Reviewer: Amanda Rhyne, MD (Salina Family Healthcare Center)
Description: This book, now in its sixth edition and updated annually, covers common screening guidelines, preventive measures, and management of conditions frequently encountered by those in the field of primary care. It is structured by system, with almost all topics addressed in the screening, prevention, and management sections. The book is heavily composed of bulleted lists with an appropriate number of tables, charts, and step-by-step algorithms.
Purpose: The intention of this book is to provide a source that has consolidated many clinical guidelines into one easily accessible format for "all clinicians interested in updated, evidence-based guidelines." These objectives are worthy, and the book particularly emphasizes updated screening guidelines. The yearly update creates a consolidated source to keep physicians updated on key changes in guidelines from major health societies, including the American College of Cardiology (ACC), the American Heart Association (AHA), and the United States Preventive Services Taskforce (USPSTF), on important topics such as hypertension. The book meets its objectives by providing concise summaries of the latest disease-screening, prevention, and management guidelines. Since the book is organized by system in a bulleted format, some areas may seem lacking but are often covered in other sections of the book.
Audience: This book is written for primary care providers. According to the author, it is intended for residents, medical students, midlevel providers, and practicing physicians in family medicine, internal medicine, pediatrics, and obstetrics and gynecology. I agree that the target audience is primary care physicians. The book addresses multiple guidelines and is useful for medical students studying for their shelf exams, clinicians looking to refresh their knowledge, or midlevel providers in a busy practice. I do not think there is enough information specific to pediatrics or OB-GYN to make these medical specialties the specific audience of focus. Overall, the book does meet the needs of its audience. In fact, it probably includes too many specific society guidelines and tries to capture too many large topic areas in one text, especially when addressing the breadth of screening, prevention, and management. The author is a credible authority on the subject and has been the author of this book for the last few years. He is an associate program director at a residency in Ventura, California, enabling him to better understand the needs of resident physicians when it comes to consolidating guidelines. He is also a clinical instructor at UCLA, which expands his understanding into the realm of medical students.
Features: The book covers screening, prevention, and management of some of the most common topics in primary care. These topics include but are not limited to cardiovascular disorders, renal disorders, and infectious disease. The screening section covers guidelines from multiple societies, allowing for comparison. The prevention section includes guidance that can be directly given to patients. The management section has multiple tables and flow charts that encompass crucial topics in a concise but adequate way. The strongest aspects of the book include the consolidation of many crucial guidelines into a readable text form, along with the bulleting of information underneath specific headings. The book contains a thorough appendix with many screening instruments, along with other pertinent medical tables. Examples include a 95th percentile table of blood pressure based on age for boys and girls and a geriatric depression scale. This unique feature enables readers to access the information presented in the book in table form and provides a resource to expand on the specific book chapter topic areas. Although the book effectively covers a large breadth of topics, addressing common screening guidelines alone would make an adequate book in itself. To enhance future editions, all topics should be represented under the screening, prevention, and management sections for consistency as some do not appear under all three (e.g., Behavioral Health is only listed under Screening and Management but not Prevention; Special Population: Newborns and Infants is listed under Screening and Prevention but not Management). The mass of guidelines, notably in the screening section, seem to provide a substantial amount of overlap without contributing to the main goal of the text. Lastly, though the book includes OB-GYN and pediatrics practitioners as part of its target audience, the amount of content that pertains to these specialties is not enough to be kept on the shelves or at the ready by these physicians.
Assessment: This book accomplishes its purpose, especially in the screening guidelines section. However, some of the guidelines included could have been omitted, as usually one to two are the most important or commonly used. Although I do not own a book that is similar in content, I use the USPSTF mobile application to garner similar information. The app is helpful because users can plug in a patient's demographics and receive current guidelines (although just one) on preventive screening for the patient. The USPSTF app does not cover management, so that is a strength of this text. As previously mentioned, new editions of this book are published annually. In the preface, the author notes significant updates since the last edition on many topics including cervical cancer screening and screening for group B strep in pregnancy. There are also multiple brand-new sections that discuss topics from external cephalic version to acute bronchitis. For these reasons, this updated edition is welcome. Besides just noting it in the preface, the new chapters or topics might benefit from something additional to make them stand out, whether that be bold text or colored print.
