Oxford Comes to Hopkins
Eager to update its American handbook of medicine, a renowned publisher turns to our docs.

The prolific John Flynn.

During the many nights, weekends and vacation days he spent working on the new Oxford American Handbook of Clinical Medicine, John Flynn would look out the window of his Outpatient Center office and gaze reflectively at the Billings Building’s iconic dome across the street. In that building, Flynn knew, was the room where William Osler, Hopkins’ first physician in chief, wrote his masterful Principles and Practice of Medicine more than a century ago—creating a classic that guided countless physicians for decades.

Flynn, clinical director of general internal medicine, and the 25 other members of the School of Medicine faculty he recruited to update and Americanize the Oxford University Press’s bestselling physicians’ handbook, aimed to produce a text on both the science and art of
patient care that would make Osler proud. The Oxford University Press
believes they have.

Originally published in 1985, the British edition of the Oxford handbook has sold more than 1 million copies and now is in its sixth reprint. An Americanized version, prepared mostly by Tufts University faculty, was produced in the mid-1990s but was overshadowed by similar texts here and has long been out of print.

“We felt we needed a strong U.S. ‘name’ author from a major institution to help get the book noticed in the U.S. market,” says William Lamsback, the Oxford Press’ executive editor in New York. “I immediately thought of Hopkins and that the director of general internal medicine would be the right person to do the book.”

The handbook is designed for medical students, residents and interns, as well as for physicians already practicing clinical medicine, says Flynn, the D. William Schlott Professor, who came to Hopkins in 1986 for his own residency, completed a fellowship in rheumatology here and then joined the faculty in 1991.

The 760-page text, designed to fit in a lab coat pocket, contains 20 sections—all written by Hopkins faculty members. It covers everything from cardiovascular medicine and epidemiology to emergency medicine, rheumatology (the section Flynn wrote), surgery, oncology and hematology.

To “Americanize” it, Flynn and his colleagues took two years to rewrite major portions of the text and add some as well. For example, the British version did not have a chapter on geriatric medicine, which the Hopkins physicians felt was essential; the British section on postoperative care of surgical patients required expansion; and the radiology section needed to be completely rewritten, Flynn says.

Focus groups of medical students at Hopkins and Thomas Jefferson University were impressed. “The concise nature of the text—the bulleted style, the use of graphics—was very well received,” says Flynn, an award-winning teacher.

Flynn is particularly pleased that as editor of the book, he “didn’t have to go far to get help” in the revision. “The collegial collaboration of my colleagues, all of whom are invested in patient care, was remarkable. That’s something special about this institution.”
The book, described as the “flagship” of Oxford’s American medical handbook series, has a first press run of 6,000 copies. “We are confident,” Lamsback says, “that the book will see many printings.” 

Oxford’s experience with Hopkins faculty on the clinical handbook was so positive, in fact, that Lamsback already has asked other Hopkins physicians to write additional volumes in the series. Rheumatologist Philip Seo will write the handbook on his specialty; Michael Choi and Paul Scheel will co-author the handbook on nephrology. Others may follow.

“Oxford,” says Flynn, “comes to Hopkins.” 

–Neil A. Grauer