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A noted medical historian and museum curator, Canadian American Howard Dittrick was a Cleveland gynecologist who served as Directing Editor of Current Researches in Anesthesia and Analgesia (1940-1954). In the aftermath of World War II, even after Congresses of Anesthetists had resumed, Dittrick and his editorial board allowed their yellow, then tan-covered journal, the so-called "yellow peril," to languish into near irrelevance.

In this study in an urban practice, the presence of a neutral observer at follow-up visits enhanced the extent to which practitioners recognized problems which patients had in a previous visit. This improvement was limited to those problems which initially had been mentioned by patients as requiring follow-up. Follow-up of problems initially mentioned by practitioners as needing follow-up was not improved by the observer unless the problem was also mentioned by the patient.In the course of a study to determine the adequacy of the medical record as a source of information,' a neutral observer of the practitioner-patient interaction appeared to influence the practitioner's recognition of patients' problems. The potential implications of this observation, both for patient care and for the design of research studies, prompts this report.

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