Principles of Ambulatory Medicine / Edition 3

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Comprehensive, major reference to patient care and preventive medicine. For primary care physicians and residents, internists, and general and family practitioners in the office setting.

The book contains black-and-white illustrations.

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Editorial Reviews

Ann B. Nattinger
This is a comprehensive review of adult ambulatory medicine. It is an update of the previous edition, which was published in 1995. As stated by the editors, the purpose is to provide guidance for the evaluation, management, and long-term course of common clinical problems addressed in the ambulatory setting, and for recognizing problems requiring specialist referral or hospitalization. I believe they succeed admirably in accomplishing these goals. The editors state that the intended audience is the office-based practitioner of internal medicine or family medicine. This book would also be helpful for residents or medical students on ambulatory rotations. A wide variety of ambulatory topics are covered, mostly organized by subspecialty area. Each chapter includes discussion of epidemiology and pathophysiology, diagnosis, and treatment. There are many helpful tables, and a nice emphasis on patient counseling and patient instructions. Some of the photographs could be clearer, but the diagrams are generally well done. The references have been updated to 1997 and are separated into general and specific references. References that are controlled trials, meta-analyses, or consensus-based recommendations are bolded. I especially liked the early chapters on general topics, such as prevention, geriatrics, adolescent medicine (including a guide to sports participation), and disability evaluation. We practitioners of primary care adult medicine are fortunate to have two other major textbooks in the field. These are Goroll's Primary Care Medicine: Office Evaluation and Management of the Adult Patient, 3rd Edition (Lippincott Williams & Wilkins, 1995), and Branch's OfficePractice of Medicine, 3rd edition (W.B. Saunders, 1994). Although the others are also excellent references, this text compares well, particularly with respect to the evidence-based approach, tables, and patient counseling aspects. This text has fewer chapters than Goroll, but each is more comprehensive. At the risk of emphasizing my age, I also found the slightly larger type attractive.
Halina Brukner
This is a comprehensive textbook of adult ambulatory medicine in its fourth edition. It is aimed toward the generalist physician caring for adult outpatients. Its multiple authors are mainly from Johns Hopkins. This book seeks to provide an in-depth account of diagnosis and management of problems in ambulatory medicine as well as indications for hospitalization and referral. Throughout this textbook, the authors emphasize the applicability of principles of clinical epidemiology in diagnostic test ordering, choosing treatment options, and evaluating prognosis. Although the book is intended for practicing internists and family practitioners, its comprehensiveness and organization make it useful for medical students and residents as well as for specialists who care for patients with diverse medical problems. This book features exhaustive tables in many chapters: these tables are very useful for reference. but are sometimes too comprehensive to peruse. The illustrations are excellent, especially in chapters relating to musculoskeletal conditions. Each chapter has its own table of contents that is useful for focused reading. The references at the end of each chapter are divided into general and specific references; the general references are annotated. The references are adequate, but tend to be dated. This comprehensive textbook is an excellent reference for all physicians who care for ambulatory patients. It covers some topics that are not often found in textbooks of primary care, such as primary care of the patient with cancer, care of patients with colostomy or ileostomy, and a chapter on special services such as disability insurance and home health services. This new edition updates suchrapidly evolving topics as HIV infection, lipid disorders, and coronary artery disease, and it would be a useful addition to any medical library.
From The Critics
This reference for practitioners who care for ambulatory adult patients provides an account of the evaluation, management, and long- term course of common clinical problems encountered in the ambulatory setting, as well as guidance for recognizing conditions that require either referral for specialized care or hospitalization. The 13 chapters by medical experts cover issues of general concern; preventive care; psychiatric and behavioral problems; allergy and infections diseases; gastrointestinal, renal and urologic, hematologic, pulmonary, cardiovascular, musculoskeletal, metabolic and endocrinologic, neurologic, and general surgical problems; gynecology and women's health; selected problems of the eyes, ears, nose, throat, and oral cavity; and common disorders of the skin. Edited by Barker, John R. Burton, and Philip D. Zieve, all of the Johns Hopkins U. School of Medicine. Annotation c. Book News, Inc., Portland, OR
**** The third edition (1991) is selected for the "minimal core list" by Brandon-Hill. A clinical textbook that provides an in-depth account of the evaluation, management, and long-term course of those common clinical problems which are handled by the generalist in the ambulatory setting, and provides guidelines for recognizing those problems which require either hospitalization or referral for specialized care. New information in this edition includes results of recent clinical trials and/or recently updated recommendations covering conditions such as coronary artery disease, diabetes, HIV infection, hypertension, lipid disorders, and mental illness. Annotation c. Book News, Inc., Portland, OR (
Doody's Review Service
Reviewer: Vincent F Carr, DO, MSA, FACC, FACP (Uniformed Services University of the Health Sciences)
Description: From the moment one begins to read this book, it is clear that the editors and authors have given us the definitive text of outpatient care. First published in 1986, this edition is an update of the 2003 edition.
Purpose: The purpose is to provide a book for practitioners who care for adult, ambulatory patients. There is a relative paucity of books addressing this area of medicine, and this stands out as one of the best, if not the best, for those practicing in the outpatient setting. This is a tremendous asset for every outpatient office.
Audience: All levels of practitioners, from medical students to office nursing staff, residents, and attendings, will benefit from this book. Physicians who primarily care for inpatients will also better understand the setting in which the outpatient practitioner works, and I would recommend it to those who are hospital-oriented in order to improve communication between the two groups. The authors are outstanding members of the Johns Hopkins medical staff and faculty and recognized as leaders in their fields.
Features: The book is divided in a traditional organ-system format, with a few informative general chapters beginning the book, which cover topics such as issues of general concern in ambulatory medicine, dealing with office proficiency and communication, and preventive care. Individual chapters include, where appropriate, sections on epidemiology, risk factors, and screening strategies. There are numerous intuitive tables, excellent figures, and color pictures. The outpatient orientation is clear, with sections such as adjusting long-acting drugs for angina and post-myocardial infarction and cardiac rehabilitation with a focus on follow-up when the patient is discharged from the hospital. Extremely impressive is the section on cardiac arrhythmia medicines, which stays away from when to use and how to initiate, and instead covers what outpatient practitioners must be aware of in the long-term care of their patients — an extraordinary section! A good section on alternative and complimentary care gives guidance when patients ask for information. The book includes the best explanation I've seen of how to use a DEXA scan along with other laboratory tests to diagnose and treat osteoporosis and osteopenia. There are numerous appropriate references and a website to find additional references and resources. The lone shortcoming is the index, which includes some medications while excluding others. Since this is not meant to be a definitive text in pharmacology, a decision to include all or none would have been appropriate.
Assessment: This is one of the best, if not the best, book in ambulatory medicine I have seen. Most books have outpatient medicine as an add-on or cover it in a specific chapter. This book lives up to the title, supplying the principles of ambulatory medicine. The new edition is necessary to reflect the changing world of medicine since 2003. I highly and unequivocally recommend it.

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780683004373
  • Publisher: Lippincott Williams & Wilkins
  • Publication date: 11/1/1990
  • Edition description: REV
  • Edition number: 3
  • Pages: 1487

Table of Contents

1 Ambulatory care : territory and core proficiencies 3
2 Practicing evidence-based medicine 13
3 The practitioner-patient relationship and communication during clinical encounters 25
4 Patient education and the promotion of healthy behaviors 38
5 Complementary and alternative medicine 61
6 Sexual disorders : diagnosis and treatment 73
7 Sleep disorders 100
8 Occupational and environmental disease and bioterrorism 118
9 Selected special services and programs : disability insurance, vocational rehabilitation, Family and Medical Leave Act, and home health services 137
10 Care of the patient with cancer 144
11 Adolescent patients : special considerations 153
12 Geriatric medicine : special considerations 177
13 Care at the end of life 192
14 Integrating prevention into ambulatory practice 211
15 Principles of nutrition in ambulatory care 228
16 Exercise for the healthy patient 241
17 Genetic testing and counseling 251
18 Immunization to prevent infectious disease 261
19 Evaluation of psychosocial problems 279
20 Psychotherapy in ambulatory practice 286
21 Somatization 293
22 Anxiety and anxiety disorders 306
23 Personality and personality disorders 324
24 Mood disorders 329
25 Schizophrenia and related psychotic disorders 349
26 Cognitive impairment and mental illness in the elderly 359
27 Tobacco use and dependence 368
28 Alcoholism and associated problems 382
29 Illicit and therapeutic use of drugs with abuse liability 411
30 Allergy and related conditions 437
31 Approach to the patient with fever 457
32 Bacterial infections of the skin 465
33 Respiratory tract
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