Family Medicine: A Systemic Approach to the Planning and Development of a Community Practice.

In this column, members of the College's Vantage Council review books that they have identified as being of interest and value to the medical management profession Reviews from other sources are included in Physician Executive as space permits.

Gerald Doeksen, PhD, Kimball A. Miller, MD, MSHA, Patti Jacobs Shelton, BS, and Deborah A. Miller, MS. Family Medicine: A Systematic Approach to the Planning and Development of a Community Practice. Tulsa, Okla.: University of Oklahoma Health Sciences Center, 1990. 88 pages. $9.95.

This well-written and data-packed resource book addresses the many dynamic and interrelated factors that influence a community family practice service. Considerations in the research analysis were from both the physician practice standpoint as well as from the standpoint of the community's ability to support the contemplated practice requirements.

The data collected were obtained from a survey of 19 rural Oklahoma family physicians. The various patient visits in different settings and the costs of equipment and operations, including laboratory procedures, were analyzed. The results, in the form of easily interpreted tables and with generous use of photographs and sample office designs, contribute to an information source to aid the potential practitioner or community in the development of a family practice program in addition to an existing practice.

Following general estimates and averages for a typical community, there are various forms and worksheets that can be utilized in sequence to determine individual needs and projections. Sample floor plans, photos of clinic spaces, amortization factors, and indices to adjust construction and operating costs, are provided in appendices.

The book is well-written and easy to understand, and the approaches to problem areas are helpful and can be utilized by the community or the prospective family practitioner. This is a well-organized and easily applied approach to planning and development of a family-community practice. Although not a complete solution, the book is a useful guide and gives direction for consideration and negotiation with eventual development of a plan for both physician and community.--JRoyston Brown, MD, FACPE, Chief of Administrative Medicine, Department of Veterans Affairs Medical Center, Dallas, Tex.