Background
: In Korean family medicine, 73.3~76.4 percent of three year resident training time is spent in outside rotations with other specialties. But there has been no study which investigated the attitudes of family medicine faculties, residents, and non-family medicine specialists regarding the contents of family medicine resident training rotations, such as whether a family physician should perform Caesarean section, etc. In order to achieve a family medicine program whose content is based on the consensus of family medicine faculties, residents, and nonfamily medicine specialists, we compared the attitudes of these groups toward various components of family medicine resident training in internal medicine, pediatrics, general surgery, obstetrics-gynecology, and psychiatry which account for 68.5% of outside rotations of family medicine resident training programs.

Methods : A questionnaire was sent to 679 family medicine faculties, family medicine residents and non-family medicine specialists in 21 different family medicine centers and related hospitals. Total response rate was 57.6%.

Results : Significantly more numbers of non-family medicine specialists felt that various skills and tasks should not be performed by family physicians. Family medicine residents and family medicine faculties were generally similar to each other in their attitudes toward training in various skills and tasks, but, in some elements of psychiatric training, more family medicine faculties failed to see the need for such training compared with family medicine residents.

Conclusion : In many elements of family medicine resident training, family medicine faculties and nonfamily medicine specialists do not agree. In order to resolve this problem, it is urgent to establish a curriculum, which is agreed upon between by family medicine faculties, residents, and nonfamily medicine specialists who are involved in the training of family medicine residents.

Background
: Recently, the traffic accidents are increasing and the frequency of the fracture of femoral shaft has been increased in children. The fracture of femoral shaft in childhood will cause disturbance of ambulation and daily life, because the abnormality of bone growth after fracture will influence the length of leg. So it is very important to manage and evaluate such patients continuously before they have reached adolescence. So, we had carried out this study in order to make appropriate therapeutic guidelines for the treatment and clinical investigation of complication in the femur shaft fracture in children.

Methods : We had examined 51 patients who had admitted to orthopedic surgery department in Seoul Christian Hospital because of the fracture of the femoral shaft, before 13 years old from Sep. 1986, to Mar. 1992.(conservative treatment group: 43 cases, operative treatment : 8 cases)

Results : The group distribution of femoral fracture was most common in 6~8 age. The main cause of fracture was traffic accident(72.5%). Most patient has occurred during spring to summer, while children's activity was relative increased. The combined injury was 60.8% ; 31 of 51 cases. The most common fracture type was transverse fracture 47.0%. The location of fracture were that middle third 60.8%, proximal third 31.4% and distal third 7.8%. The average callus formation time in X-ray was 16 days in conservative group and 20 days in operative group. The average overgrowth range was 10.3mm in conservative group and 9.7mm in operative group. Both of all were good result and difference between them was not statistically significant.

Conclusion : The most of the fracture of femoral shaft in children have been treated conservatively, whereas a small proportion treated operatively and both have revealed relatively good result. The operative management would be the one of the excellent management methods, if the patient was selected according to accurate indication. We must have the knowledge of continuous management and consultation about the overgrowth of leg in children with the fracture of femoral shaft.

Background
: The primary practitioners have been lift their position from their primary care fields more and more recently. The quiet few of primary care practitioners are blaming present Korean medical insurance policy for declining their practice. This study was planned to find out the possible reasons for deduction from medical insurance which primary care practitioners wanted to be paid for their effort, and the influence from "unreasonable deduction" to their practice if there is any.

Methods : A 14-item self-administered survey questionnaire was designed, and mailed to randomly selected 500 primary practitioners. Their main practice fields were internal medicine, pediatrics, family medicine, and general practitioner.

Results : 37(7.47%) out of 500 were responded to our survey. 75% responders experienced insurance premium deduction. The half of responders had argued against the deduction, and 72.2% of those were received the premium back. And 71.5% of responders demanded the readjustment of insurance deduction policy.

Conclusion : Even though there may be many biases exist in this study, the author have to call conclusion that current medical insurance in Korea may need to be changed in many aspects of that policy. Because the reason of deduction for the primary care physician's fee were unclear and those deduction could interfere the patients-doctors relationship and primary care practice.

Background
: Most medical institutions usually do practice in daytime that it is difficult for the ordinary worker or student to visit clinics, and all more is so when family members are willing to visit altogether. Evening practice was set up and has been operated at the department of Family Medicine in Presbyterian Medical Center located in Jeon Ju City to offer medical services to community to inhabitants in their convenient time, in order to increase their work efficiency. Our study was done to evaluate the actual situation and details of evening practice.

Methods : Medical records of a total of 586 visitors who had used evening practice between October 1991 and July 1992 were reviewed. Data including age, sex, month and day of visit, occupation, reason for encounter, clinical studies, procedures, and consultations to other department were collected in detail, and the diagnoses were classified according to ICPC.

Results : Of 586 visitors sex ratio was 1.29:1 with male predominance, age distribution was highest in twenties(35.9%), and company employee was the largest in occupation(29.3%). The number of encounter was counted as much as 683(average 1,165 per visitor), and reasons for encounter were 171 items of which health examination was the first in number(15.9%). Among organ-systemically classified reasons for encounter generalized and unspecified reasons were the most frequent(32.8%). A total of 612 diagnoses were made (average 1.04 per visitor) among 97 kinds of diagnosis. The most common diagnosis was 'no disease', and among the organ-systemically classified diagnosis generalized and unspecified diseases was the most frequent(24.3%). A total of 1,985 diagnostic tests were carried out (mean 3.39 per visitor), the kinds of tests were 32, and the most frequently used test was CBC (11.6%). Consultation to other department was taken in 1.54% of visitors, of which infectious hepatitis was the main problem.(33.3%)

Conclusion : The major reasons to encounter evening practice were health examinations of company employees and medical certificates for employments. We suggest that we should evaluate whether the visitors are satisfied with the family medicine-based evening practice.

Background
: Once attacked by paralytic poliomyelitis, most of patients have difficulties in their social activities and need a close assistance in their rehabilitation efforts. By examining the relation between the onset of paralytic poliomyelitis and the paralytic pattern, this study made to provide some helps in estimating the prognosis of the paralytic poliomyelitis and their rehabilitation activities.

Methods : Authors made suvey on 48 paralytic poliomyelitis victims who work at 00 electronic company in Seoul, Korea.

Results : The ratio between male and female was approximately 2 to 1. Out of 48 victims, 46(95.8%) were attacked by poliomyelitis before 5 years old. The victims were country-widely distributed and most of them were attacked in summer. The victims attacked under 5 years old have paralysis on their both legs (52.2%), those after 5 years old show paralysis on both legs.

Conclusion : Most of the victims were attacked by poliomyelitis under 5 year old, have paralysis on their both legs and need early stage rehabilitational education and treatment. Family members and social level concern and help should be continuously given to them so that they can manage their stable social activity. In relation, the role of family physician is important for them.