Physician

A physician, medical practitioner, medical doctor, or simply doctor is a professional who practises medicine, which is concerned with promoting, maintaining, or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments. Physicians may focus their practice on certain disease categories, types of patients and methods of treatment—known as specialities—or they may assume responsibility for the provision of continuing and comprehensive medical care to individuals, families, and communities—known as general practice.[2] Medical practice properly requires both a detailed knowledge of the academic disciplines (such as anatomy and physiology) underlying diseases and their treatment—the science of medicine—and also a decent competence in its applied practice—the art or craft of medicine.

Both the role of the physician and the meaning of the word itself vary around the world. Degrees and other qualifications vary widely, but there are some common elements, such as medical ethics requiring that physicians show consideration, compassion, and benevolence for their patients.

Physician
The Doctor Luke Fildes crop
The Doctor by Luke Fildes (detail)[1]
Occupation
NamesPhysician, medical practitioner, medical doctor or simply doctor
Occupation type
Professional
Activity sectors
Medicine, health care
Description
CompetenciesThe ethics, art and science of medicine, analytical skills, critical thinking
Education required
MBBS, MD, DO
Fields of
employment
Clinics, hospitals
Related jobs
General practitioner
Family physician
Surgeon
Medical specialties

Modern meanings

Francesco Redi
The Italian Francesco Redi, considered to be the founder of experimental biology, was the first to recognize and correctly describe details of many important parasites.[3]

Specialist in internal medicine

Around the world the term physician refers to a specialist in internal medicine or one of its many sub-specialties (especially as opposed to a specialist in surgery). This meaning of physician conveys a sense of expertise in treatment by drugs or medications, rather than by the procedures of surgeons.[4]

This term is at least nine hundred years old in English: physicians and surgeons were once members of separate professions, and traditionally were rivals. The Shorter Oxford English Dictionary, third edition, gives a Middle English quotation making this contrast, from as early as 1400: "O Lord, whi is it so greet difference betwixe a cirugian and a physician."[5]

Henry VIII granted a charter to the London Royal College of Physicians in 1518. It was not until 1540 that he granted the Company of Barber-Surgeons (ancestor of the Royal College of Surgeons) its separate charter. In the same year, the English monarch established the Regius Professorship of Physic at the University of Cambridge.[6] Newer universities would probably describe such an academic as a professor of internal medicine. Hence, in the 16th century, physic meant roughly what internal medicine does now.

Currently, a specialist physician in the United States may be described as an internist. Another term, hospitalist, was introduced in 1996,[7] to describe US specialists in internal medicine who work largely or exclusively in hospitals. Such 'hospitalists' now make up about 19% of all US general internists,[8] who are often called general physicians in Commonwealth countries.

This original use, as distinct from surgeon, is common in most of the world including the United Kingdom and other Commonwealth countries (such as Australia, Bangladesh, India, New Zealand, Pakistan, South Africa, Sri Lanka, Zimbabwe), as well as in places as diverse as Brazil, Hong Kong, Indonesia, Japan, Ireland, and Taiwan. In such places, the more general English terms doctor or medical practitioner are prevalent, describing any practitioner of medicine (whom an American would likely call a physician, in the broad sense).[9] In Commonwealth countries, specialist pediatricians and geriatricians are also described as specialist physicians who have sub-specialized by age of patient rather than by organ system.

Physician and surgeon

Around the world, the combined term "physician and surgeon" is used to describe either a general practitioner or any medical practitioner irrespective of specialty.[4][5] This usage still shows the original meaning of physician and preserves the old difference between a physician, as a practitioner of physic, and a surgeon. The term may be used by state medical boards in the United States of America, and by equivalent bodies in provinces of Canada, to describe any medical practitioner.

North America

Elizabeth Blackwell
Elizabeth Blackwell, the first female physician to receive a medical degree in the United States.

In modern English, the term physician is used in two main ways, with relatively broad and narrow meanings respectively. This is the result of history and is often confusing. These meanings and variations are explained below.

In the United States and Canada, the term physician describes all medical practitioners holding a professional medical degree. The American Medical Association, established in 1847, as well as the American Osteopathic Association, founded in 1897, both currently use the term physician to describe members. However, the American College of Physicians, established in 1915, does not: its title uses physician in its original sense.

American physicians

The vast majority of physicians trained in the United States have a Doctor of Medicine degree, and use the initials M.D. A smaller number attend Osteopathic schools and have a Doctor of Osteopathic Medicine degree and use the initials D.O.[10] After completion of medical school, physicians complete a residency in the specialty in which they will practice. Subspecialties require the completion of a fellowship after residency.

All boards of certification now require that physicians demonstrate, by examination, continuing mastery of the core knowledge and skills for a chosen specialty. Recertification varies by particular specialty between every seven and every ten years.

Podiatric physicians

Also in the United States, the American Podiatric Medical Association (APMA) defines podiatrists as physicians and surgeons that fall under the department of surgery in hospitals.[11] They undergo training with the Doctor of Podiatric Medicine (DPM) degree.[12] This degree is also available at one Canadian university, namely the Université du Québec à Trois-Rivières. Students are typically required to complete an internship in New York prior to the obtention of their professional degree.

Shortage

Many countries in the developing world have the problem of too few physicians.[13] In 2015, the Association of American Medical Colleges warned that the US will face a doctor shortage of as many as 90,000 by 2025.[14]

Social role and world view

Biomedicine

Within Western culture and over recent centuries, medicine has become increasingly based on scientific reductionism and materialism. This style of medicine is now dominant throughout the industrialized world, and is often termed biomedicine by medical anthropologists.[15] Biomedicine "formulates the human body and disease in a culturally distinctive pattern",[16] and is a world view learnt by medical students. Within this tradition, the medical model is a term for the complete "set of procedures in which all doctors are trained" (R. D. Laing, 1972),[17] including mental attitudes. A particularly clear expression of this world view, currently dominant among conventional physicians, is evidence-based medicine. Within conventional medicine, most physicians still pay heed to their ancient traditions:

The critical sense and sceptical attitude of the citation of medicine from the shackles of priestcraft and of caste; secondly, the conception of medicine as an art based on accurate observation, and as a science, an integral part of the science of man and of nature; thirdly, the high moral ideals, expressed in that most "memorable of human documents" (Gomperz), the Hippocratic oath; and fourthly, the conception and realization of medicine as the profession of a cultivated gentleman.

Sir William Osler, Chauvanism in Medicine (1902)[18]

In this Western tradition, physicians are considered to be members of a learned profession, and enjoy high social status, often combined with expectations of a high and stable income and job security. However, medical practitioners often work long and inflexible hours, with shifts at unsociable times. Their high status is partly from their extensive training requirements, and also because of their occupation's special ethical and legal duties. The term traditionally used by physicians to describe a person seeking their help is the word patient (although one who visits a physician for a routine check-up may also be so described). This word patient is an ancient reminder of medical duty, as it originally meant 'one who suffers'. The English noun comes from the Latin word patiens, the present participle of the deponent verb, patior, meaning 'I am suffering,' and akin to the Greek verb πάσχειν (= paskhein, to suffer) and its cognate noun πάθος (= pathos).[5][19]

Physicians in the original, narrow sense (specialist physicians or internists, see above) are commonly members or fellows of professional organizations, such as the American College of Physicians or the Royal College of Physicians in the United Kingdom, and such hard-won membership is itself a mark of status.

Alternative medicine

While contemporary biomedicine has distanced itself from its ancient roots in religion and magic, many forms of traditional medicine[20] and alternative medicine continue to espouse vitalism in various guises: 'As long as life had its own secret properties, it was possible to have sciences and medicines based on those properties' (Grossinger 1980).[21] The US National Center for Complementary and Alternative Medicine (NCCAM) classifies CAM therapies into five categories or domains, including:[22] alternative medical systems, or complete systems of therapy and practice; mind-body interventions, or techniques designed to facilitate the mind's effect on bodily functions and symptoms; biologically based systems including herbalism; and manipulative and body-based methods such as chiropractic and massage therapy.

In considering these alternate traditions that differ from biomedicine (see above), medical anthropologists emphasize that all ways of thinking about health and disease have a significant cultural content, including conventional western medicine.[15][16][23][24]

Ayurveda, Unani medicine and homeopathy are popular types of alternative medicine. They are included in national system of medicines in countries such as India. In general, the practitioners of these medicine in these countries are referred to as Vaidya, Hakim and homeopathic doctor/homeopath/homeopathic physician, respectively.

Many disease have their root cause in mind related issues, and most physicians (and psychologists) following the Western system do not completely understand the functioning of the mind. Such physicians (who follow the Western system of science) also root out the role of ghosts and spirits as the cause of mind-oriented diseases.

Physicians' own health

Some commentators have argued that physicians have duties to serve as role models for the general public in matters of health, for example by not smoking cigarettes.[25] Indeed, in most western nations relatively few physicians smoke, and their professional knowledge does appear to have a beneficial effect on their health and lifestyle. According to a study of male physicians,[26] life expectancy is slightly higher for physicians (73.0 years for white and 68.7 for black) than lawyers or many other highly educated professionals. Causes of death less likely in physicians than the general population include respiratory disease (including pneumonia, pneumoconioses, COPD, but excluding emphysema and other chronic airway obstruction), alcohol-related deaths, rectosigmoidal and anal cancers, and bacterial diseases.[26]

Physicians do experience exposure to occupational hazards, and there is a well-known aphorism that "doctors make the worst patients".[27] Causes of death that are shown to be higher in the physician population include suicide among doctors and self-inflicted injury, drug-related causes, traffic accidents, and cerebrovascular and ischaemic heart disease.[26]

Education and training

Medical education and career pathways for doctors vary considerably across the world.

All medical practitioners

In all developed countries, entry-level medical education programs are tertiary-level courses, undertaken at a medical school attached to a university. Depending on jurisdiction and university, entry may follow directly from secondary school or require pre-requisite undergraduate education. The former commonly takes five or six years to complete. Programs that require previous undergraduate education (typically a three- or four-year degree, often in Science) are usually four or five years in length. Hence, gaining a basic medical degree may typically take from five to eight years, depending on jurisdiction and university.

Following completion of entry-level training, newly graduated medical practitioners are often required to undertake a period of supervised practice before full registration is granted, typically one or two years. This may be referred to as an "internship", as the "foundation" years in the UK, or as "conditional registration". Some jurisdictions, including the United States, require residencies for practice.

Medical practitioners hold a medical degree specific to the university from which they graduated. This degree qualifies the medical practitioner to become licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for internship or conditional registration.

Specialists in internal medicine

Specialty training is begun immediately following completion of entry-level training, or even before. In other jurisdictions, junior medical doctors must undertake generalist (un-streamed) training for one or more years before commencing specialization. Hence, depending on jurisdiction, a specialist physician (internist) often does not achieve recognition as a specialist until twelve or more years after commencing basic medical training—five to eight years at university to obtain a basic medical qualification, and up to another nine years to become a specialist.

Regulation

In most jurisdictions, physicians (in either sense of the word) need government permission to practice. Such permission is intended to promote public safety, and often to protect the public purse, as medical care is commonly subsidized by national governments.

In some jurisdictions (e.g., Singapore), it is common for physicians to inflate their qualifications with the title "Dr" in correspondence or namecards, even if their qualifications are limited to a basic (e.g., bachelor level) degree. In other countries (e.g., Germany), only physicians holding an academic doctorate may call themselves doctor – on the other hand, the European Research Council has decided that the German medical doctorate does not meet the international standards of a PhD research degree.[28][29]

All medical practitioners

Among the English-speaking countries, this process is known either as licensure as in the United States, or as registration in the United Kingdom, other Commonwealth countries, and Ireland. Synonyms in use elsewhere include colegiación in Spain, ishi menkyo in Japan, autorisasjon in Norway, Approbation in Germany, and "άδεια εργασίας" in Greece. In France, Italy and Portugal, civilian physicians must be members of the Order of Physicians to practice medicine.

In some countries, including the United Kingdom and Ireland, the profession largely regulates itself, with the government affirming the regulating body's authority. The best known example of this is probably the General Medical Council of Britain. In all countries, the regulating authorities will revoke permission to practice in cases of malpractice or serious misconduct.

In the large English-speaking federations (United States, Canada, Australia), the licensing or registration of medical practitioners is done at a state or provincial level or nationally as in New Zealand. Australian states usually have a "Medical Board," which has now been replaced by the Australian Health Practitioner Regulatory Authority (AHPRA) in most states, while Canadian provinces usually have a "College of Physicians and Surgeons." All American states have an agency that is usually called the "Medical Board", although there are alternate names such as "Board of Medicine," "Board of Medical Examiners", "Board of Medical Licensure", "Board of Healing Arts" or some other variation.[30] After graduating from a first-professional school, physicians who wish to practice in the U.S. usually take standardized exams, such as the USMLE for MDs).

Specialists in internal medicine

Most countries have some method of officially recognizing specialist qualifications in all branches of medicine, including internal medicine. Sometimes, this aims to promote public safety by restricting the use of hazardous treatments. Other reasons for regulating specialists may include standardization of recognition for hospital employment and restriction on which practitioners are entitled to receive higher insurance payments for specialist services.

Performance and professionalism supervision

The issue of medical errors, drug abuse, and other issues in physician professional behavior received significant attention across the world,[31] in particular following a critical 2000 report[32] which "arguably launched" the patient-safety movement.[33] In the U.S., as of 2006 there were few organizations that systematically monitored performance. In the U.S. only the Department of Veterans Affairs randomly drug tests, in contrast to drug testing practices for other professions that have a major impact on public welfare. Licensing boards at the U.S. state level depend upon continuing education to maintain competence.[34] Through the utilization of the National Practitioner Data Bank, Federation of State Medical Boards Disciplinary Report, and American Medical Association Physician Profile Service, the 67 State Medical Boards (MD/DO) continually self-report any Adverse/Disciplinary Actions taken against a licensed Physician in order that the other Medical Boards in which the Physician holds or is applying for a medical license will be properly notified so that corrective, reciprocal action can be taken against the offending physician.[35] In Europe, as of 2009 the health systems are governed according to various national laws, and can also vary according to regional differences similar to the United States.[36]

Related occupations and divisions of labor

Nurse practitioners

Nurse practitioners (NPs) in the United States are advanced practice registered nurses holding a post-graduate degree such as a Doctor of Nursing Practice.[37] In Canada, nurse practitioners typically have a Master of nursing degree as well as substantial experience they have accumulated throughout the years. Nurse practitioners are not physicians but may practice alongside physicians in a variety of fields. Nurse practitioners are educated in nursing theory and nursing practice. The scope of practice for a nurse practitioner in the United States is defined by regulatory boards of nursing, as opposed to boards of medicine that regulate physicians.

See also

References

  1. ^ In 1949, Fildes' painting The Doctor was used by the American Medical Association in a campaign against a proposal for nationalized medical care put forth by President Harry S. Truman. The image was used in posters and brochures along with the slogan, "Keep Politics Out of this Picture" implying that involvement of the government in medical care would negatively affect the quality of care. 65,000 Posters of The Doctor were displayed, which helped to raise public skepticism for the nationalized healthcare campaign.
  2. ^ World Health Organization: Classifying health workers. Geneva, 2010.
  3. ^ Roncalli Amici R (2001). "The history of Italian parasitology" (PDF). Veterinary Parasitology. 98 (1–3): 3–10. doi:10.1016/S0304-4017(01)00420-4. PMID 11516576. Archived from the original (PDF) on 23 October 2013.
  4. ^ a b H.W. Fowler (1994). A Dictionary of Modern English Usage (Wordsworth Collection). NTC/Contemporary Publishing Company. ISBN 1-85326-318-4.
  5. ^ a b c Brown, Lesley (2002). The New shorter Oxford English dictionary on historical principles. Oxford [Eng.]: Clarendon. ISBN 0-19-861271-0.
  6. ^ "University of Cambridge: History of the School of Clinical Medicine". University of Cambridge. Archived from the original on 9 December 2012. Retrieved 5 February 2008.
  7. ^ Wachter R; Goldman L (1996). "The emerging role of "hospitalists" in the American health care system". N Engl J Med. 335 (7): 514–7. doi:10.1056/NEJM199608153350713. PMID 8672160.
  8. ^ Kuo, YF; Sharma, G; Freeman, JL; Goodwin, JS (2009). "Growth in the care of older patients by hospitalists in the United States". N Engl J Med. 360 (11): 1102–1112. doi:10.1056/NEJMsa0802381. PMC 2977939. PMID 19279342. See also editorial by Hamel M. B. et al. on pp1141–1143 of same issue
  9. ^ "The Royal Australasian College of Physicians: What are Physicians?". Royal Australasian College of Physicians. Archived from the original on 6 March 2008. Retrieved 5 February 2008.
  10. ^ Medline Plus (2012). "Doctor of Osteopathic Medicine". U.S. National Library of Medicine of National Institutes of Health. Retrieved 22 December 2012.
  11. ^ "About Podiatry". Apma.org. Retrieved 19 September 2011.
  12. ^ "Podiatrist". Office of Science Education. Archived from the original on 29 April 2013. Retrieved 22 December 2012.
  13. ^ Physician supply
  14. ^ Bernstein, Lenny (3 March 2015). "U.S. faces 90,000 doctor shortage by 2025, medical school association warns". The Washington Post. Retrieved 27 October 2016.
  15. ^ a b A. Gaines, R.A. Hahn, ed. (1985). "Chapter 1: Introduction (by editors)". Physicians of western medicine. Dordrecht (Netherlands): D. Reidel. pp. 3–22. ISBN 90-277-1790-7.
  16. ^ a b Good, Byron J (1994). "Chapter (pbk)3". Medicine, rationality, and experience: an anthropological perspective (based on the Lewis Henry Morgan Lectures, at the University of Rochester, NY, in March 1990). Cambridge, UK: Cambridge University Press. pp. 65, 65–87. ISBN 0-521-42576-X.
  17. ^ Laing, R.D. (1971). The politics of the family and other essays. London: Tavistock Publications.
  18. ^ Osler, Sir William (1902). "Chauvanism in medicine: address to the Canadian Medical Association, Montreal (17 September 1902)". The Montreal Medical Journal. XXXI.
  19. ^ Partridge, Eric (1966). Origins: a short etymological dictionary of modern English. New York: Macmillan. ISBN 0-02-594840-7.
  20. ^ Galdston, Iago, ed. (1963). "Part 1: Medicine and primitive man (five chapters); Part 2: Medical man and medicine man in three North American Indian societies (three chapters)". Man's image in medicine and anthropology: Monograph IV, Institute of social and historical medicine, New York Academy of Medicine. New York: International Universities Press. pp. 43–334.
  21. ^ Grossinger, Richard (1982) [1980]. "Planet medicine: from stone age shamanism to post-industrial healing" (Revised ed.). Berkeley, CA, US: North Atlantic Books: 116–131. ISBN 978-1-55643-369-6.
  22. ^ "Complementary and Alternative Medicine – U.S. National Library of Medicine Collection Development Manual". Retrieved 31 March 2008.
  23. ^ Galdston, Iago, ed. (1963). "Part V: Culture and the practice of modern medicine (two chapters)". Man's image in medicine and anthropology: Monograph IV, Institute of social and historical medicine, New York Academy of Medicine. New York: International Universities Press. pp. 477–520.
  24. ^ Joralemon, DonaldJ (1999). "chapter 1: What's so cultural about disease? (pbk)". Exploring medical anthropology. Needham Heights, MA, US: Allyn and Bacon. pp. 1–15. ISBN 0-205-27006-9.
  25. ^ Appel JM (2009). "Smoke and mirrors: one case for ethical obligations of the physician as public role model". Camb Q Healthc Ethics. 18 (1): 95–100. doi:10.1017/S0963180108090142. PMID 19149049.
  26. ^ a b c Frank E; Biola H; Burnett CA (October 2000). "Mortality rates and causes among U.S. physicians". Am J Prev Med. 19 (3): 155–9. doi:10.1016/S0749-3797(00)00201-4. PMID 11020591.
  27. ^ Schneck SA (December 1998). "'Doctoring' doctors and their families". JAMA. 280 (23): 2039–42. doi:10.1001/jama.280.23.2039. PMID 9863860.
  28. ^ Schmidt, Sarah (30 September 2017). "Kommt ein Doktor zum Arzt ..." Sueddeutsche.de. Retrieved 30 September 2017.
  29. ^ Kramer, Bernd (28 September 2015). "Medizin-Promotionen: Akademische Ramschware". Spiegel.de. Retrieved 30 September 2017.
  30. ^ "AMA Links to state medical boards". Retrieved 1 March 2008.
  31. ^ Lim MK (February 2004). "Quest for quality care and patient safety: the case of Singapore". Qual Saf Health Care. 13 (1): 71–5. doi:10.1136/qshc.2002.004994. PMC 1758053. PMID 14757804.
  32. ^ Committee on Quality of Health Care in America, Institute of Medicine. (2000). To Err is Human: Building A Safer Health System. National Academies Press. Free full-text.
  33. ^ Wachter RM (2010). "Patient safety at ten: unmistakable progress, troubling gaps". Health Aff (Millwood). 29 (1): 165–73. doi:10.1377/hlthaff.2009.0785. PMID 19952010.
  34. ^ Leape LL; Fromson JA (January 2006). "Problem doctors: is there a system-level solution?". Ann. Intern. Med. 144 (2): 107–15. doi:10.7326/0003-4819-144-2-200601170-00008. PMID 16418410.
  35. ^ "Medical Board Licensing Service for Physicians seeking an Expedited Medical License with any of the 50 State Medical Boards". MedLicense.com. Retrieved 19 September 2011.
  36. ^ Suñol R; Garel P; Jacquerye A (February 2009). "Cross-border care and healthcare quality improvement in Europe: the MARQuIS research project". Qual Saf Health Care. 18 Suppl 1: i3–7. doi:10.1136/qshc.2008.029678. PMC 2629851. PMID 19188459.
  37. ^ "Title 21 CFR - PART 1300 - DEFINITIONS". Deadiversion.usdoj.gov. Retrieved 30 September 2017.

External links

  • Media related to Physicians at Wikimedia Commons
  • The dictionary definition of physician at Wiktionary
Assisted suicide

Assisted suicide is suicide undertaken with the aid of another person. The term refers to physician-assisted suicide (PAS), which is suicide that is assisted by a physician or other healthcare provider. Once it is determined that the person's situation qualifies under the assisted suicide laws for that place, the physician's assistance is usually limited to writing a prescription for a lethal dose of drugs.

In many jurisdictions helping a person die by suicide is a crime. People who support legalizing assisted suicide want the people who assist in a voluntary suicide to be exempt from criminal prosecution for manslaughter or similar crimes. Assisted suicide is legal in some countries, under certain circumstances, including Canada, Belgium, the Netherlands, Luxembourg, Colombia, Switzerland, and parts of the United States and Australia. In most of those countries, to qualify for legal assistance, people who want to use the assisted-suicide model to die must meet certain criteria, including having a terminal illness, proving they are of sound mind, voluntarily and repeatedly expressing their wish to die, and taking a specified, lethal dose of drugs themselves.

Chief physician

A chief physician, also called a head physician, physician in chief, senior consultant, or chief of medicine, is a physician in a senior management position at a hospital or other institution. In many institutions, it is the title of the most senior physician, but it may also be used as the title of the most senior physician of a particular department within a larger institution. A chief physician generally is in charge of medical matters and often is the superior of other physicians (including consultants and attending physicians), but may also be in charge of other professional groups and areas of responsibility.

Doctor of Osteopathic Medicine

Doctor of Osteopathic Medicine (DO or D.O.) is a professional doctoral degree for physicians and surgeons offered by medical schools in the United States. A DO graduate may become licensed as an osteopathic physician, having equivalent rights, privileges, and responsibilities as a physician who has earned the Doctor of Medicine (MD) degree. DO physicians are licensed to practice the full scope of medicine and surgery in 65 countries, and in all 50 US states. They constitute 11% of all US physicians. As of 2018, there were more than 145,000 osteopathic medical physicians and osteopathic medical students in the United States.DO degrees are offered in the United States at 35 medical schools, at 55 locations compared to MD degrees offered at 140 schools. Since 2007, total DO student enrollment has been increasing yearly. In 2015, more than 20% of all medical school enrollment in the US comprised DO students. The curricula at osteopathic medical schools are similar to those at MD-granting medical schools, which focus the first two years on the biomedical and clinical sciences, then two years on core clinical training in the clinical specialties.Upon completing medical school, a DO graduate may enter an internship or residency training program, which may be followed by fellowship training. Some DO graduates attend the same graduate medical education programs as their MD counterparts, and then take MD specialty board exams, while other DO graduates enter osteopathic programs, and take DO specialty board examinations.One notable difference between DO and MD training is that DO training adds 300–500 hours studying techniques for hands-on manipulation of the human musculoskeletal system, a system shared (in general but not all particulars) with chiropractic medicine.

Emergency medicine

Emergency medicine, also known as accident and emergency medicine, is the medical specialty concerned with the care of illnesses or injuries requiring immediate medical attention. Emergency physicians care for unscheduled and undifferentiated patients of all ages. As first-line providers, their primary responsibility is to initiate resuscitation and stabilization and to start investigations and interventions to diagnose and treat illnesses in the acute phase. Emergency physicians generally practice in hospital emergency departments, pre-hospital settings via emergency medical services, and intensive care units, but may also work in primary care settings such as urgent care clinics. Sub-specializations of emergency medicine include disaster medicine, medical toxicology, ultrasonography, critical care medicine, hyperbaric medicine, sports medicine, palliative care, or aerospace medicine.

Different models for emergency medicine exist internationally. In countries following the Anglo-American model, emergency medicine was originally the domain of surgeons, general practitioners, and other generalist physicians, but in recent decades it has become recognised as a speciality in its own right with its own training programmes and academic posts, and the specialty is now a popular choice among medical students and newly qualified medical practitioners. By contrast, in countries following the Franco-German model, the speciality does not exist and emergency medical care is instead provided directly by anesthesiologists (for critical resuscitation), surgeons, specialists in internal medicine, pediatricians, cardiologists or neurologists as appropriate. In developing countries, emergency medicine is still evolving and international emergency medicine programs offer hope of improving basic emergency care where resources are limited.

Family medicine

Family medicine (FM), formerly family practice (FP), is a medical specialty devoted to comprehensive health care for people of all ages; the specialist is named a family physician or family doctor. In Europe the discipline is often referred to as general practice and a practitioner as a general practice doctor or GP; this name emphasises the holistic nature of this speciality, as well as its roots in the family. Family practice is a division of primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body; family physicians are often primary care physicians. It is based on knowledge of the patient in the context of the family and the community, emphasizing disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is to provide personal, comprehensive, and continuing care for the individual in the context of the family and the community. The issues of values underlying this practice are usually known as primary care ethics.

Galen

Aelius Galenus or Claudius Galenus (Greek: Κλαύδιος Γαληνός; September 129 AD – c. 200/c. 216), often Anglicized as Galen and better known as Galen of Pergamon (), was a Greek physician, surgeon and philosopher in the Roman Empire. Arguably the most accomplished of all medical researchers of antiquity, Galen influenced the development of various scientific disciplines, including anatomy, physiology, pathology, pharmacology, and neurology, as well as philosophy and logic.

The son of Aelius Nicon, a wealthy architect with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. Born in Pergamon (present-day Bergama, Turkey), Galen travelled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors.

Galen's understanding of anatomy and medicine was principally influenced by the then-current theory of humorism (also known as the four humors – black bile, yellow bile, blood, and phlegm), as advanced by ancient Greek physicians such as Hippocrates. His theories dominated and influenced Western medical science for more than 1,300 years. His anatomical reports, based mainly on dissection of monkeys, especially the Barbary macaque, and pigs, remained uncontested until 1543, when printed descriptions and illustrations of human dissections were published in the seminal work De humani corporis fabrica by Andreas Vesalius where Galen's physiological theory was accommodated to these new observations. Galen's theory of the physiology of the circulatory system remained unchallenged until ca. 1242, when Ibn al-Nafis published his book Sharh tashrih al-qanun li’ Ibn Sina (Commentary on Anatomy in Avicenna's Canon), in which he reported his discovery of the pulmonary circulation.Galen saw himself as both a physician and a philosopher, as he wrote in his treatise entitled That the Best Physician Is Also a Philosopher. Galen was very interested in the debate between the rationalist and empiricist medical sects, and his use of direct observation, dissection and vivisection represents a complex middle ground between the extremes of those two viewpoints. Many of his works have been preserved and/or translated from the original Greek, although many were destroyed and some credited to him are believed to be spurious. Although there is some debate over the date of his death, he was no younger than seventy when he died.

In medieval Europe, Galen's writings on anatomy became the mainstay of the medieval physician's university curriculum, but because of the collapse of the Roman Empire in the West they suffered greatly from stasis and intellectual stagnation. However, in the Eastern Roman Empire and the Abbasid Caliphate they continued to be studied and followed. Some of Galen's ideas were incorrect, as he did not dissect a human body. Greek and Roman taboos had meant that dissection was usually banned in ancient times, but in Middle Ages it changed: medical teachers and students at Bologna began to open human bodies, and Mondino de Luzzi (ca. 1275–1326) produced the first known anatomy textbook based on human dissection.Galen's original Greek texts gained renewed prominence during the early modern period. In the 1530s, Belgian anatomist and physician Andreas Vesalius took on a project to translate many of Galen's Greek texts into Latin. Vesalius's most famous work, De humani corporis fabrica, was greatly influenced by Galenic writing and form.

General practitioner

In the medical profession, a general practitioner (GP) is a medical doctor who treats acute and chronic illnesses and provides preventive care and health education to patients.

A general practitioner manages types of illness that present in an undifferentiated way at an early stage of development, which may require urgent intervention. The holistic approach of general practice aims to take into consideration the biological, psychological, and social factors relevant to the care of each patient's illness. Their duties are not confined to specific organs of the body, and they have particular skills in treating people with multiple health issues. They are trained to treat patients of any age and sex to levels of complexity that vary between countries.

The role of a GP can vary greatly between (or even within) countries. In urban areas of developed countries, their roles tend to be narrower and focused on the care of chronic health problems; the treatment of acute non-life-threatening diseases; the early detection and referral to specialised care of patients with serious diseases; and preventive care including health education and immunisation. Meanwhile, in rural areas of developed countries or in developing countries, a GP may be routinely involved in pre-hospital emergency care, the delivery of babies, community hospital care and performing low-complexity surgical procedures. In some healthcare systems GPs work in primary care centers where they play a central role in the healthcare team, while in other models of care GPs can work as single-handed practitioners.

The term general practitioner or GP is common in the UK, Republic of Ireland, and several Commonwealth countries. In these countries the word "physician" is largely reserved for certain other types of medical specialists, notably in internal medicine. While in these countries, the term GP has a clearly defined meaning, in North America the term has become somewhat ambiguous, and is not synonymous with the terms family doctor or primary care physician, as described below.

Historically, the role of a GP was once performed by any doctor qualified in a medical school working in the community. However, since the 1950s, general practice has become a specialty in its own right, with specific training requirements tailored to each country. The Alma Ata Declaration in 1978 set the intellectual foundation of what primary care and general practice is nowadays.

Harvard Medical School

Harvard Medical School (HMS) is the graduate medical school of Harvard University. It is located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts.

There are approximately 2,900 full- and part-time voting faculty members consisting of assistant, associate, and full professors, and over 5,000 full or part-time, non-voting instructors.

Health care

Health care or healthcare is the maintenance or improvement of health via the prevention, diagnosis, and treatment of disease, illness, injury, and other physical and mental impairments in human beings. Health care is delivered by health professionals (providers or practitioners) in allied health fields. Physicians and physician associates are a part of these health professionals. Dentistry, midwifery, nursing, medicine, optometry, audiology, pharmacy, psychology, occupational therapy, physical therapy and other health professions are all part of health care. It includes work done in providing primary care, secondary care, and tertiary care, as well as in public health.

Access to health care may vary across countries, communities, and individuals, largely influenced by social and economic conditions as well as the health policies in place. Countries and jurisdictions have different policies and plans in relation to the personal and population-based health care goals within their societies. Health care systems are organizations established to meet the health needs of targeted populations. Their exact configuration varies between national and subnational entities. In some countries and jurisdictions, health care planning is distributed among market participants, whereas in others, planning occurs more centrally among governments or other coordinating bodies. In all cases, according to the World Health Organization (WHO), a well-functioning health care system requires a robust financing mechanism; a well-trained and adequately paid workforce; reliable information on which to base decisions and policies; and well maintained health facilities and logistics to deliver quality medicines and technologies.Health care can contribute to a significant part of a country's economy. In 2011, the health care industry consumed an average of 9.3 percent of the GDP or US$ 3,322 (PPP-adjusted) per capita across the 34 members of OECD countries. The US (17.7%, or US$ PPP 8,508), the Netherlands (11.9%, 5,099), France (11.6%, 4,118), Germany (11.3%, 4,495), Canada (11.2%, 5669), and Switzerland (11%, 5,634) were the top spenders, however life expectancy in total population at birth was highest in Switzerland (82.8 years), Japan and Italy (82.7), Spain and Iceland (82.4), France (82.2) and Australia (82.0), while OECD's average exceeds 80 years for the first time ever in 2011: 80.1 years, a gain of 10 years since 1970. The US (78.7 years) ranges only on place 26 among the 34 OECD member countries, but has the highest costs by far. All OECD countries have achieved universal (or almost universal) health coverage, except the US and Mexico. (see also international comparisons.)

Health care is conventionally regarded as an important determinant in promoting the general physical and mental health and well-being of people around the world. An example of this was the worldwide eradication of smallpox in 1980, declared by the WHO as the first disease in human history to be completely eliminated by deliberate health care interventions.

Hippocrates

Hippocrates of Kos (; Greek: Ἱπποκράτης ὁ Κῷος, translit. Hippokrátēs ho Kṓos; c. 460 – c. 370 BC), also known as Hippocrates II, was a Greek physician of the Age of Pericles (Classical Greece), who is considered one of the most outstanding figures in the history of medicine. He is often referred to as the "Father of Medicine" in recognition of his lasting contributions to the field as the founder of the Hippocratic School of Medicine. This intellectual school revolutionized medicine in ancient Greece, establishing it as a discipline distinct from other fields with which it had traditionally been associated (theurgy and philosophy), thus establishing medicine as a profession.However, the achievements of the writers of the Corpus, the practitioners of Hippocratic medicine and the actions of Hippocrates himself were often commingled; thus very little is known about what Hippocrates actually thought, wrote, and did. Hippocrates is commonly portrayed as the paragon of the ancient physician, and credited with coining the Hippocratic Oath, which is still relevant and in use today. He is also credited with greatly advancing the systematic study of clinical medicine, summing up the medical knowledge of previous schools, and prescribing practices for physicians through the Hippocratic Corpus and other works.

Ken Jeong

Kendrick Kang-Joh Jeong (born July 13, 1969) is an American comedian, actor and physician. He is best known for playing Ben Chang on the sitcom Community and the gangster Leslie Chow in The Hangover film series. He was the lead in the ABC sitcom Dr. Ken, in which he was also the creator, writer, and executive producer. Jeong is a licensed physician, but has stopped practicing in favor of his acting career.He currently appears as a panelist on the singing competition show The Masked Singer.

Medical sign

A medical sign is an objective indication of some medical fact or characteristic that may be detected by a patient or anyone, especially a physician, before or during a physical examination of a patient. For example, whereas a tingling paresthesia is a symptom (only the person experiencing it can directly observe their own tingling feeling), erythema is a sign (anyone can confirm that the skin is redder than usual). Symptoms and signs are often nonspecific, but often combinations of them are at least suggestive of certain diagnoses, helping to narrow down what may be wrong. In other cases they are specific even to the point of being pathognomonic.

Some signs may have no meaning to the patient, and may even go unnoticed, but may be meaningful and significant to the healthcare provider in assisting diagnosis.

Examples of signs include elevated blood pressure, a clubbing of the ends of fingers (which may be a sign of lung disease, or many other things), a staggering gait (human) and arcus senilis of the eyes.

The term sign is not to be confused with the term indication, which in medicine denotes a valid reason for using some treatment.

Osteopathy

Osteopathy is a type of alternative medicine that emphasizes manual readjustments, myofascial release and other physical manipulation of muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Its name derives from Ancient Greek "bone" (ὀστέον) and "sensitive to" or "responding to" (-πάθεια).While the UK's National Health Service says there is "limited evidence to suggest" that osteopathy "may be effective for some types of neck, shoulder or lower limb pain and recovery after hip or knee operations", it acknowledges that there is no evidence that osteopathy is effective as a treatment for health conditions "unrelated" to the bones and muscles, "such as headaches, migraines, painful periods, digestive disorders, depression and excessive crying in babies (colic)"; an explicit reference to the claims of osteopathic manipulative medicine. Others have concluded that osteopathic style manipulation "failed to produce compelling evidence" for efficacy in treating musculoskeletal pain.The government policy and legal framework in which practitioners operate vary greatly from country to country, with some having both non-physician osteopaths and medically trained osteopathic physicians.

Physician assistant

A Physician Assistant (PA) is a professional who practices medicine in collaboration or under indirect supervision of a physician, depending on state laws. Physicians do not need to be on-site with PAs and collaboration or supervision often occurs via electronic means when consults are necessary. Their scope of practice varies by jurisdiction and healthcare setting.

In the United States, PAs are nationally certified and state licensed to practice medicine. A certified PA may add "C" at the end of his/her postnominal credentials. PAs are trained with the medical model and complete these qualifications in less time than a traditional medical degree. The educational model for PAs is based on the fast-tracked training of physicians during World War II. In Canada, Canadian Certified Physician Assistant (CCPA) is the credential awarded upon licensure.

The occupational title originated in the United States in the 1960s; similar occupations elsewhere include clinical officers in parts of Africa and feldshers in states of the former Soviet Union.Several other countries including Australia and New Zealand have begun developing the new role of physician assistant or physician associate to fill actual or perceived deficiencies in rural medical care.

Priscilla Chan

Priscilla Chan (born February 24, 1985) is an American pediatrician and philanthropist. She and her husband Mark Zuckerberg, the co-founder and CEO of Facebook, established the Chan Zuckerberg Initiative in December 2015, with a pledge to donate 99 percent of their Facebook shares, then valued at $45 billion. She is a graduate of Harvard University and received her medical degree from the University of California, San Francisco (UCSF).

Pulmonology

Pulmonology is a medical speciality that deals with diseases involving the respiratory tract. The term is derived from the Latin word pulmō, pulmōnis ("lung") and the Greek suffix -λογία, -logia ("study of"). Pulmonology is synonymous with pneumology (from Greek πνεύμων ("lung") and -λογία), respirology and respiratory medicine.

Pulmonology is known as chest medicine and respiratory medicine in some countries and areas. Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine. Pulmonology often involves managing patients who need life support and mechanical ventilation. Pulmonologists are specially trained in diseases and conditions of the chest, particularly pneumonia, asthma, tuberculosis, emphysema, and complicated chest infections.

Residency (medicine)

Residency or postgraduate training is a stage of graduate medical education. It refers to a qualified physician, podiatrist, or dentist (one who holds the degree of MD, DPM, DDS, DMD, DO or MB; BS, MBChB, or BMed, BDS,

BDent) who practices medicine, usually in a hospital or clinic, under the direct or indirect supervision of a senior clinician registered in that specialty such as an attending physician or consultant. In many jurisdictions, successful completion of such training is a requirement in order to obtain an unrestricted license to practice medicine, and in particular a license to practice a chosen specialty. An individual engaged in such training may be referred to as a resident, house officer, registrar or trainee depending on the jurisdiction. Residency training may be followed by fellowship or sub-specialty training.

Whereas medical school teaches physicians a broad range of medical knowledge, basic clinical skills, and supervised experience practicing medicine in a variety of fields, medical residency gives in-depth training within a specific branch of medicine.

Specialty (medicine)

A specialty, or speciality, in medicine is a branch of medical practice. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency to become a medical specialist.

Veterinary physician

A veterinary physician, usually called a vet, which is shortened from veterinarian (American English) or veterinary surgeon (British English), is a professional who practices veterinary medicine by treating diseases, disorders, and injuries in animals.

This page is based on a Wikipedia article written by authors (here).
Text is available under the CC BY-SA 3.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.