THE BUSINESS OF MEDICINE by J K Silver, MD, Hanley & Belfus, Inc., Philadelphia, 1998, xi + 376 pages + index, ISBN 1-56053254-8

J K Silver, MD, from Carmichael, California, UC Davis graduate, (as is her sister who practices at Permanente and is a member of our society) instructor in Physical Medicine and Rehabilitation at Harvard, has assembled 31 authors who deliver 21 chapters on the business aspects of medicine ranging from solo practice to finding a job to physician executives. Many of these authors are non-MDs and of the authors who are MDs, many hold additional degrees such as MBA, MHA, MPH, DPH, and JD. Each author represents their own point of view.

Gail Bender, MD, MS, author of the chapter, "Solo Practice," feels that solo practice is the best way to deliver high quality, personable and personalized care, be a patient advocate, be more available and accessible, and, because of better continuity of care, be the most cost-effective for both outpatient and hospital care. She feels if quality of patient outcomes and cost-effectiveness could be analyzed comprehensively and objectively, they probably would demonstrate that the medical outcomes in the solo independent practice setting are at least as good and probably more cost-effective than in many fully integrated group settings.

Four persons--a health educator, a social worker, a naturopath, and a physician--contribute to the chapter, "Practicing the Art of Medicine." Although one cannot fathom an Art of Medicine that is not grounded to the scientific method and good clinical judgement, close attention to the points about communication, an open attitude, being fully present, intuition, and respecting the imbalance of power, will make any of us more effective in our practice.

The book contains a wealth of data on numerous areas of practice from physician compensation to physician errors, their types and importance. Practical help on running the office with help for your office manager followed by a chapter on checking the vital signs of your practice is worth reviewing from time to time.

Since each chapter is relatively autonomous, one can review a chapter or two without the compunction of reading the entire book.

Del Meyer, MD
delmeyer@healthcarecom.net