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Paul M. Paulman
Robert B. Taylor
Audrey A. Paulman
Laeth S. Nasir
Editors

Family
Medicine
Principles and Practice
Eighth Edition
Family Medicine
Paul M. Paulman • Robert B. Taylor •
Audrey A. Paulman • Laeth S. Nasir
Editors

Family Medicine
Principles and Practice

Eighth Edition

With 198 figures and 357 Tables

Editors
Paul M. Paulman Robert B. Taylor
Department of Family Medicine Department of Family and Community
University of Nebraska Medical Center Medicine
Omaha, NE, USA Eastern Virginia Medical School
Norfolk, VA, USA
Oregon Health Science University
Portland, OR, USA

Audrey A. Paulman Laeth S. Nasir

Department of Family Medicine Department of Family Medicine
University of Nebraska Medical Center Creighton University School of Medicine
Omaha, NE, USA Omaha, NE, USA

ISBN 978-3-030-54440-9 ISBN 978-3-030-54441-6 (eBook)

ISBN 978-3-030-54442-3 (print and electronic bundle)
https://doi.org/10.1007/978-3-030-54441-6
1st to 6th edition: Springer-Verlag New York Inc.; 1978, 1983, 1988, 1994, 1998, 2003
7th edition: Springer International Publishing Switzerland 2017
8th edition: © Springer Nature Switzerland AG 2022
All rights are reserved by the Publisher, whether the whole or part of the material is concerned,
specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting,
reproduction on microfilms or in any other physical way, and transmission or information storage
and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are exempt
from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authors or the editors give a warranty, expressed or implied, with respect to the material contained
herein or for any errors or omissions that may have been made. The publisher remains neutral with
regard to jurisdictional claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
“Thanks to all family physicians and others who provide primary
care to their patients; without you, there would be no reason to
publish this book.”
Preface to the Eighth Edition

Family Medicine: Principles and Practice, eighth edition, is designed to

provide point of care and reference information for family physicians,
mid-level providers, residents, medical and osteopathic students, and all others
who provide primary care for patients. The supervising editors from the
seventh edition also supervised the production of this volume. The fact that
only a few chapters were removed and a few chapters added is yet another
tribute to Dr. Robert Taylor’s book design as he published the first of this series
and continues to serve on the editorial team and provide advice and counsel.
Given that this project took place during the COVID-19 pandemic, the addi-
tion of a chapter covering pandemics is very timely.
The editors are very grateful to the staff and administrators at Springer and
chapter authors who not only provided very good chapter manuscripts but also
cared for themselves and their families during this pandemic. My personal
thanks to Dr. Audrey Paulman and Dr. Laeth Nasir for their great work on the
editorial team, and of course, thank you to all our readers/users of this book, as
I said in the preface of the previous edition: providing good information which
helps our readers improve the care of their patients will be our highest marker
of success.

Stay well.
For the editors,
Omaha, USA Paul M. Paulman
December 2021 Lead Editor

vii
Preface to the First Edition

As we celebrate the publication of the 8th edition of Taylor’s Family Medicine:

Principles and Practice, we are also celebrating the 45th anniversary of the
publication of the landmark textbook Taylor’s Family Medicine: Principles
and Practice, 1st edition.
This book is about people: the patient, the family, and the family physician.
It presents health problems of the patient and health care by the physician in the
context of mankind’s most enduring societal unit – the family.
The objectives in preparation of this book have been:

1. To compile in a single textbook the fundamental principles of family

medicine and the methods to implement these principles on a global basis.
2. To describe the approach of the family physician to clinical problems.
3. To help identify the clinical content of family medicine.
4. To provide a data base which can serve as a day-by-day reference source for
the resident physician and clinician.
5. To explore the history and philosophy of the family practice movement.

These objectives were pursued by seeking the advice and participation of

family medicine educators and practitioners around the world; preparing a
book format intended to present data in a logical, cohesive manner; selecting
authors based on their interests and contributions in family medicine; consid-
ering the priorities family physicians ascribe to achieving competence in
various clinical areas; and including chapters telling the evolution of the
modern family physician and his focus on the patient in relation to the family.
A new textbook should differ significantly from other literature in the field.
The following 94 chapters represent new material prepared specifically for this
first edition, including many facts and theories never before in print. There are
several chapters giving personal viewpoints on topics pertinent to the spe-
cialty. The format employs units of sequential chapters that allow full eluci-
dation of concepts. The broad scope of family medicine is covered, including
sections on family medicine education, behavior and counseling, and the full
spectrum of clinical medicine. The development of clinical chapters has
included the Competence Priority Classification of Behavior, Concepts, and
Skills in Family Medicine, a unifying taxonomy that is intended to be aca-
demically instructive and clinically relevant.

ix
x Preface to the First Edition

The editor expresses appreciation to the 128 contributing authors and to the
four associate editors: John L. Buckingham, E. P. Donatelle, William E. Jacott,
and Melville G. Rosen. Also gratefully acknowledged is the cooperation of the
American Academy of Family Physicians, The American Board of Family
Practice, the College of Family Physicians of Canada, and the Society of
Teachers of Family Medicine. My family – Anita, Diana, and Sharon – shared
in the preparation of this book, as did literally hundreds of other persons too
numerous to list individually, and to whom the editors, authors, and readers are
indebted.

R.B.T
Acknowledgments

We dedicate this book to all the workers who labored to keep us healthy, fed,
and safe during the COVID-19 pandemic. There will never be adequate
recognition or rewards for these incredible men and women; nevertheless,
we’d like to add our thanks.
We have many more people to thank: Dr. Robert Taylor has continued to
inspire us in his role as founder of this series of reference books; his advice and
counsel have been invaluable.
Saskia Ellis, our production manager, provided a steady, consistent guiding
hand throughout the production process. When it seemed that we had reached
insurmountable roadblocks, Saskia was there to let us know how much
progress we had made and how we weren’t THAT far behind schedule. We
appreciate your work, Saskia!
Sylvia Blago has also been inspirational for us and has helped us keep our
eye on the prize. Having worked with Sylvia on previous projects, we have had
great production experiences and she did not disappoint during this project.
Thank you, Sylvia.
Our chapter authors came through with great material, while also caring for
their patients and keeping themselves and their families safe from the virus. We
are in your debt.
Personal thanks to Dr. Audrey Paulman and Dr. Laeth Nasir, volume
editors, for their great efforts to recruit chapter authors and overcome any
and all problems in order to bring this book to publication. We look forward to
future editions of this reference book from Dr. Laeth Nasir and his team. Future
editions of this book will be outstanding.

For the editors,

Paul M. Paulman
Editor

xi
Contents

Volume 1

Part I The Principles of Family Medicine . . . . . . . . . . . . . . . . . . . . . 1

1 Family Medicine: Fifty Years of Caring for America . . . . . . 3

John W. Saultz, Robert B. Taylor, and Paul M. Paulman
2 Culture, Race, and Ethnicity Issues in Health Care . . . . . . . 17
Mila Lopez, Jingnan Bu, and Michael Dale Mendoza
3 Family Issues in Health Care . . . . . . . . . . . . . . . . . . . . . . . . . 29
Thomas L. Campbell, Susan H. McDaniel, and
Kathy Cole-Kelly
4 Family Stress and Counseling . . . . . . . . . . . . . . . . . . . . . . . . . 39
Marjorie Guthrie, Max Zubatsky, Lauren Redlinger, and
Craig W. Smith
5 Population-Based Health Care . . . . . . . . . . . . . . . . . . . . . . . . 53
Tanya E. Anim, George Rust, Cyneetha Strong, and
Joedrecka S. Brown Speights

Part II Preventive Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

6 Clinical Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
Roger J. Zoorob, Maria C. Mejia, and Robert S. Levine
7 Health Promotion and Wellness . . . . . . . . . . . . . . . . . . . . . . . 95
Jennifer Dalrymple, Kristen Dimas, Rose Anne Illes, and
Tyler Spradling
8 Health Care of the International Traveler . . . . . . . . . . . . . . . 107
Timothy Herrick

Part III Pregnancy, Childbirth, and Postpartum Care . . . . . . . . . . 119

9 Preconception Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121

Stephen D. Ratcliffe, Stephanie E. Rosener, and
Daniel J. Frayne

xiii
with

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xiii

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