April 7, 2003

Branch edits practical book on medicine

By Alicia Sands Lurry

William Branch, Carter Smith Sr. Professor of Medicine and director of general medicine at Grady Hospital, is editor of the newly published Office Practice of Medicine, one of the largest, nationally recognized medical textbooks of its kind.

Published by the W.B. Saunders Co., the book is now in its fourth edition and is bigger and more comprehensive, with chapters written by several School of Medicine physicians. There are 160 authors and 99 detailed chapters, covering diseases and disorders of every major body system and medical topics from gynecology to neurology. The book, which has sold between 50,000 and 60,000 copies since first published, is designed to help practitioners address the challenges of primary care by enhancing their efficiency and clinical skills.

“Many people consider this book to be the standard for outpatient medicine,” said Branch, who also serves as vice chair for primary care at Emory and wrote nine chapters himself. “When I started this book, there was no book on outpatient medicine at the time. This book fills the void of dealing with problems that are commonly encountered by the physician in practice.”

The textbook specifically focuses on clinical epidemiology and medical conditions not covered in general medicine texts. Rather than concentrate on diseases, the textbook focuses on symptoms. Problem-oriented chapters dealing with everything from headache to lower-back pain help clinicians better analyze a patient’s condition and other pertinent details, including questions to ask, assessing common disease symptoms, and ordering and interpreting tests.

The fourth edition includes 16 new chapters and an expanded nationwide group of experts—from not only Emory’s medical school and Emory Hospital but also Harvard and Boston universities—as chapter authors.

Some of the new chapters include information on management of ischemic heart disease; coronary artherosclerosis and the effects of aspirin, oxidative stress, alcohol, and psychosocial factors; cough; medical disorders of pregnancy; menopause and hormone replacement therapy; preoperative assessment and care of the surgical patient; and medical care for adolescents and young adults. There also is a reorganized section on women’s health that includes chapters on intimate-partner violence and benign breast disease.

“We’re not so interested in explaining a disease process,” Branch said. “For the practicing doctor, what’s more important is how to diagnose and treat the disease once it is encountered in the clinical setting. We also emphasize preventive care, which often is not emphasized in textbooks.”

Branch said that when the book was first published in 1982, it was “quite radical” in its approach. And while there now are similar textbooks on the market, Branch said his book is the most detailed and provides more substantive approaches to medical problems.

“Someone who once reviewed the book told me it provided more information and belonged on the doctor’s desk,” Branch said. “The book is designed to explain how the experts approach a problem. If we’re looking at headache, we’re trying to find out what does a true, world renowned expert in headache do, in terms of diagnosing and treating a patient?

“We’re looking for a way of getting that information out to the practicing doctors,” Branch continued. “We’re looking for evidence that the average practicing doctors may not know about.”