Instructions for Patients
Journal of the American Board of Family Medicine
This new clinical reference provides a comprehensive look at conditions commonly encountered by any primary care physician who provides care for children and adolescents. It has been developed as a quick and easyto-read manual for the busy clinician to use in the office or at the bedside. A collaborative effort, the book has 190 contributors who are expert in their fields and covers 351 topics. The book is divided into 21 sections, with most sections subdivided into common symptoms, specific
... mptoms, specific disorders, critical states, and procedures. Each chapter is in an outline format so that the reader can access the following information quickly: definition, etiology and epidemiology, pathophysiology, clinical findings, laboratory and radiologic findings, treatment, and prevention. A unique chapter feature is a key-point summary box that provides the reader with highlighted points of interest. Not all chapters contain these key points, however. The content is easy to read, and the format, including the tables that are included with most chapters, makes information quick and easy to find. Each chapter cites at least five recent or classic references for those who want additional information. The text does contain some illustrations, but they seem to be lacking in those sections where an illustration would be most welcome, such as in the chapters on dermatology, ophthalmology, and orthopedics. The procedural illustrations found throughout the textbook are helpful and complement the sections in each chapter well. I was somewhat disappointed with the index. Finding subjects of interest often required a search of two to three synonyms (eg, failure to thrive, short stature, toxic synovitis, tympanic membrane perforation). A frustrating index was an oddity in a manual that should give me quick access to the information I need. Overall, this well-written and well-organized reference is full of useful clinical information for busy physicians who care for children. It is comparable, though, to other textbooks that also use a quick-access format. Physicians who already possess basic medical knowledge of pediatrics will quickly recognize the advantage of this textbook as a bedside reference. Although medical students, residents, and other health professionals in training might want to rely on a reference that would provide more in-depth information, they will be able to depend on this text for the pure basics of any pediatric condition. David A. Acosta, MD Tacoma Family Medicine Tacoma, \\Tash Instructions for Patients. Fifth edition. (Spanish language.) firtha Borges-Nebeker, and edited by Ray Kersey. 558 pp, illustrated Pbikldelphia, WB Saunders Company, 1997. 149.95 (paper). ISBN 0-7216-6997-2 . . Both reviewers for this text are bilingual and from Hispanic families. Both care for a considerable number of Hispanic patients from countries of origin that include Mexico, Cuba, Puerto Rico, and several countries from Central and South America. The information in this book is quickly accessible, and the good indexes in both Spanish and English make it easy for non-Spanish-speaking practitioners to use. There is a desirably broad range of general medical diagnoses, which are organized topically, and the authors offer pragmatic advice, including appropriate guidelines for seeking further physician consultation. The diagrams are helpful, especially considering crosscultural physician-patient communication and educational barriers that could impair optimal understanding of written medical concepts. Our only suggestions for improvement revolve around the complexity of language used. In many instances the concepts and vocabulary are appropriate for college-educated patients, whereas most of our Spanish-speaking patient population has only a 4th-to 7th-grade education. Simpler and more colloquial language would meet the needs of the potential users of this information. In summary, this text is a valuable tool for family physicians whose patients come from a medically diverse, Spanish-speaking population. It will enhance the physician's ability to communicate more effectively and could increase time efficiency for clinical encounters, especially for non-Spanish-speaking physicians who might otherwise depend heavily on the expertise of an available translator for patient education.