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Doody's Review ServiceReviewer: Isaac Kleinman, MD (Baylor College of Medicine)
Description: This is a text of 23 chapters in four sections: (1) a review of the typical skills taught in the dominant biomedical approach followed by a chapter contrasting it with a more patient-centered or systemic approach; (2) a discussion of traditional history taking and examining skills and use of the laboratory; (3) improvement of skills in decision making, patient education, counseling, and management of patients with chronic illness; (4) achieving a program for development of a personal lifelong learning program and skills in teaching, research, and development of clinical guidelines.
Purpose: It is designed as an introductory text focusing on skills beyond the routine diagnostic, treatment, and technical skills that are useful in achieving optimal patient outcomes.
Audience: It is designed for an audience of students, residents, and primary care practitioners.
Features: There are good introductions to a wide range of topics, including geriatric assessment, patient education, and the impact of illness on the family and the community. Each chapter is followed by one or more case studies with pertinent questions. An unusual feature are the chapters on personal professional development, in teaching and research, and the development of an approach to lifelong learning. The number of topics makes for chapters too brief for the material to be covered. One could wish for a little longer book in this regard. However, there are many references. Some of the chapters on psychosocial medicine suffer from an excess of jargon, especially in view of the fact that this is an introductory text. A glossary might have helped. Although the case studies would be useful for group discussion, they are not as effective for individual study as they would be had answers and discussion of answers been supplied. An additional section for that purpose, or a comparison answer and discussion book, would have been helpful.
Assessment: Among the many new texts on primary care, this one serves well as an introduction to all the main topics of systemic medicine. The references are numerous and more current than most similar texts. The authors are knowledgeable. The text does well what it purports to do: provide an introduction to the myriad clinical and patient management skills required of a good primary care physician, many of which are not well taught in medical school and residency.