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20 Common Problems—Ethics in Primary Care
Mayo Clin Proc, August 2001, Vol 76
Book Reviews
869
recognized authors from various subspecialty areas. Part 4 deals with the lower extremity and includes an excellent review on the anatomy, biomechanics, and physical examination of the knee. Strengths: This text represents a definitive work on the orthopedic aspects of sports medicine. Most chapters are well written, straightforward, and sufficiently referenced to direct interested readers to the original literature as needed. Deficiencies: Several chapters are surprisingly devoid of illustrations, most notably the chapter on posterolateral corner injuries of the knee. The complex anatomy of the posterolateral corner has been nicely distilled in the text of this chapter, but the lack of illustrations may leave many readers frustrated. Recommended Readership: This book would be a welcome addition to the libraries of all practicing orthopedic surgeons with an interest in sports medicine. Residents and fellows in orthopedic surgery and physical medicine and rehabilitation will find it a valuable basic reference source on sports-related problems. Overall Grading: ####
tistics and background theory for the novice reader to understand the potentially conflicting views surrounding each problem. Because many ethical problems overlap with others, the chapters are nicely cross-referenced. The text is easy to read, and the tables are clear and concise. Finally, the reader is given practical advice and strategies on how to approach, manage, and resolve these common ethical problems. Deficiencies: None. Recommended Readership: Although intended for primary care providers, this text would be a valuable resource for subspecialty clinicians as well. Teachers and students (at all levels) of medical ethics will find it especially useful. Overall Grading: #####
Mark W. Pagnano, MD, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minn
Dyspepsia, edited by David A. Johnson, Philip O. Katz, and Donald O. Castell, 191 pp, with illus, $35, 190 N Independence Mall West, Philadelphia, PA 19106-1572, American College of Physicians (telephone: 800-523-1546), 2001, ISBN 0-94312697-5
20 Common Problems—Ethics in Primary Care, edited by Jeremy Sugarman, 279 pp, $34.95, New York, NY, McGraw-Hill (telephone: 800-722-4726), 2000, ISBN 0-07-063369-X Type of Book: A textbook of medical ethics authored by 30 leading scholars in the field. Scope of Book: This book reviews 20 ethical problems commonly encountered in primary care practice. Contents: The text is divided into 4 parts that focus on (1) ethical problems that may be inconspicuous (eg, ethical problems of preventive medicine), (2) problems related to systems of care (eg, ethical problems of consultation and referral), (3) problems related to the process of care (eg, truth telling), and (4) preventive ethics (eg, informed consent). Each of the 20 chapters in the book is devoted to a unique ethical problem. The chapters follow a standard format—case vignettes (56 vignettes are used) that illustrate the ethical problem followed by a description of its scope and context, background theory (ie, ethical, philosophical, and legal), and practical suggestions for resolving the problem. Each chapter is richly referenced (549 references are cited). The book concludes with an appendix that lists resources (eg, books, journals, and organizations) on medical ethics. Strengths: A major strength of this textbook is the breadth of topics it covers. The ethical problems encountered in primary practice (eg, requests for inappropriate tests) are often more subtle than those encountered in the hospital setting (eg, withdrawal of life-sustaining treatment). Hence, clinicians may be unfamiliar with the nuances of these common problems and how to address them. This book succeeds at thoroughly reviewing these issues. Another strength is the structure of the chapters, in which each ethical problem is illustrated with relevant case vignettes. The discussions of scope, context, and background theory are up-todate and extensively referenced. The authors give sufficient sta-
Paul S. Mueller, MD, Division of General Internal Medicine, Mayo Clinic, Rochester, Minn
Type of Book: A multiauthored text on dyspepsia. Scope of Book: This book comprehensively reviews issues and controversies regarding the epidemiology, diagnosis, and management of dyspepsia. Contents: In 10 chapters, the authors achieve the editors’ goal to “put in perspective the specific questions that pertain to the day-today clinical management of patients with dyspepsia.” The focus is on clinical outcomes and an evidence-based approach. The chapters address topics such as epidemiology and natural history, management, quality-of-life and economic issues, nonprescription and alternative therapies, and the role of gastroesophageal reflux disease, Helicobacter pylori infection, motility disorders, and nonsteroidal anti-inflammatory drugs in dyspepsia. The text is supplemented by 3 clinical vignettes that highlight important issues. Strengths: The relatively short chapters are easy to read and appropriately supplemented with tables and figures. Each chapter ends with “Conclusions,” “Key Points,” and/or “Recommendations” that summarize the issues discussed. The chapters are extensively referenced. Deficiencies: There is significant overlap among the chapters (eg, the definition of dyspepsia and nonulcer dyspepsia, reviews of dyspepsia subtypes, H pylori issues). Tricyclic antidepressants receive scant attention, whereas entire chapters are devoted to over-the-counter treatments and “alternative” therapies. Recommended Readership: This book serves as an excellent introduction to the various issues regarding dyspepsia for gastroenterology fellows. It would also be an excellent review source for internists or practicing gastroenterologists. Overall Grading: #### Darrell S. Pardi, MD, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn
For personal use. Mass reproduce only with permission from Mayo Clinic Proceedings.
Book Reviews
869
recognized authors from various subspecialty areas. Part 4 deals with the lower extremity and includes an excellent review on the anatomy, biomechanics, and physical examination of the knee. Strengths: This text represents a definitive work on the orthopedic aspects of sports medicine. Most chapters are well written, straightforward, and sufficiently referenced to direct interested readers to the original literature as needed. Deficiencies: Several chapters are surprisingly devoid of illustrations, most notably the chapter on posterolateral corner injuries of the knee. The complex anatomy of the posterolateral corner has been nicely distilled in the text of this chapter, but the lack of illustrations may leave many readers frustrated. Recommended Readership: This book would be a welcome addition to the libraries of all practicing orthopedic surgeons with an interest in sports medicine. Residents and fellows in orthopedic surgery and physical medicine and rehabilitation will find it a valuable basic reference source on sports-related problems. Overall Grading: ####
tistics and background theory for the novice reader to understand the potentially conflicting views surrounding each problem. Because many ethical problems overlap with others, the chapters are nicely cross-referenced. The text is easy to read, and the tables are clear and concise. Finally, the reader is given practical advice and strategies on how to approach, manage, and resolve these common ethical problems. Deficiencies: None. Recommended Readership: Although intended for primary care providers, this text would be a valuable resource for subspecialty clinicians as well. Teachers and students (at all levels) of medical ethics will find it especially useful. Overall Grading: #####
Mark W. Pagnano, MD, Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minn
Dyspepsia, edited by David A. Johnson, Philip O. Katz, and Donald O. Castell, 191 pp, with illus, $35, 190 N Independence Mall West, Philadelphia, PA 19106-1572, American College of Physicians (telephone: 800-523-1546), 2001, ISBN 0-94312697-5
20 Common Problems—Ethics in Primary Care, edited by Jeremy Sugarman, 279 pp, $34.95, New York, NY, McGraw-Hill (telephone: 800-722-4726), 2000, ISBN 0-07-063369-X Type of Book: A textbook of medical ethics authored by 30 leading scholars in the field. Scope of Book: This book reviews 20 ethical problems commonly encountered in primary care practice. Contents: The text is divided into 4 parts that focus on (1) ethical problems that may be inconspicuous (eg, ethical problems of preventive medicine), (2) problems related to systems of care (eg, ethical problems of consultation and referral), (3) problems related to the process of care (eg, truth telling), and (4) preventive ethics (eg, informed consent). Each of the 20 chapters in the book is devoted to a unique ethical problem. The chapters follow a standard format—case vignettes (56 vignettes are used) that illustrate the ethical problem followed by a description of its scope and context, background theory (ie, ethical, philosophical, and legal), and practical suggestions for resolving the problem. Each chapter is richly referenced (549 references are cited). The book concludes with an appendix that lists resources (eg, books, journals, and organizations) on medical ethics. Strengths: A major strength of this textbook is the breadth of topics it covers. The ethical problems encountered in primary practice (eg, requests for inappropriate tests) are often more subtle than those encountered in the hospital setting (eg, withdrawal of life-sustaining treatment). Hence, clinicians may be unfamiliar with the nuances of these common problems and how to address them. This book succeeds at thoroughly reviewing these issues. Another strength is the structure of the chapters, in which each ethical problem is illustrated with relevant case vignettes. The discussions of scope, context, and background theory are up-todate and extensively referenced. The authors give sufficient sta-
Paul S. Mueller, MD, Division of General Internal Medicine, Mayo Clinic, Rochester, Minn
Type of Book: A multiauthored text on dyspepsia. Scope of Book: This book comprehensively reviews issues and controversies regarding the epidemiology, diagnosis, and management of dyspepsia. Contents: In 10 chapters, the authors achieve the editors’ goal to “put in perspective the specific questions that pertain to the day-today clinical management of patients with dyspepsia.” The focus is on clinical outcomes and an evidence-based approach. The chapters address topics such as epidemiology and natural history, management, quality-of-life and economic issues, nonprescription and alternative therapies, and the role of gastroesophageal reflux disease, Helicobacter pylori infection, motility disorders, and nonsteroidal anti-inflammatory drugs in dyspepsia. The text is supplemented by 3 clinical vignettes that highlight important issues. Strengths: The relatively short chapters are easy to read and appropriately supplemented with tables and figures. Each chapter ends with “Conclusions,” “Key Points,” and/or “Recommendations” that summarize the issues discussed. The chapters are extensively referenced. Deficiencies: There is significant overlap among the chapters (eg, the definition of dyspepsia and nonulcer dyspepsia, reviews of dyspepsia subtypes, H pylori issues). Tricyclic antidepressants receive scant attention, whereas entire chapters are devoted to over-the-counter treatments and “alternative” therapies. Recommended Readership: This book serves as an excellent introduction to the various issues regarding dyspepsia for gastroenterology fellows. It would also be an excellent review source for internists or practicing gastroenterologists. Overall Grading: #### Darrell S. Pardi, MD, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minn
For personal use. Mass reproduce only with permission from Mayo Clinic Proceedings.