Richard B. Goldbloom
Philadelphia: Saunders; 2002. 395 pp., 545 illust. $99.95 ISBN 0-7216-9475-6
Rating: ***
Audience: Medical students, family physicians, pediatricians
Content: There is often a mismatch between the basic interviewing and physical examination skills we acquire as physicians-in-training and the realities of actual practice. My own clinical skills were acquired with patients who for the most part were men, sometimes women and, rarely, children. But now, when I look through the glass divider into my waiting room, I see many children, some women and few men. Family practice rooms everywhere demonstrate the need for generalists to be well equipped with pediatric skills. Most general clinical skills texts I own give only superficial overviews of how to approach pediatric problems. Fortunately, this book by Richard Goldbloom, Chancellor and Professor of Pediatrics at Dalhousie University, Halifax, fills an important void by reviewing basics such as rashes and examination of the newborn, as well as more complex issues, including dysmorphology, murmurs and psychiatric problems.
Strengths: “Remember that normality is far more common and far more variable than abnormality,” concludes one chapter. This tone — one that places pathologic variants in a realistic, reassuring context — pervades the book. It does not pretend to be a comprehensive guide to differential diagnosis, but instead gives organized approaches to such things as the assessment of visual problems, gynecologic concerns and the “two-minute” musculoskeletal evaluation of children prior to their participation in sports. The use of illustrations and key-point summaries throughout makes this softcover book an easy read.
Limitations: The only photographs of non-white children in the entire book appear on the cover. And, although welcome, the section on “Culturally sensitive pediatric care” offers limited information on First Nations children and other Canadian minority groups. Goldbloom's bluntness may not appeal to everyone — e.g., “The evidence clearly indicates that physicians who attribute a baby's unexplained symptoms to teething are seeking the last haven of refuge for the diagnostically destitute.” — but I found this combination of wit and wisdom greatly appealing. The book's price is merited, but may be an issue for those still in training.
Eric Wooltorton
Associate Editor, CMAJ
Family Physician
Ottawa, Ont.
This book is available through your local book retailer, or through the publisher at www.elsevier.ca/product.jsp?isbn=0721694756