Primary Care Medicine: Evidence-Based Outpatient Diagnosis, Multimorbidity Management, and Clinical Decision Frameworks for Primary Care Physicians and Residents

Primary care medicine is not a simplified version of internal medicine. It is a distinct clinical discipline that demands diagnostic reasoning across every organ system, management of multiple coexisting conditions in a single encounter, and the ability to make sound decisions under uncertainty with limited time and incomplete information. This textbook was written to address that discipline directly.Primary Care Medicine by Dr. Sigrid Vanhanen is a comprehensive, evidence-based clinical reference written for primary care physicians, general practitioners, internal medicine residents, and family medicine practitioners who require a textbook built around how outpatient medicine is actually practiced. The book is organized across ten sections covering the full breadth of primary care medicine, from cardiovascular and respiratory disease through psychiatry, geriatrics, and global primary care contexts.Unlike references organized as narrow symptom catalogues, this textbook integrates screening, evaluation, management, and monitoring into unified clinical reasoning chapters. Every chapter is structured around the clinical questions a primary care physician faces in practice, not around isolated diagnoses. Every chapter closes with a clinical decision framework, a signature feature that synthesizes the chapter content into a practical outpatient decision architecture. This feature is absent from all major competing primary care references.The opening section establishes the foundational principles of primary care practice including the biopsychosocial model, preventive medicine and health maintenance, diagnostic reasoning, Bayesian test interpretation, and benefit-harm analysis in treatment selection. These chapters address the intellectual framework of primary care before any organ system is discussed.Subsequent sections cover cardiovascular medicine including hypertension, dyslipidemia, heart failure, arrhythmias, and peripheral vascular disease; respiratory medicine including COPD, asthma, tuberculosis, lung cancer screening, and smoking cessation; gastrointestinal and hepatic medicine including cirrhosis, viral hepatitis, colorectal cancer screening, and inflammatory bowel disease; endocrinology and metabolic medicine including diabetes, obesity, thyroid disease, and adrenal disorders; hematology, oncology, and anticoagulation; genitourinary and women's health; musculoskeletal and neurologic medicine; dermatology, ophthalmology, and ENT disorders; and psychiatry and behavioral health.The final section addresses multidisciplinary primary care including geriatrics and frailty, adolescent medicine, chronic non-malignant pain and opioid stewardship, perioperative medical evaluation, complementary therapies, and the global primary care context with specific attention to resource-limited and high-burden disease settings.Every chapter includes evidence-based management guidance referencing current society guidelines, practical clinical pearls drawn from outpatient practice, and the signature clinical decision framework that closes each chapter. The book contains images including clinical algorithms, diagnostic frameworks, and data visualizations distributed across all chapters.Topics covered include multimorbidity management, SGLT2 inhibitor evidence in diabetes and heart failure, anticoagulation with DOACs, sickle cell disease in primary care, cervical and breast cancer screening, PSA controversy navigation, dementia evaluation, opioid stewardship in chronic pain, and primary care approaches adapted for global and African patient populations.This textbook is designed to serve as both a learning resource for residents and a long-term clinical reference for practicing primary care physicians. Read more