Big book of 1,500 disease photos achieves international success

SAN ANTONIO (Aug. 31, 2009) — Medicine isn’t always pretty. But a medical reference guide featuring 1,500 color photographs of disease has achieved international success in less than a year, scoring a third printing, three foreign-language translations and a rave review from the Journal of the American Medical Association.

In the review, The Color Atlas of Family Medicine was described as “a genuine treat to review. The more than 1,000 pages are chock full of figures and photographs illustrating virtually every illness seen by a family physician or other specialist.”

Richard P. Usatine, M.D., professor of Family & Community Medicine and Dermatology and Cutaneous Surgery at The University of Texas Health Science Center at San Antonio, took the lead in compiling and editing the book, which was first published in October 2008. He was joined by another professor of Family & Community Medicine, James W. Tysinger, Ph.D., along with doctors from several other institutions.

The result of their efforts is a comprehensive guide to the practice of medicine that, in addition to photos, includes over 1,000 pages of evidence-based text.

“I’ve always been a teacher as well as a doctor,” said Dr. Usatine, who also is an assistant director of Medical Humanities Education in the Center for Medical Humanities and Ethics at the UT Health Science Center. “I know that one of the best ways to teach medicine is to use images instead of just words.”

Dr. Usatine has taken photographs since he was a teenager. His first camera, inherited from his grandfather, was manufactured in 1926 and completely manual: “It taught me how to understand the science behind photography because I had to understand light and optics and all the nuances of F-stops and shutter speeds.” He also learned to develop and print his own photographs in a darkroom.

He has photographed patients since he began working as a family doctor in 1985, first using 35-millimeter cameras and later moving onto digital.

He has used these photos throughout his teaching and writing, including in the development of a Web site called “The Interactive Dermatology Atlas.”

The Web site was a precursor to “Photo Rounds” a weekly feature in the Journal of Family Practice that offers photos and descriptions of various conditions and challenges readers to make a diagnosis. Dr. Usatine initially did most of the columns with his own photographs, later opening it up to submissions from others.

In 2000, Dr. Usatine – then a professor at UCLA – began giving digital cameras to medical students to teach them to be better observers and doctors. “They would go out and, with patients’ permission, take photographs of the most interesting cases they saw,” he said. “And they’d bring the pictures back, and we’d go over them as a group. And we continue to do that at the UT Health Science Center.”

He had long considered putting together a book like The Color Atlas of Family Medicine, but he did not attempt to pursue it on his own. Then publisher McGraw-Hill approached him with the proposal: “Since it was something I had thought about for years, it was an easy answer.”

Almost always, patients are very receptive to being photographed. Dr. Usatine said he can count on one hand the number of patients who, over the years, have declined. One regular patient with a skin condition bought a copy of the book and asked Dr. Usatine to sign it for her.

“People are very positive,” Dr. Usatine said. “They want to share – it’s very altruistic on their part. They say, ‘If this will help other doctors and other people, please, go ahead.’”

Dr. Usatine is continuing to take photographs for future editions of The Color Atlas of Family Medicine, as well as a version for the general public that he hopes will promote good health practices and help people better understand their own health and diseases.

He received tremendous help from the Health Science Center community on the book, notably from the Division of Dermatology and the Departments of Ophthalmology and Otolaryngology.

The University of Texas Health Science Center at San Antonio is the leading research institution in South Texas and one of the major health sciences universities in the world. With an operating budget of $668 million, the Health Science Center is the chief catalyst for the $16.3 billion biosciences and health care sector in San Antonio’s economy. The Health Science Center has had an estimated $36 billion impact on the region since inception and has expanded to six campuses in San Antonio, Laredo, Harlingen and Edinburg. More than 25,600 graduates (physicians, dentists, nurses, scientists and other health professionals) serve in their fields, including many in Texas. Health Science Center faculty are international leaders in cancer, cardiovascular disease, diabetes, aging, stroke prevention, kidney disease, orthopaedics, research imaging, transplant surgery, psychiatry and clinical neurosciences, pain management, genetics, nursing, dentistry and many other fields. For more information, visit

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