Preface

The discipline of general practice has become complex, expansive and challenging, but nevertheless remains manageable, fascinating and rewarding. John Murtagh’s General Practice attempts to address the issue of the base of knowledge and skills required in modern general practice. Some of the basics of primary healthcare remain the same. In fact, there is an everlasting identity about many of the medical problems that affect human beings, be it a splinter under a nail, a stye of the eyelid, a terminal illness or simply stress-related anxiety. Many of the treatments and approaches to caring management are universal and timeless.

This text covers a mix of traditional and modern practice with an emphasis on the importance of clinical reasoning, early diagnosis, strategies for solving common presenting problems, continuing care, holistic management and ‘tricks of the trade’. One feature of our discipline is the patient who presents with undifferentiated problems featuring an overlap of organic and psychosocial components. There is the constant challenge to make an early diagnosis and identify the ever-lurking, life-threatening illness. Hence the ‘must not be missed’ catch cry throughout the text. To reinforce this awareness, ‘red flag pointers’ to serious disease are included where appropriate. The general practice diagnostic model, which pervades all the chapters on problem solving, is based on the authors’ experience, but readers can draw on their own experience to make the model work effectively for themselves.

This eighth edition expands on the challenging initiative of diagnostic triads (or tetrads), which act as a brief aide-memoire to assist in identifying a disorder from three (or four) key symptoms or signs. A particular challenge in the preparation of the text was to identify as much appropriate and credible evidence-based information as relevant. This material, which still has its limitations, has been combined with considerable collective wisdom from experts, especially from the Therapeutic Guidelines series. A key objective of this publication is to achieve a balance between science and the art of general practice. To provide updated accuracy and credibility, the authors have had the relevant chapters peer reviewed by independent experts in the respective disciplines. These consultants are acknowledged in the reviewers section. The revised editions also have the advantage of co-authorship from experienced general practitioner Dr Jill Rosenblatt. Additional authors include Dr Clare Murtagh, a general practitioner with experience in medical education, and Dr Justin Coleman, past president of the Australasian Medical Writers Association with special interests in ‘Choosing wisely’ programs and evidence-based medicine.

A comprehensive book such as this one, which presents a basic overview of primary medicine, cannot possibly cover all the medical problems likely to be encountered. An attempt has been made, however, to focus on problems that are common, significant, preventable and treatable. Recent content includes expanded material on genetic disorders and infectious diseases, particularly coronaviruses and acute respiratory distress syndrome.

John Murtagh’s General Practice is written as a user-friendly text with the recent graduate, the international medical graduate and the medical student in mind. However, all primary-care practitioners will gain useful information from the book’s content.