Textbook of Physical Diagnosis: History and Examination, 4th Ed.

By M. H. Swartz. Philadelphia: W. B. Saunders Company. $. ISBN: 0-7216-9411-X. pages.

This book is a comprehensive, systemic approach in providing a physical examination for the physician. The book begins with the basic principles of the interview process. This section provides the framework for the physical examination. It introduces to the reader the concepts of basic interviewing techniques such as questioning confrontation, and reflection. It reminds the medical profession that the patient history should be approached in a more patient-oriented focus then a disease-oriented focus. This holistic approach is needed to provide a more complete physical history that includes all aspects of the patient's life. The interview section of the book also provides several suggestions and examples of ways to ask patient-sensitive questions that clinicians often avoid or ask inappropriately, thus alienating the patient altogether. The remaining chapters in the first section include the consideration of different cultures, patient responses to illness, and the importance of nutritional status in understanding the patient's presenting problems. The book then applies a structure to the interview and brings the history together to form the patient's story. The last sections of the book identify how to examine a patient from head to toe with actual disease pictures to give you a flavor for what the disease process would be like. The book then provides a basic anatomical structure to remind us of the location and function of the specific structures. The conclusion describes age-specific functions and disease processes. It reminds us that we should all be devoted and compassionate when we begin our interview with the patient, and to always remain caring in listening and observing the patient's story.

Although the book is suggested for physicians, I would recommend this book for the clinical nurse specialist/nurse practitioner beginning in the clinical arena. The book provides a reference for beginners as a comprehensive review of the system with different system diagnosis pictures as a point of reference. This book would also support a medical educator/professor in instructing a novice physician or nurse in the art of interviewing a patient, different cultural beliefs, and a comprehensive head-to-toe physical examination. This book would be more valued at an advanced level in nursing or beginning medical education.