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Saunders' Manual of Pediatric Practice The 5 Minute Pediatric Consult
Saunders' Manual of Pediatric Practice, edited by Laurence Finberg, 1088 pp, $75, with 84 illus, ISBN 0-7216-6537-3, Philadelphia, Pa, WB Saunders Co, 1998.
The 5 Minute Pediatric Consult, edited by William Schwartz, 893 pp, ISBN 0-683-07640-X, $59.95, Baltimore, Md, Williams & Wilkins, 1997.
Reviewer Richard Neill, MD, FAAFP
Arch Fam Med. 1999;8:357-358.
Several years ago, while precepting in a residency program, an upper-level resident excused himself to retrieve a text, returning seconds later with Mark Dambro's 5 Minute Clinical Consult, an encyclopedic primary care reference wherein alphabetically arranged chapters follow a rigorous 2-page outline format. The book rapidly became one of the most frequently used texts in the office. Its success in the publishing market quickly generated competition from W. B. Saunders Company in the form of Saunders' Manual of Medical Practice, which while less structured, offered similar outline-based chapters with bulleted key symptoms, signs, and treatments. Now there are pediatric versions of each text slugging it out as well: Saunders' Manual of Pediatric Practice and The 5 Minute Pediatric Consult, each hoping to gain as much shelf space as their predecessors for adults.
Saunders' Manual of Pediatric Practice is a formidable, though in the end inferior, competitor. Weighing in at almost 6 lb, the text is a multiauthored, multi-institution effort coordinated by 21 section editors and more than 180 authors, many of whom are experts in their chapter topics. Unfortunately, the organization of the text is somewhat complex, making it difficult to quickly locate information, even when using the index. The fact that the 10-page table of contents is buried behind 13 pages of front matter does not help one find things quickly either.
Individual chapters attempt to follow a uniform outline, containing subchapter headings including definition, etiology, epidemiology, pathophysiology, clinical findings, laboratory/radiology findings, and treatment. Numerous tables of "Key Findings" highlight important messages in the text, but diagrams and photographs are sparse. Unfortunately, the outline format is adhered to inconsistently, often with confusing results. For example, in chapter 84, "Vasculitis Syndromes of Childhood," the "Clinical Findings" subheading includes a lengthy list of illnesses, including their symptoms, laboratory findings, and treatments. This is despite later chapter subheadings dealing with symptoms and treatment, a more logical place for this information. Unless one knew in advance where to look, the reader would perhaps overlook specific treatment options for several conditions.
There are also duplicate discussions of several conditions. For example, an entire chapter is devoted to otititis media, but a more engaging discussion of its treatment and prevention occurs in the chapter on earaches.
Despite these drawbacks, Saunders' Manual of Pediatric Practice fits the niche between small pocket handbooks and exhaustive disease-oriented textbooks like Nelson's Textbook of Pediatrics. Like the latter, however, Saunders' manual is better suited for more general reading rather than a ready reference in the office. Students and residents on their inpatient or subspecialty pediatrics rotations will likely find the text more useful than will practicing primary care physicians.
The 5 Minute Pediatric Consult, in contrast, is a quick reference text divided into 4 sections: chief complaints, specific diseases, syndromes, and tables of useful information. With the exception of the last section, the text is formatted entirely as 2-page chapters, with a rigid outline format for each chapter. Although there is a complete index and an easily located table of contents, one rarely has to use them, as the chapters are arranged alphabetically with bold titles at the upper/outer corner of each page to help one find a topic.
The 5 Minute Pediatric Consult is the preference here. One can find topics faster, review major concepts more quickly, and return to patient care with the information one needs. While the Saunders text can be used as a backup from time to time, Nelson's Textbook of Pediatrics is probably a better choice if one cannot find the necessary information in The 5 Minute Pediatric Consult.
University of Pennsylvania
Department of Family Practice and Community Medicine
Philadelphia
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