Complexity in primary care

OVERALL RATING Good

STRENGTHS Thought provoking, organized, intelligent

WEAKNESSES Complex language

AUDIENCE General practitioners, health care organizations, and policy makers

This book deals with health care models that influence the provision of primary care. My first impression of this book was one of intimidation at the unfamiliar language and concepts used to describe these models. The author, however, reviews each model then adds clinical commentary to enhance the understanding of the concepts discussed. He also reaffirms the features of each model during the discussions to facilitate understanding.

This book is divided into chapters, each reviewing the different models that have contributed to the evolution of the current understanding of the practice of medicine. The first chapter questions why it is important to understand how physicians think in order to make decisions in clinical practice. In the subsequent 3 chapters, the author outlines the historical development of the scientific models that determine our current decision-making processes in medicine. Once the foundations of the current models have been discussed, the author uses the next 2 chapters to discuss an enhanced model in health care—that of complexity. He reviews the mathematical theories involved in the understanding of complex systems and differentiates complexity from chaos. Throughout the presentation of the facets of the model, there are clinical examples to illustrate the components of the theory. In the final chapter the author reviews the principles of complexity in relation to 4 of his published articles. I found this section of the text difficult to relate to the previously described principles in the book. However, there is an extensive reference and reading list included in the book and an index to access text easily.

Overall, I thought the author put forth an intriguing, thought-provoking account of the different models of care that underlie current medical practice. His illustration of the model of complexity in medicine further advances understanding of the doctor-patient relationship and ultimately the principles that guide health care policy.

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