The expertise required to assess practically and accurately the office patient guarantees an eager approach to a book entitled Towards Earlier Diagnosis in Primary Care.
The author, Keith Hodgkins, MD, has correctly diagnosed a medical training deficiency, namely, inadequate experience with office problems.
The author has also correctly established the cause of the deficiency—"many common problems of general practice are never encountered in the hospital."
The author's book, prescribed as therapy, consists of two phases. The first phase is an excellent overview of the primary physician's job of assessment and the patient's development, behavior, and responses to societal influences. The second phase of the therapy involves 400 pages of suspected or confirmed diagnoses of National Health Service patients in Britain, with compilation of symptoms and signs. Few of the ensuing suggestions for practice audit are applicable in this country and the "Clinical Pointers" are considered an inadequate part of Hodgkin's