Objective. The goal of this pilot study was to develop and field-test questions for use as a poverty case-finding tool to assist primary care providers in identifying poverty in clinical practice. Methods. 156 questionnaires were completed by a convenience sample of urban and rural primary care patients presenting to four family practices in British Columbia, Canada. Univariate and multivariate logistic regression analyses compared questionnaire responses with low-income cut-off (LICO) levels calculated for each respondent. Results. 35% of respondents were below the “poverty line” (LICO). The question “Do you (ever) have difficulty making ends meet at the end of the month?” was identified as a good predictor of poverty (sensitivity 98%; specificity 60%; OR 32.3, 95% CI 5.4–191.5). Multivariate analysis identified a 3-item case-finding tool including 2 additional questions about food and housing security (sensitivity 64.3%; specificity 94.4%; OR 30.2, 95% CI 10.3–88.1). 85% of below-LICO respondents felt that poverty screening was important and 67% felt comfortable speaking to their family physician about poverty. Conclusions. Asking patients directly about poverty may help identify patients with increased needs in primary care.

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You get the point. If a reasonably articulate curmudgeon like myself cannot obtain emergency contraception, what chance does a worried, upset teenage girl have? Her choice would be to openly disclose intensely personal information, or to leave empty handed and humiliated.The next day I went to the second of three pharmacies. I made my request and, on cue, the pharmacist was called over. Same routine, but with a twist; the pharmacist had not received the mandatory training. The pharmacy association, he said, insists that pharmacists receive special training on how to counsel women who ask for Plan B. The pharmacist had meant to sign up for the training but gosh, darn it all, he just hadn't got round to it.I never made it to the Wal-Mart pharmacy. It was too far away, and I had no car.Midday snack at the nutritional centre, Rhini, Eastern Cape South Africa. This is the last of 3 photographs selected for publication in CMAJ from 6 finalists in a medical student photo contest and charity auction sponsored by McMaster University in 2005. This photograph, taken by Caroline Eberdt during an 8-week clinical elective, shows how preventive care can be delivered in many forms and reminds us that even the simplest interventions can be effective. The setting is South Africa, but it could be many places; anyone can identify with the effort of these children to deal with those bright oranges -awkward to eat, but tangy and delicious. One child is aware of the camera; the viewer is curious to know what holds the divided attention of the others. The photographer writes: "Rhini is a black township on the edges of Grahamstown, South Africa. Speaking in his home state, the Eastern Cape, Nelson Mandela called Rhini in 1996 'the most economically impoverished city in South Africa.' During this elective I was based at the public Settler's Hospital, working in obstetrics and primary care. Concurrently I conducted a small-scale research project examining the benefits and drawbacks to local organizational responses to gender-based violence and HIV/AIDS. Amid the tragedy that the AIDS epidemic has inflicted on the community, this nutritional centre, run by several community members, was a refreshing site of laughter and smiles." For the previous photos see CMAJ 2005;173(12):1514 and CMAJ 2006;174(1):71.