Reviewer: Alan Blum, MD (Baylor College of Medicine)
Description: This is a question-and-answer companion to Taylor's venerable textbook, Family Medicine: Principles and Practice, 5th Edition (Springer-Verlag, 1998). The 1200 questions (primarily case-based), all written by the editor for uniformity of style and clinical relevance, are keyed to the fifth edition of the textbook.
Purpose: The intention is to help the family physician reader "review the full scope of family medicine," either to prepare for a broad-based clinical examination such as the American Board of Family Practice recertification, or "simply to enhance one's clinical knowledge." The editor more than succeeds in his mission, since the quality of the questions also makes this book a helpful adjunct to teaching rounds. In spite of the rise of interactive computer-based learning, with all its bells and whistles, there is still an important need for such a solid, straightforward, understated paperback.
Audience: Although the predominant readership is family physicians undergoing their sabbatical ritual of recertification, I suspect this will be a worthwhile volume for all medical students in a family practice interest group, as well as nurse practitioners working in a family medicine setting. The editor, a longstanding chairman of a department of family medicine and a person with a multiplicity of clinical interests, is the ideal expert for such a book.
Features: The 130 chapters of the companion textbook are distilled into 27 chapters of questions in this book, organized either by organ system, age (e.g., care of the infant and child), or clinical event (e.g., injuries and poisoning). The crisp, mostly mini-case-based questions are both realistic and practical. They are equally divided among diagnosis, therapy, and pure knowledge. There are reminders of important techniques in physical diagnosis (e.g., DixHallpike maneuver, Thompson's test), and almost every chapter includes at least one example of an emergency management decision. The most common conditions are given greater attention, and there are few tricks or trivia. The chapter on "Questions in Care of the Elderly," for instance, distills some of the most important points about Alzheimer's disease, incontinence, and pressure sores. At the same time, however, there is scant material on polypharmacy. Some chapters, such as "Family Conflict and Violence," while not intellectually challenging, make an impact as important reminders of daily situations for which the family physician must keep a high index of suspicion. In "Care of the Adolescent," there is contemporary, down-to-earth discussion of sexuality and gender issues. The 15 tips for Board examinations in the introductory chapter on test taking techniques make good sense. Similarly, there is a good closing chapter of questions on principles and applications in family medicine, as well as an excellent index. Although the typography and layout are pleasing to the eye, there are just 30 illustrations; fortunately, they are well-chosen. The black-and-white photographs all are clear, even for dermatologic questions and two cases involving funduscopic examination.
Assessment: This book is a worthy competitor to Swanson's Family Practice Review, even though it is unlikely to dethrone it as the book of choice for the Family Practice Board Examination review. The latter is more comprehensive in terms of the number of questions and the depth of the problem-oriented case discussions. Nonetheless, a chapter a day of this book should keep test anxiety at bay. One criticism of the book as a whole: although the case presentation questions are sensitively written for the most part, I would prefer to see the inclusion of occupational status and the refinement of racial identifiers. Surely, in an increasingly multicultural world, authors in family medicine of all specialties, need to move beyond such descriptions as "8 year old white male" and "48 year old black female."
