Book Review  |   February 2009
Essentials of Family Medicine
Author Affiliations
  • David Kuo, DO
    Department of Family Medicine, Director, Roxborough Healthcare Center, Associate Program Director, Family Medicine Residency, Philadelphia College of Osteopathic Medicine, Philadelphia, Pa
    Assistant Professor
Article Information
Book Review   |   February 2009
Essentials of Family Medicine
The Journal of the American Osteopathic Association, February 2009, Vol. 109, 74-75. doi:10.7556/jaoa.2009.109.2.74
The Journal of the American Osteopathic Association, February 2009, Vol. 109, 74-75. doi:10.7556/jaoa.2009.109.2.74
The fifth edition of Essentials of Family Medicine covers a broad range of topics that family physicians encounter on a daily basis. 
It is a well-written, softbound textbook created by several accomplished authors. Philip D. Sloane, MD, MPH, is an Elizabeth and Oscar Goodwin Distinguished Professor of Family Medicine at the University of North Carolina at Chapel Hill (UNC-CH). Lisa M. Slatt, MEd, is an associate professor of family medicine at UNC-CH. Mark H. Ebell, MD, MS, is an associate professor at the Medical College of Georgia in Augusta and deputy editor of American Family Physician. Louis B. Jacques, MD, is an associate professor at Georgetown University in Washington, DC. Mindy A. Smith, MD, MS, is a professor of family medicine at Michigan State University College of Human Medicine in East Lansing and associate editor of Family Medicine. In addition to these five primary authors, more than 125 contributors, including several osteopathic physicians, are credited in the book as coauthors. 
The book is organized into three main sections: “Principles of Family Medicine” (chapters 1-3); “Preventive Care” (chapters 4-7), and “Common Problems” (chapters 8-51). 
The opening chapter, “Family Medicine in Today's Changing Health Care System,” reviews national health priorities and the role that primary care providers play in achieving these goals. It details a convincing argument for the benefits of healthcare delivery through a system based on primary care rather than one based on subspecialty care. 
A large part of the authors' approach relies on basic principles of family medicine—continuity of care, comprehensiveness, coordination of care, community orientation, prevention as the focus of care, evidence-based practice, the biopsychosocial or lifecycle perspective, and family-centeredness. 
Chapter 1 also provides illuminating vignettes into the variety of family practices functioning well within our modern healthcare system. These short stories offer an insightful overview of the many opportunities available to family physicians. 
For example, the authors report the story of Adele O'Sullivan, MD, named by the American Academy of Family Physicians as “2006 Family Physician of the Year.” Dr O'Sullivan provides healthcare to the homeless population of Phoenix, Ariz. This chapter is an excellent introduction to the specialty of family medicine for medical students. It will also serve residents well—particularly as they begin to seek employment. 
As an attending physician, I found chapter 1 to be truly inspirational. It shows how family physicians, when seen as a “specialty” group of their own, are vital to the well-being of our nation—and it made me hopeful for our future. Sometimes when the stress of work feels overwhelming, it is nice to be reminded of why you went into family medicine and to know that you are appreciated. 
Chapter 2, “The Challenging Patient Encounter,” describes difficult clinical situations that can be daunting to a young medical student or resident—and even to a seasoned physician. These situations include encounters with the “rambling” patient, patients seeking pain medicine, and the “reticent” patient. The authors provide sound and useful advice on managing such challenging cases. 
Chapter 3, “Information Mastery: Basing Care on the Best Available Evidence,” provides a good review of using the best available evidence when providing patient care. This chapter starts with an introduction to evidence-based medicine and gives advice on making it part of your practice. The chapter also provides a succinct review of the diagnostic use of sensitivity and specificity measures, predictive values, and likelihood ratios. A table lists and describes online resources for evidence-based clinical information. 
Throughout this first section of the book, “Principles of Family Medicine,” first-rate information is made available for medical students, residents, and attending physicians. 
The book's second section, “Preventive Care,” is composed of four chapters: “Prenatal Care,” “Well Child and Adolescent Care,” “Well Adult Care,” and “Palliative and End-of-Life Care.” Each chapter promotes the goal of high-quality preventive medicine. Likewise, each chapter begins with a thoughtfully described clinical case and associated questions and ends with a case discussion. 
For example, the chapter on prenatal care presents the case of a 37-year-old pregnant woman who inquires about genetic screening because her sister gave birth to a baby with Down syndrome. The patient also expresses concern about possibly having abnormal blood glucose levels. The concluding case discussion includes suggestions for Down syndrome screening between 16 and 21 weeks' gestation and diabetes mellitus screening using a 1-hour glucose challenge followed by repeat testing if initial results are normal. 
All chapters in the second section have detailed descriptions of patient education and counseling, immunizations, general health screening, appropriate laboratory screening, and the use of evidence-based guidelines. Included are many helpful tables. 
Indeed, the chapter on end-of-life care even contains a table on constipation management—seemingly an issue of priority on every elderly patient's mind! Like the first section of the book, the second section contains excellent information on which medical students and residents can build their general knowledge base. 
The third section, “Common Problems,” is the largest section in the book, presenting comprehensive accounts of a vast number of medical topics. In this section, chapters are generally arranged by organ system, which makes it effortless to navigate the text quickly. 
“Common Problems” begins with a chapter that outlines a basic approach to common problems in family medicine. The remaining chapters are divided among the following subsections: “Cardiovascular Problems,” “Problems of Children,” “Endocrine Problems,” “Eye, Ear, Nose, and Throat Problems,” “Gastrointestinal Problems,” “Men's and Women's Health,” “Musculoskeletal and Skin Problems,” “Neurologic Problems,” “Psychiatric Problems and Substance Abuse,” and “Respiratory Problems.” 
Each chapter in this section begins with a clinical case followed by a differential diagnosis, management strategy, follow-up monitoring and patient education tips, and concludes with a case discussion. The authors, once again, include numerous helpful tables, as well as many algorithms, diagrams, and photographs. Two sets of glossy color plates feature photographs of eye problems and dermatologic conditions. 
I found it quite easy to locate the information I needed throughout the “Common Problems” section. Although not comprehensive in breadth, these chapters cover the issues that are most commonly seen in the primary care setting, and they impart sound advice in a clear and concise manner. 
In summary, Essentials of Family Medicine is a terrific textbook that is simple to navigate, and it provides pertinent information and a wonderful overview of family medicine in today's ever-changing world of healthcare. 
This book will be exceedingly helpful to medical students and residents who are learning to practice general medicine and family medicine. It is also a good review for attending physicians. 
In an age in which medical information can be obtained in minutes using the Internet, this textbook remains relevant because of its high quality and user-friendliness. 
 By Philip D. Sloane, MD, MPH; Lisa M. Slatt, MEd; Mark H. Ebell, MD, MS; Louis B. Jacques, MD; and Mindy A. Smith, MD, MS. 816 pp, $52.95. ISBN: 978-0-7817-8188-6. Baltimore, Md: Lippincott Williams & Wilkins; 2007.
 Editor's Note: Corrections to this article were published in the July 2009 issue of JAOA—The Journal of the American Osteopathic Association (2009;109:388). The corrections have been incorporated in this online version of the article, which was posted December 2009. An explanation of these changes is available at: