Book Review

Comprehensive Pediatric Hospital Medicine

N Engl J Med 2008; 358:2301-2302May 22, 2008

Article

Comprehensive Pediatric Hospital Medicine
Edited by Lisa B. Zaoutis and Vincent W. Chiang. 1349 pp., illustrated. Philadelphia, Mosby, 2007. $139. ISBN: 978-0-323-03004-5

More than 20,000 doctors currently identify themselves as hospitalists — physicians whose practices center on inpatient services and who focus on organizing and coordinating care; on communicating with patients, their families, and staff; and on educating residents and other staff. There are now numerous pediatric hospitalists among these practitioners; more than 40% of pediatricians currently in practice admit patients to facilities that have pediatric hospitalists on staff.

Those who write textbooks on the evolving field of pediatric hospital medicine have the unusual opportunity to influence not only trainees, but also those who have long been in practice in a variety of areas within pediatrics. Currently, however, there are few textbooks about hospital-based medicine and even fewer about pediatric hospital-based care. When the first edition of one such book, Pediatric Hospital Medicine: Textbook of Inpatient Management (Philadelphia: Lippincott Williams & Wilkins) appeared in 2003, it was reviewed in the Journal. A second edition of this concise book (Philadelphia: Lippincott Williams & Wilkins, 2008) was recently published, and its editors aim to cover both the rationale for the hospitalist movement and the underpinnings that a health care professional needs to provide competent pediatric care in a hospital.

A new textbook in this field, Comprehensive Pediatric Hospital Medicine, edited by Lisa Zaoutis and Vincent Chiang along with three associate editors, is written with a somewhat different intent, as indicated by the first word of the title. Those acting as hospitalists or wishing to understand the role of hospitalists would do well to acquire a copy of this book. It is the most in-depth compilation of information on the topic to date, presenting chapters that aim both to explain the roles of the hospitalist and to provide broad teaching about inpatient pediatric medicine.

Especially useful are the ways in which this book differs from standard pediatric textbooks, most of which focus on developmental stages, organ systems, and diseases, often without emphasis on what is important in the outpatient setting and what is key in the inpatient milieu. In contrast to these classic pediatric textbooks, Comprehensive Pediatric Hospital Medicine is focused specifically on inpatient medical care. It begins with a section entitled “General Issues of Inpatient Pediatric Medicine.” Robert Wachter, who coined the term “hospitalist” in 1996 with Lee Goldman, is the author of the first chapter in the section, “What Is a Hospitalist?” The book ends with 19 chapters on medical procedures that may be required during a child's hospitalization. Another useful section focuses on caring for the medically complex child.

An unusual component of this textbook, as well as of Pediatric Hospital Medicine, is the inclusion of sections on the structural and financial aspects of hospital-based care. Such chapters are no doubt a response to worries that have been voiced about the viability of this field. Although proponents of the pediatric hospitalist movement would argue that the presence of a full-time pediatrician in the hospital facilitates smooth and high-quality care, communication, and overall patient satisfaction, those who raise doubts about this emerging specialty often note that pediatric hospitalists cannot cover their salary requirements with the reimbursements that are provided for the services they deliver. Some readers may find these chapters jarring, but they contain helpful information for those who are trying to learn more about the field.

Comprehensive Pediatric Hospital Medicine is a single-volume book that weighs in at 9.1 lb, rendering it unwieldy to hold comfortably while reading. In future editions, the editors would do well to split the work into two volumes that could be handled more easily. This book would also lend itself to an online version or supplement, which would permit enhancements such as animations and videos.

In the aggregate, this book provides very helpful information about the field of hospital-based pediatrics and how it is structured and presents a rational and sensitive approach to the treatment of the hospitalized child. You don't have to be a hospitalist to benefit from this book, which does the pediatric community a service by providing an in-depth overview of inpatient pediatric medicine. All who are involved in delivering health care to children and adolescents would do well to obtain this unique textbook.

Julie R. Ingelfinger, M.D.

Citing Articles (2)

Citing Articles

1. 1

   Erin R. Stucky, Mary C. Ottolini, Jennifer Maniscalco. (2010) Pediatric hospital medicine core competencies: Development and methodology. Journal of Hospital Medicine 5:6, 339-343
   CrossRef

2. 2

   Erin R. Stucky, Mary C. Ottolini, Jennifer Maniscalco. (2010) Pediatric hospital medicine core competencies: Development and methodology. Journal of Hospital Medicine 5:S2, 110-114
   CrossRef