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Doody's Review ServiceReviewer: 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.