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Thomas C. Royer, the physician. CEO of Christus ... to integrate physicians, in both the employed and the ... list ofmedicinal herbs suggested for various health ...
BOOK REVIEWS

"The Qualities of an Effective Health Care CEO" and "How to Recruit a Top Health Care CEO"-written by recruiters and key consultants-provided insights on the ideal candidate and successful leader, the chapters written by the CEOs themselves proved to be the most informative. Take, for example, a young junior health administrator in quest of the next step in his or her career-who is best to provide pertinent knowledge than an experienced CEO. The CEO lives and breathes the nuances of managing a healthcare organization everyday. The CEO can provide the pros and cons, and provide the details on how they succeeded and how they failed. Furthermore, a CEO can describe what it takes to be an effective leader, how to work with board members, their role within the community and how to handle pretentious physicians. As Thomas C. Royer, the physician CEO of Christus Health, so eloquently states, "Physicians, although as a group sometimes challenging to manage, are the driver of most of the costs. In addition, their clinical knowledge is essential in assisting in the strategic planning process. Healthcare organizations must continue to seek successful ways to integrate physicians, in both the

employed and the private practice model." The wisdom the CEOs display is essential to the success of this book. Although, the diverse group of backgrounds from chapter to chapter is a nice way to present opinions on the nature of healthcare, the chapters seem redundant, with their opinions all being very similar. Furthermore, the slight attempts of adding figures to provide the reader with more information, which are prevalent in the first eight chapters, border close to page fillers. For anyone eyeing the CEO's position, this book would be a nice start for the basics ofunderstanding a healthcare CEO's character traits and gives a brief synopsis of the critical issues and challenges facing the CEO. However, when the guest authors try to provide solutions on how to face these challenges, they tend to fall short. Reviewed by Loleta M. Robinson, MD, MBA [email protected]

The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs Heather Boon and Michael Smith; Toronto, Ontario Canada: Robert Rose, Inc., 2004; ISBN 07788-0082-2; 352 pages; $19.95

Considering the growing number ofpeople who are using alternative medicine as an answer to the difficulty in obtaining healthcare, this easy-to-read, well-organized book is a blessing for the patient or practitioner trying to understand the appropriate use of common medicinal herbs. The two pharmacists who wrote it who participated in a thorough systematic effort to develop course materials for pharmacists about botanical medicine that culminated in a 1999 published refer-

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ence book, The Botanical Pharnacy. They wrote the current tome using undated information and research, and they have published it for the common reader and nonpharmacist. As more patients turn to alternative medicine, physicians must either become familiar with herbal medicines or have a reference book to refer to should their patients come in with questions or concerns. This great book supplies useful information about 50 ofthe most common medicinal herbs. As allopathic physicians may not be familiar with botanical medicine terms, after a short introduction to the text, the authors provide a glossary. For example, they define a cholagogue as "an agent that promotes the secretion of bile by causing the contraction of the gallbladder." This section is followed by a list of medicinal herbs suggested for various health conditions. For example, they list kava as one of the most appropriate herbs for anxiety/tension. Most of the text then provides a drawing, thumbnail sketch (containing information on common uses, active constituents, adverse effects, cautions/contraindications, drug interactions, doses-oral and topical), description, parts of the plant used, traditional use and current medicinal use ofthe 50 plants that are the focus of the text. Also included is current, THE COMPLETE NATURAL MEDICINE GUIDE TO THE

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BOOK REVIEWS

relevant research that addresses preventive and therapeutic main effects, miscellaneous effects, adverse effects, cautions and contraindications, drug interactions and dosage regimens for 50 common herbs: alpha, aloe vera, astragalus, black cohosh, Burdock, calendula, capsicum, cat's claw, chamomile, chaste tree, cranberry, dandelion, devil's claw, dong quai (angelica), echinacea, Elder, evening primrose, feverfew, garlic, ginger, ginkgo, ginseng (Asian and American/Canadian), Ginseng (Siberian), goldenseal, hawthorn, hops, horsechestnut, juniper, kava, lemon balm, licorice, lobelia, ma huang (ephedra), meadowsweet, milk thistle, nettle, passionflower, peppermint, red raspberry, saw palmetto, scullcap, St. John's wort, tea tree oil, thyme, turmeric, uva-ursi (bearberry), Valerian, wild yam and willow]. Pharmacists Boon and Smith fill the text with interesting obscure facts about medicinal herbs. Fact is well-separated from fiction. For example, garlic is the most well-researched herb, and while it may not reduce blood pressure as touted, it does reduce cholesterol. A major strength of the text is the reference list (organized according to the herb being considered in the reference article) derived from scientific literature. The work is essentially the physician's desk reference to common medicinal herbs and should be on every practicing physician's desk next to the commonly found PDR.

Reviewed by Carl C. Bell, MD President/CEO Community Mental Health Council, Inc. Professor ofPsychiatry and Public Health University ofIllinois at Chicago

[email protected]

Cystic Fibrosis: Everything You Need to Know Edited by Wayne Kepron; New York: Firefly Books, 2004; ISBN 1-55297-740-4; 190 pages

Cystic fibrosis is the most common autosomal recessive disorder in Caucasian people. Approximately one in 25 Caucasians is a heterozygous carrier for this disorder, with one newborn in every 2,500 live births being affected. The disorder is caused by a genetic mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) gene located on the long arm of chromosome 7. Cystic fibrosis is the major cause of severe chronic lung disease and exocrine pancreatic insufficiency in children. The disorder causes significant morbidity and mortality both in children and adults. This book is written by Dr. Wayne Kepron, a professor of medicine at the University of Manitoba and a respirologist who has been treating patients with cystic fibrosis for more than a quarter of a century. The book is aimed at a very wide readershippatients with cystic fibrosis, their family members, lay people and heath professionals. The book is divided into 10 chapters: "What is Cystic Fibrosis", "The Cystic Fibrosis Gene", "Cystic Fibrosis and the Respiratory System", "Cystic Fibrosis and the Gastrointestinal System", " Cystic Fibrosis and the Reproductive System", "Unusual Manifestations of Cystic Fibrosis", "Problems of Adolescence and Adulthood", "Issues of Respiratory Therapy", "Issues of Eating and Nutrition", and "Lung Transplantation and Gene Therapy". A table of common drugs, a thorough glossary, and a list of resources and support networks supplement the text. This convenient pocket-sized

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book is written in simple lay terms for patients and families affected by cystic fibrosis. It provides comprehensive information on almost every situation that might be encountered by these patients and answers practically all the questions that are most frequently asked. The language is clear and easy-to-read. In general, the information given is appropriate, accurate and up-to-date. The current status and future prospects of gene therapy are well-described. The case histories are illustrative. The book has a few minor deficiencies. The author mentions that a sweat chloride test detects all cystic fibrosis patients. In reality, approximately 5% of tests are false negative. Conditions, such as hypoproteinemic edema, can lead to false negative results. The information can also be more pediatric-focused. For example, the clinical features of acute sinusitis in children are different from those ofadults. In children, the diagnosis is based on persistent or severe upper respiratory tract symptoms. Transillumination is not an accurate maneuver in young children. The routine use of roentgenograms to confirm the diagnosis of uncomplicated sinusitis is not recommended for children six years of age or younger. The author should also caution against the use of soy protein formulas in infants with cystic fibrosis. Infants with VOL. 97, NO. 1, JANUARY 2005 113