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Behavioral medicine in primary care—a practical guide
  1. G Price

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    M D Feldman, J F Christensen. McGraw Hill: New York, 2003, pp 366, $39.95. ISBN 0-07-138336-0

    It is well known that a large proportion of consultations in primary care have their origins in the psychological wellbeing of the patient. There is clearly a need for a reference book in this area that strikes the right balance in presentation, engagement, and usefulness, without being overbearing. With this in mind, is this book of use to a primary care physician with limited training in behavioural medicine?

    The early chapters go back to basics and focus on the doctor–patient relationship. The reader not so keen on this approach may be lost by the wayside in these chapters. However, for those prepared to re-valuate the patient interview, these chapters could be very insightful. Because this is a quick reference book, if the reader is so inclined, the early chapters can be skipped, but the reader may miss out on the central message of the book, which is the understanding of the doctor–patient relationship. Further thumbing through the book will reveal comprehensive backgrounds and practical approaches to psychiatric, medical, and behavioural disorders in primary care, including pharmacological treatments for psychiatric illnesses. The book is written for the US healthcare system but most treatment options suggested are available in the UK.

    The presentation of information is stylish and cohesive, with the 35 chapters following a similar format including case illustrations. These illustrations are interesting but occasionally a little too simplistic. The book’s major achievement is its diversity, which is also its weakness, as some detail is lost. However, this is a minor criticism.

    Overall, this is a well edited and presented book, which fulfils its aims as a practical reference book adequately. It offers a different approach to behavioural and medical problems in the primary care setting. Although the book would be of limited use to trainees in psychiatry, due to its primary care focus, it would serve as a useful text to those in primary care, other healthcare professionals, and students.

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