Synopses & Reviews
The 5th edition of Swansons Family Practice Review is a case base programmed text written for physicians with the certification and recertification examinations in mind, but is also of value for all physicians desiring to update their knowledge concerning practical aspects of primary care.
Up to 79.5 hours of Category 1 CME credit available with purchase!More than 75% all-new cases and questionsthe most thorough revision of the text everAll new or enhanced content in sports medicine, public health, bioterrorism, evidence-based medicine, reading & interpreting medical literature, chronic & acute pain management, systems medicine, and medical errors and error reduction
More than 2100 board-style questionsmore than any competing productNew 8-page color insert featuring dermatology images, which mimic the type of images seen on the examinationProblem-oriented format that simulates clinical situations and allows the user to relate questions to real-life patient scenariosCase-based organization, with questions related to each case
Up to 79.5 hours of Category 1 CME credit available with purchase!
Synopsis
Background: "Family Practice" (FP) officially became the 20th primary medical specialty in February, 1969, with the establishment of the American Board of Family Practice (ABFP). The effort to make this so was led by such pioneers as Richard Swanson (died 11/1996), the original author of the first 1991 edition of the present book, and Robert Rakel, Elsevier"s most well-published author and editor in FP. The specialty of FP, based on the heritage of "General Practice," has graduate programs (residencies) for physicians whose training encompass (1) first contact care; (2) continuous care; (3) comprehensive care; (4) personal care (caritas); (5) family care; and, (6) competency in scientific general medicine. The ABFP, Inc. (Lexington, KY, USA) offers their primary certification and recertification examination in mid-July each year, with an in-training examination the first week of November. The ABFP also offers Certificates of Added Qualifications (CAQs) in Geriatrics (early November), Sports Medicine (mid-April), and Adolescent Medicine (mid-August).Types of End-Users and Size of Market: The American Association of Family Practitioners currently has a membership of over 94,000, with 69,000 of these members declaring Family Practice - FP- specialty, with the remainder in "general practice" or "general preventive medicine." Approximately 90% of the overall membership is US-based MDs, with most of the remainder made up primarily of Canadian FPs, other international members, and medical students seeking residencies in FP programs. It is important to know that only about 40% of the total number of MDs calling themselves "FPs" are actually board certified. Interestingly, however, though the total number of FPs seems to be contracting (with more med school graduates opting for other specialties), the proportionate number of those choosing to board or double-board in the FP specialty is actually trending up, which means that even if FP overall is shrinking somewhat, the total number of people wishing to certify or recertify is fairly stable and possibly even expanding. Part of the reason for this is undoubtedly the fact that more and more HMOs, hospitals, and other health care institutions are requiring board certification for employment and participation in health care plans. Approximately 5,000 US medical residents (approximately 3400 FP residency positions in the US each year) or veteran MDs who are pursuing a change in their specialty sit for the boards in FP each year. Recertification in FP is required every 7 years, though most take the exam every 6 years to allow for the possibility of a fail, which provides one more year for re-examination and a pass. Approximately 10,000 practicing FPs recertify each year. Also, thanks to the fact that the ABFP and the American Boards of Internal Medicine and Psychiatry and Neurology have established guidelines for combined FP-Internal Medicine and FP-Psychiatry training, FP board review books also appeal to some extent to general Internists, Psychiatrists, and Neurologists seeking to board, recertify, or double-board in FP and Internal Medicine or FP and Psychiatry. Thus the potential market size may be substantially larger, as high as several thousand additional individuals. There are also many states that require physicians to maintain their licenses by sitting for the SPEX, or Special Purpose Examination, a general medical board review examination, with content decided upon by state boards of medicine. Many individuals facing this exam will purchase materials for FP or Internal Medicine board review, and this number is probably between 15,000-25,000 each year. Perhaps most importantly besides the ABFP exam and SPEX groups, a great number of customers buy Swanson"s specifically for review in preparation for the USMLE Step 3 exam, or in addition to another book (such as the Crush Step 3 book, LWW"s best-seller for the USMLE Step 3 exam) or other resource that they use for USMLE Step 3 preparation. The United States Medical Licensing Examination (USMLET) is sponsored by the Federation of State Medical Boards (FSMB) of the United States, Inc., and the National Board of Medical Examiners(R) (NBME(R)). Results of the USMLE are reported to medical licensing authorities in the United States and its territories for use in granting the initial license to practice medicine. The three Steps of the USMLE assess a physician's ability to apply knowledge, concepts, and principles that are important in health and disease and that constitute the basis of safe and effective patient care. Step 3 of the exam is taken by all new MDs and MDs from other countries who want a license to practice in the US, and each year they number in the tens of thousands, from the US and the rest of the world. Despite the apparent specificity of Swanson"s title as a "Family Practice" review, it is likely that this USMLE Step 3 group of customers represents the largest sales channel. These people recognize that an FP review presents the broadest presentation of medical topics (including peds and special issues, which, for example, many Internal Medicine board review resources lack) for clinical medicine in an ambulatory care setting. These numbers notwithstanding, this book is intended for the FP audience and USMLE exams are somewhat different from the ABFP exams - we achieve great sales already amongst USMLE customers, and would need to be very careful about pushing this book too much for them. We should explore this issue further with current users, reviewers, and Kaplan Medical. In addition, Canada has a population of about 8,000 FPs and another 19,000 "general practitioners," and the numbers of General Practitioners in the UK, Europe, and Asia, may easily be an additional 300,000 practicing physicians. Many of these people may seek out an FP review book, either with a view to taking the USMLE Step 3, or as a basic personal review reference. Finally, there is an increasingly large group of Nurse Practitioners - NPs - and Physician Assistants - PAs - to whom a resource such as Swanson"s has had and will continue to have strong appeal. Nurse practitioners already have a certification exam for a subspecialty in FP, and the review books available for this tend to be very poor. The total number of nurse practitioners now exceeds 80,000, with 8,000-10,000 new NPs added per year. At least 10% of these, or 800-1000 new NPs, plus a number of veteran NPs seeking new or additional certification, opt to sit for the FP certification exam each year. Physician Assistants also have their own published materials for study and review in their educational and certification programs, but like NPs, they often choose to purchase materials intended for medical students or MDs in addition to or instead of materials made expressly for PAs. PAs in active practice are projected to reach 79,000 by 2015, with 42,000 of those in primary care, and about 30,000 of these working in FP practices. It is likely that at least some of these people would buy a book like Swanson"s. Rolling up all of these numbers, there is a conservative total yearly potential market of between 30,000 and 50,000 individuals per year who may seek out FP board review materials, including books, in-service courses, special package courses, and on-line materials. Given Swanson"s third edition LOT sales of over 60,000 units, and fourth edition sales so far of over 46,000 units, it seems clear that we have one of the most preferred books for ABFB, and very likely the best seller. Purchasers of this and competing titles are naturally interested in obtaining the most current resource, and so sales do tend to fall off sharply after 2 years. This book was first published in 1991 and was the second such board review book to appear in the marketplace, after the Appleton & Lange Specialty Board Review, Family Practice (see under Competition, below). By the second edition, thanks to Dr. Swanson"s hard work and superb reputation, the book was easily the market leader. Print and Electronic Products: It remains to be seen whether customers will continue to prefer a BOOK as their information delivery system of choice for this particular type of review. Based on several PSG rep interviews (10/2002), discussions with Ed Bope and 6 of his FP residents in Columbus (9/2002), and discussions with 3 FP MDs in Charlottesville, VA (10/2002), as well as the success of the current edition of Swanson"s, it may be surmised that at very least customers seek to purchase a book either as their primary or secondary reference tool for the ABFP certification process. Nevertheless, we will need an online resource since the ABFP plans to begin offering on-line Board certification exams in 2004, and they anticipate that about 20-30% of all of their applicants will almost immediately opt to take the online exam, rather than sit for the traditional exam. Although the cases and question formats will be identical to those in the printed Swanson"s, the "experience" of taking an online exam will of course be different from that of sitting for a paper exam. We will be ready with online practice exams that will emulate what the ABFP will offer. (See "Additional Comments" under Production, below)Relationship with Kaplan Medical: Kaplan representatives are willing and eager to update this book and companion resources as often as necessary in order to maintain absolutely up-to-date materials, especially CME accreditation, which expires every 3 years. For this reason, Kaplan would like to see the book placed on a strict 3-year revision cycle, and in the meantime, revise the current 4th edition on-line tests in order to extend CME accreditation for the 4th edition from July 2003 until the new edition can publish (in January 2004). The only possible downside of the relationship with Kaplan is their new demand for a greater share of profits, via significantly higher royalty requirements. This is clearly an important con
Synopsis
The 5th edition of Swanson's Family Practice Review is a case base programmed text written for physicians with the certification and recertification examinations in mind, but is also of value for all physicians desiring to update their knowledge concerning practical aspects of primary care.