Swartz - Textbook of physical diagnosis: history and examination

This is the seventh edition of the Textbook of Physical Diagnosis: History and Examination , which, like its predecessors, has been written for students of health care who are learning to communicate effectively with patients, examine patients, and assess patients' medical problems. Although 25 years have passed since the publication of the first edition, this text still offers a unique, comprehensive (but concise) approach to physical diagnosis. By discussing pathophysiology of disease and emphasizing the humanistic element of health care, I attempt to show the importance of the old-fashioned doctor's approach to the patient. The primary aim of this textbook, as stated in the preface to the first edition, is to provide a framework for the clinical assessment of the patient in a humanistic manner. The book, then and now, focuses on the patient: his or her needs, problems, and concerns.

The history and physical examination must not be seen as procedures performed by a robot but rather as a process that requires interpersonal awareness and technical skill. In this era of extraordinary advances in diagnostic modalities, procedures and tests have been emphasized, whereas the importance of the history and physical examination has been minimized. It is well known, however, that among the most valuable and least costly medical evaluations are the history and physical examination. This book focuses on how to offer the best medical care through the art of effective interviewing and physical examination.

The seventh edition represents a major revision based on a complete review of the field of physical diagnosis. The chapters have been reviewed and modified where appropriate. Extensive changes have been made to many chapters. As times change, so do standards of physical diagnosis. Several of the tests indicated in the previous editions have been either modified or eliminated.

Included with this print text is an accompanying website on Student Consult ( and entering the unique PIN code provided on the inside front cover of this book.

In trying to keep up with the needs of the readership and recognizing that many readers place a premium on portability and accessibility in textbooks, this edition introduces several changes. The print book has been made much smaller than the previous edition by moving select material to the online version of the text, available on Student Consult. All of the chapters on history-taking and the physical examination remain in this printed edition, but the chapters on the focused history and physical examination (), the epilogue (Chapter 30), and all the appendices are found exclusively on Student Consult.

The DVD-ROM that previously accompanied this book has also been eliminated, and the content can now be streamed directly from Student Consult . These high-quality videos contain step-by-step demonstrations of the complete physical examination of the man and of the breast and pelvic examinations of the woman. They also illustrate the pediatric examinations of the newborn and the toddler and the neurologic evaluation of the toddler. Using standardized patients, the video presentation shows history-taking with an adolescent and her mother and interviewing techniques regarding sensitive topics with a geriatric patient. These sensitive topics include a discussion of advance directives (i.e., health care proxy determination and living wills), a mental status examination of a patient with a cognitive impairment, and a scenario showing how to give bad news. Finally, scenarios demonstrating the focused history and physical examination of a young man with abdominal pain, counseling a woman about health-related issues, and a pediatric telephone consultation are presented. These are very useful scenarios for preparing for the USMLE Step 2CS Examination. This online resource, coupled with the printed textbook, provides a comprehensive clinical reference for the understanding of the organization and fluidity of the complete assessment of the patient.