Family History Basically Useless, Doctor Claims

              Shreveport Physician
Family History Basically
Useless, Doctor Claims
By Margaret Martin
Times Medical Writer
Family histories taken by
physicians are "often irrelevant
and thus useless . . . " a local
physician charged in a paper
published in the April 3 "Jour-nal
of the American Medical
Association."
Dr. Richard C. Juberg, direc-tor
of the Birth Defects Center
and associate professor of pe-diatrics
at Louisiana State Uni-v
e r s i t y Medical School in
Shreveport, wrote the paper!
"Making the Family History
Relevant."
In an interview, Juberg said
that "basically the family histo-ry
as commonly taken is not
relevant to the problem in the
patient."
Juberg is e s p e c i a l l y con-cerned
that genetic disorders
are many times not taken into
consideration in compiling the
family history and blames this
on the fact that "genetics have
developed in the last 15 to 20
years as a legitimate discipline
of the medical curriculum,"
while the system of taking a
family history has evolved over
many more years.
Medical educators, he s a i d,
continue to teach students to
take the family history "in the
same old way."
Doctors, Juberg said, reel off
"an impressive list of questions
to impress the patient . . . "
The physician feels "he has
done his duty, when he really
hasn't done anything."
• A common p r o c e d u r e for
taking a family history "is the
I recital of a list of diseases and
i defects by the physicians to
each of which the patient is
asked to make a positive or
negative response."
This, he says in the paper,
"may demonstrate the physi-cian's
ability to memorize and
may impress the patient and
bystanders, but it actually ac-complishes
little. . . ."
"Possibly the worst part of
this method is that the physi-cian
thinks he has actually ob-tained
some relevant informa-
; tion when he has only gone thro-ugh
a meaningless ritual," the
paper said.
Juberg also takes his col-leagues
totask for sometimes
taking no history at all, even in
the case of an emergency.
Failure to take a family
history, he says, "can be disas-trous
because it can mean a
missed diagnosis."
"Even the emergency case is
no excuse for such negligence
because relatives are often
available there for questioning
or the patient himself may be]
able to furnish information if his
condition is stabilised within a
reasonable time," the paper
says.
Juberg recommends a three-step
plan for taking the family
history w h i c h is: 1 Minimal
information, including vital sta-tistics.
2. A relevant summary
designed to survey the family
for the occurrence of disease
and defect. 3. A maximal family
history which includes construe- •
tion of the family pedigrees —
equivalent to a complete genetic
history.