Book Reviews

What is more important: a good bedside manner, or a good bedside manual? Both are essential parts of the overall health care picture. Everyone benefits when patients have access to medical information that can be perused at leisure or referred to in a crisis. Medical care costs can be avoided or diminished when patients don't immediately reach for the phone at the onset of minor medical situations. Patient confidence in medical professionals increases when office visit advice is confirmed by a text. And patient education, understanding, and compliance may well improve when information is read and reread on the patient's own time.

But which text to choose?

Kaiser Permanente's (KP's) Healthwise Handbook: A Self-Care Guide for You and Your Family is a 300-page paperback that is easy to use and easy to keep on a bedside table. In addition to the expected sections on health problems, this book also advises health plan members how to get the most from the KP system, how to make and prepare for medical appointments, how to share in medical decisions, when to use emergency services, and how to prevent and detect specific medical problems. This book is easy to usepermitting search by symptom and advising patients when to treat themselves at home and when to call a health professional. Descriptions are concise and include only the information needed for determining what action, if any, to take in response to a given set of symptoms.

Unlike the relatively brief Healthwise Handbook, The American College of Physicians' Complete Home Medical Guide is a1000-page tome, a true medical encyclopedia that covers all human medical topics. The book is packaged with a complimentary CD-ROM, "The Ultimate Human Body," whose three-dimensional graphics allow users "to rotate the body, peel away the layers, examine the organs, circulatory system, and the skeleton, and call up data, thus ensuring a total understanding of how the body's complex organs work." Like all Dorling Kindersley publications, the book is a gorgeous production with slick paper and numerous color photographs and illustrations. Handy flowcharts based on queries about specific symptoms help readers determine whether to contact a health care provider or to use home treatment. The book also contains a lengthy list of health organizations and their Web site addresses. Although the book is well organized and is a pleasure to read, it contains much more information than is necessary for occasional consultation by most patients. Thus, this book is most suitable for those who wish to read extensively about the human body or who tend to be hypochondriacal.

For most people, one of the shorter books mentioned here will be most suitable for everyday use. Use of the texts showed that just the weight of the two larger volumes hindered rapid research. These tomes are literally too weighty to use handilysort of like dragging the Oxford English Dictionary into bed or bathroom for consultation during a midnight bout of diarrhea or fever. The big books require readers to scan a topic's abundant index listings to find the page pertaining to first aidnot what is wanted when rushing to find a treatment for burns.

Although the two longer books are fairly comparable in scope, as are the pair of handbooks, they are not identical. Nor do the bigger books necessarily contain all the information that the handbooks contain. For example, only the KP Healthwise Handbook instructs patients on the "hot wire" technique of relieving the pressure of a blood clot located under a fingernail or toenail; the other three books don't mention this very useful topic. The Mayo Clinic Family Health Book instructs how to make a tourniquet, whereas the handbooks mention the tourniquet as a last resort but do not direct how to make one, and the American College of Physicians' book advises patients never to use one. Where emergency help is required, the Mayo Clinic Guide to Self-Care instructs the reader to "Dial 911," whereas the other books merely instruct patients to "contact professional help"; the more specific directiveto dial "911"would probably be of greater use to a panicked reader.

Either of the medical encyclopedias mentioned here would make a good addition to any home reference library but might not occasion much use. On the other hand, I have countless times referred to a medical handbook similar to the two smaller texts listed here. Clearly, some form of home medical reference is important. Which one of these four is best is more a matter of personal preference. If your patients have received the KP Healthwise Handbook, they probably have all they need. Ask them to read it–-especially the sections on how to better participate in their medical care and any section currently relevant to their own health.

Kemper DW, et al, compilers. Kaiser Permanente Healthwise Handbook: a self-care guide for you and your family. 12th ed. Boise, Idaho: Healthwise 1995, ©1994. 352 p. $14.95. ISBN 1877930-091

Goldmann DR, editor. American College of Physicians complete home medical guide. 1st Amer ed. New York: DK Publishing; 1999. 1104 p. $40.00. ISBN 0-7894-4412-7

Larson DE, Editor. Mayo Clinic family health book. 2nd ed. New York: W. Morrow; 1996. $42.50. ISBN 0688144780

Hagen PT, editor. Mayo Clinic guide to self-care. 2nd ed. New York: Kensington; 1999. 272 p. $19.95. ISBN 0962786578

Eve F. Lynch is a San Francisco attorney, recently retired into motherhood.