Caring for patients is challenging work—because people are complicated. Patients seek help not only for acute or chronic medical problems, but they also bring to the clinical encounter their life circumstances, worries, and concerns. Medical problems are rarely only about biomedical issues but are almost always accompanied by problems at work, with family, finances, and a myriad of other life concerns. Physicians and other health professionals need to understand not only the illness but also its impact on the person's life. They must demonstrate a broad understanding of and concern for the patient. As far back as 1925, Dr. Francis Peabody said, "The secret of the care of the patient is in caring for the patient".1
While Peabody's adage is still true, we now need to understand a broader variety of behavioral disorders and the best treatments for them. We need to care for increasing numbers of elderly patients and more ethnically diverse populations. We need to tailor our care to a wider variety of patients with more complex needs and with complex problems such as multiple chronic illnesses, palliative care, HIV/AIDS, and other challenging issues such as intimate partner violence.
Behavioral Medicine: A Guide for Clinical Practice, helps practitioners understand the interplay between psychological, physical, social, and cultural issues of patients. It provides practical information about many of the topics listed above and also includes guidance about how to manage common situations. The case illustrations throughout the book are jewels for medical practitioners who need suggestions about how to communicate effectively in challenging situations. For example, the book provides suggestions for ways to coach patients about lifestyle changes or respond to a patient with a somatic symptom disorder.
In addition, the book is useful to those who teach behavioral medicine. It includes topics related to understanding and assessing the competencies of trainees and developing a curriculum in social and behavioral medicine.
One of the significant elements of the book is the recognition that the well-being of physicians and other health professionals is critically important to caring for patients. As a profession we often do not pay enough attention to the feelings of the physicians who can become burned out doing the work they love and, in turn, provide less good care to patients. Chapters on mindful practice and practitioner well-being enhance the book.
It is no surprise that this book is in its fourth edition. With much new content, it provides insight and information not available anywhere else for those who seek to provide comprehensive high-quality care for patients. And it does so in a way that acknowledges patients as people who have problems that often go far beyond the reach of traditional medical care.
Wendy Levinson, MD
Sir John and Lady Eaton Professor and Chair,
Department of Medicine, University of Toronto, Canada