonably complete information about the family at 98% of consultations and the cards were used at 95% of consultations. The doctors believed the information was useful for establishing rapport, identifying patients' concerns, obtaining relevant history, forming diagnostic hypotheses and managing the present complaint. Trainees and locums found the cards more useful than principals.