Journal of the New Zealand Medical Association, 05-November-2004, Vol 117 No 1205
Practical Guide to the Care of the Medical Patient (6th edition)
Fred Ferrari, editor. Published by Mosby, 2004. ISBN 0323023975.
Contains 1203 pages. Price A$69.30
The author’s forward modestly states this is a “practical, portable resource to get you through your internal medicine clerkship or residency”. Well, is it?
The first section advises on general evaluation of the medical patient, how to write progress notes, prepare a discharge summary, and pronounce death. The next provides exhaustive lists for differential diagnoses. Particular diseases are then explored in detail. At first glance management of asthma seemed cursory. I would have expected a practical guide to include more about drugs, dosages, and routes of administration than “in the Emergency Room: oxygen, inhaled short acting beta agonists, consider anticholinergics (ipratropium), intravenous or oral corticosteroids.” Yes, that’s it. This is followed by nine pages on mechanical ventilation, which seems like overkill. Then the text returns to acute asthma.
Why the duplication? Treatment of non-alcoholic fatty liver disease is “weight reduction in all obese patients (not unreasonable)....500g per week in children, 1600g per week in adults is preferred....”. Well, good luck. I specialise in diabetes and “split dose therapy with regular and NPH insulin...2/3 of the total daily dose administered in the morning and 1/3 in the evening” wouldn’t work for most of my patients, nor would these particular insulins likely be chosen with insulin analogues now on offer.
It tries to do too much. A tour-de-force, largely the efforts of one man, it could be so much better if half the size (it might really fit into a pocket) contributed to by a panel of experts who do this stuff for real and then keenly edited. My junior staff agreed. There are some excellent guides to practical management available, one example being from my own hospital, the Christchurch “Blue Book”. Not as exhaustive as Fred Ferri’s book, it certainly is far more practical.
Department of General Medicine
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