HOME

TheInfoList




A physician (
American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of variety (linguistics), varieties of the English language native to the United States. Currently, American English is the m ...
), medical practitioner (
Commonwealth English The use of the English language English is a of the , originally spoken by the inhabitants of . It is named after the , one of the ancient that migrated from , a peninsula on the (not to be confused with ), to the area of later nam ...
), medical doctor, or simply doctor, is a
professional A professional is a member of a profession or any person who earns a living from a specified professional activity. The term also describes the standards of education and training that prepare members of the profession with the particular knowled ...
who practices
medicine Medicine is the science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts ( descriptive knowledge), skills (proced ...

medicine
, which is concerned with promoting, maintaining or restoring
health Health, according to the World Health Organization The World Health Organization (WHO) is a specialized agency of the United Nations United Nations Specialized Agencies are autonomous organizations working with the United Nations and each ...

health
through the
study Study or studies may refer to: General * Education **Higher education * Clinical trial * Experiment * Observational study * Research * Study skills, abilities and approaches applied to learning Other * Study (art), a drawing or series of drawing ...
,
diagnosis Diagnosis is the identification of the nature and cause of a certain phenomenon. Diagnosis is used in many different academic discipline, disciplines, with variations in the use of logic, analytics, and experience, to determine "causality, cause an ...
,
prognosis Prognosis (Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approximately ...
and
treatment Treatment may refer to: * Treatment (song), "Treatment" (song), a 2012 song by * Film treatment, a prose telling of a story intended to be turned into a screenplay * Medical treatment or therapy * Sewage treatment * Surface treatment or surface fi ...
of
disease A disease is a particular abnormal condition that negatively affects the structure A structure is an arrangement and organization of interrelated elements in a material object or system A system is a group of Interaction, interactin ...
,
injury Injury, also known as physical trauma, is damage Damage is any change in a thing, often a physical object, that degrades it away from its initial state. It can broadly be defined as "changes introduced into a system that adversely affect its ...

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 Family medicine is a medical Specialty (medicine), specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who ...
. Medical practice properly requires both a detailed
knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is something that is truth, true. The usual test for a statement of fact is verifiability—that is whether it can be demonstrated to correspond to e ...
of the
academic disciplines An academic discipline or academic field is a subdivision of knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the real world. The usual test for a statement of fact is ...
, such as
anatomy Anatomy (Greek ''anatomē'', 'dissection') is the branch of biology concerned with the study of the structure of organisms and their parts. Anatomy is a branch of natural science which deals with the structural organization of living things. It ...

anatomy
and
physiology Physiology (; ) is the scientific Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is an occurrence in the real world. ...
, underlying diseases and their treatment—the ''
science Science () is a systematic enterprise that builds and organizes knowledge Knowledge is a familiarity or awareness, of someone or something, such as facts A fact is something that is truth, true. The usual test for a statement of ...

science
'' of medicine—and also a decent competence in its applied practice—the art or ''
craft A craft or trade is a pastime or an occupation that requires particular skills and knowledge of skilled work. In a historical sense, particularly the Middle Ages In the history of Europe The history of Europe concerns itself wit ...
'' 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 Medical ethics is an applied branch of ethics Ethics or moral philosophy is a branch of philosophy Philosophy (from , ) is the study of general and fundamental questions, such as those about Metaphysics, existence, reason, Epistemology, k ...
requiring that physicians show consideration, compassion, and benevolence for their
patient A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, psych ...

patient
s.


Modern meanings


Specialist in internal medicine

Around the world the term physician refers to a specialist in
internal medicine Internal medicine or general internal medicine (in Commonwealth of Nations, Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are ...
or one of its many sub-specialties (especially as opposed to a specialist in
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical or dental specialty that uses operative manual and instrumental techniques on a person to investigate or t ...
). This meaning of physician conveys a sense of expertise in treatment by drugs or medications, rather than by the procedures of
surgeon In modern medicine Medicine is the science Science (from the Latin word ''scientia'', meaning "knowledge") is a systematic enterprise that Scientific method, builds and Taxonomy (general), organizes knowledge in the form of Testability, ...

surgeon
s. 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 The ''Shorter Oxford English Dictionary'' (''SOED'') is an English language dictionary published by the Oxford University Press. The SOED is a two-volume abridgement of the twenty-volume ''Oxford English Dictionary'' (''OED''). Print editions P ...
'', third edition, gives a
Middle English Middle English (abbreviated to ME) was a form of the English language English is a West Germanic language of the Indo-European language family The Indo-European languages are a language family A language is a structured sys ...
quotation making this contrast, from as early as 1400: "O Lord, whi is it so greet difference betwixe a cirugian and a physician." Henry VIII granted a charter to the London
Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
in 1518. It was not until 1540 that he granted the
Company of Barber-Surgeons The Royal College of Surgeons of England (abbreviated RCS England and sometimes RCS) is an independent professional body Regulatory colleges are legal entities in Canada charged with serving the public interest by regulating the practice of a p ...
(ancestor of the
Royal College of Surgeons The Royal College of Surgeons is an ancient college A college (Latin: ''collegium'') is an educational institution or a University system, constituent part of one. A college may be a academic degree, degree-awarding Tertiary education, tertiar ...
) its separate charter. In the same year, the English monarch established the Regius Professorship of Physic at the
University of Cambridge , mottoeng = Literal: From here, light and sacred draughts. Non literal: From this place, we gain enlightenment and precious knowledge. , established = , other_name = The Chancellor, Masters and Scholars of ...
. Newer universities would probably describe such an academic as a professor of
internal medicine Internal medicine or general internal medicine (in Commonwealth of Nations, Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are ...
. 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, to describe US specialists in
internal medicine Internal medicine or general internal medicine (in Commonwealth of Nations, Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are ...
who work largely or exclusively in hospitals. Such 'hospitalists' now make up about 19% of all US ''general internists'', who are often called ''general physicians'' in
Commonwealth A commonwealth is a traditional English term for a political community founded for the common good In philosophy Philosophy (from , ) is the study of general and fundamental questions, such as those about reason, Metaphysics, existenc ...

Commonwealth
countries. This original use, as distinct from surgeon, is common in most of the world including the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain,Usage is mixed. The Guardian' and Telegraph' use Britain as a synonym for the United Kingdom. Some prefer to use Britain as shorth ...

United Kingdom
and other Commonwealth countries (such as
Australia Australia, officially the Commonwealth of Australia, is a Sovereign state, sovereign country comprising the mainland of the Australia (continent), Australian continent, the island of Tasmania, and numerous List of islands of Australia, sma ...

Australia
,
Bangladesh Bangladesh (, bn, বাংলাদেশ, ), officially the People's Republic of Bangladesh, is a country in South Asia South Asia is the southern region of Asia, which is defined in both geography, geographical and culture, ethno-c ...

Bangladesh
,
India India, officially the Republic of India (Hindi Hindi (Devanagari: , हिंदी, ISO 15919, ISO: ), or more precisely Modern Standard Hindi (Devanagari: , ISO 15919, ISO: ), is an Indo-Aryan language spoken chiefly in Hindi Belt, ...

India
,
New Zealand New Zealand ( mi, Aotearoa ''Aotearoa'' (; commonly pronounced by English English usually refers to: * English language English is a West Germanic languages, West Germanic language first spoken in History of Anglo-Saxon Engl ...

New Zealand
,
Pakistan Pakistan, . Pronounced variably in English as , , , and . officially the Islamic Republic of Pakistan, is a country in South Asia. It is the world's List of countries and dependencies by population, fifth-most populous country, with a popul ...

Pakistan
,
South Africa South Africa, officially the Republic of South Africa (RSA), is the southernmost country in Africa. With over 60 million people, it is the world's 23rd-most populous nation and covers an area of . South Africa has three capital citie ...

South Africa
,
Sri Lanka Sri Lanka (, ; si, ශ්‍රී ලංකාව, Śrī Laṅkā, translit-std=ISO (); ta, இலங்கை, Ilaṅkai, translit-std=ISO ()), formerly known as Ceylon, and officially the Democratic Socialist Republic of Sri Lanka, is ...

Sri Lanka
, and
Zimbabwe Zimbabwe (), officially the Republic of Zimbabwe, is a landlocked country A landlocked country is a country A country is a distinct territory, territorial body or political entity. It is often referred to as the land of an individ ...

Zimbabwe
), as well as in places as diverse as
Brazil Brazil ( pt, Brasil; ), officially the Federative Republic of Brazil (Portuguese: ), is the largest country in both South America and Latin America. At 8.5 million square kilometers (3.2 million square miles) and with over 211 mill ...

Brazil
,
Hong Kong Hong Kong (; , ), officially the Hong Kong Special Administrative Region of the People's Republic of China (HKSAR), is a List of cities in China, city and Special administrative regions of China, special administrative region of China on the ...

Hong Kong
,
Indonesia Indonesia ( ), officially the Republic of Indonesia ( id, Republik Indonesia, links=yes ), is a country in Southeast Asia Southeast Asia, also spelled South East Asia and South-East Asia, and also known as Southeastern Asia or SEA, is t ...

Indonesia
,
Japan Japan ( ja, 日本, or , and formally ) is an island country An island country or an island nation is a country A country is a distinct territory, territorial body or political entity. It is often referred to as the land of an in ...

Japan
,
Ireland Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic. It is separated from Great Britain to its east by the North Channel (Great Britain and Ireland), North Channel, the Irish Sea ...

Ireland
, and
Taiwan Taiwan, officially the Republic of China (ROC), is a country in East Asia East Asia is the eastern region of Asia Asia () is Earth's largest and most populous continent, located primarily in the Eastern Hemisphere, Eastern and N ...

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). In Commonwealth countries, specialist
pediatricians Paediatrics ( also spelled pediatrics or pædiatrics) is the branch of medicine Medicine is the science Science (from the Latin word ''scientia'', meaning "knowledge") is a systematic enterprise that Scientific method, builds and Taxono ...

pediatricians
and geriatricians are also described as specialist physicians who have sub-specialized by age of patient rather than by
organ Organ may refer to: Biology * Organ (anatomy) An organ is a group of Tissue (biology), tissues with similar functions. Plant life and animal life rely on many organs that co-exist in organ systems. A given organ's tissues can be broadly cate ...
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. 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, and by equivalent bodies in Canadian provinces, to describe any medical practitioner.


North America

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 The American Medical Association (AMA), founded in 1847 and incorporated in 1897, is the largest association and lobby group Advocacy groups, also known as special interest groups, use various forms of advocacy Advocacy is an activity by a ...
, established in 1847, as well as the
American Osteopathic Association The American Osteopathic Association (AOA) is the representative member organization for the more than 145,000 osteopathic medical doctors ( D.O.s) and osteopathic medical students in the United States The United States of America (USA), c ...
, founded in 1897, both currently use the term ''physician'' to describe members. However, the
American College of Physicians The American College of Physicians (ACP) is a national organization of internists, who specialize in the diagnosis, treatment, and care of adults.Sokanu "What is an Internist?" Retrieved 20 October 2014 With 154,000 members, ACP is the largest medi ...
, 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 Doctor of Medicine (abbreviated M.D., from the Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. ...
degree, and use the initials
M.D. Doctor of Medicine (abbreviated M.D., from the Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. ...
A smaller number attend osteopathic
medical schools A medical school is a tertiary educational institution, or part of such an institution, that teaches medicine, and awards a professional degree for physicians and surgeons. Such medical degrees include the Bachelor of Medicine, Bachelor of Surge ...
and have a
Doctor of Osteopathic Medicine Doctor of Osteopathic Medicine (DO or D.O.) is a professional doctoral degree of osteopathic medicine offered by medical schools in the United States The United States of America (USA), commonly known as the United States (U.S. or US), ...
degree and use the initials
D.O.#REDIRECT Doctor of Osteopathic Medicine Doctor of Osteopathic Medicine (DO or D.O.) is a professional doctoral degree of osteopathic medicine offered by medical schools in the United States The United States of America (USA), commonly ...
The
World Directory of Medical Schools In its most general sense, the term "world" refers to the totality of entities, to the whole of reality or to everything that is. The nature of the world has been conceptualized differently in different fields. Some conceptions see the world ...
lists both MD and DO granting schools as ''medical schools'' located in the United States. After completion of
medical school A medical school is a tertiary education Tertiary education, also referred to as third-level, third-stage or post-secondary education, is the education Education is the process of facilitating learning, or the acquisition of knowled ...
, physicians complete a
residency Residency may refer to: * Residency (domicile), the act of establishing or maintaining a residence in a given place ** Permanent residency, indefinite residence within a country despite not having citizenship Education * Residency (medicine), a ...
in the specialty in which they will practice. Subspecialties require the completion of a
fellowship A fellow is a broad concept whose exact meaning depends on context. In learned or professional A professional is a member of a profession or any person who earns their living from a specified professional activity. The term also describes th ...
after residency. Both MD and DO physicians participate in the
National Resident Matching ProgramThe National Resident Matching Program (NRMP), also called The Match, is a United States The United States of America (USA), commonly known as the United States (U.S. or US), or America, is a country Contiguous United States, primarily locate ...
(NRMP) and attend
ACGME The Accreditation Council for Graduate Medical Education (ACGME) is the body responsible for accrediting all Graduate medical education, graduate medical training programs (i.e., internships, residencies, and fellowships, a.k.a. subspecialty progr ...
-accredited residencies and fellowships across all medical specialties to obtain licensure. 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.


= Primary care

=
Primary care physician A patient having his blood pressure measured A primary care physician (PCP) is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply do ...
s guide patients in preventing disease and detecting health problems early while they are still treatable. They are divided into two types:
family medicine Family medicine is a medical Specialty (medicine), specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who i ...
doctors and
internal medicine Internal medicine or general internal medicine (in Commonwealth of Nations, Commonwealth nations) is the medical specialty dealing with the prevention, diagnosis, and treatment of internal diseases. Physicians specializing in internal medicine are ...
doctors. Family doctors, or family physicians, are trained to care for patients of any age, while internists are trained to care for adults. Family doctors receive training in a variety of care and are therefore also referred to as
general practitioner In the medical profession, a general practitioner (GP) is a medical doctor A physician (American English American English (AmE, AE, AmEng, USEng, en-US), sometimes called United States English or U.S. English, is the set of varieties ...
s. Family medicine grew out of the general practitioner movement of the 1960s in response to the growing specialization in medicine that was seen as threatening to the doctor-patient relationship and continuity of care.


Podiatrists

In the United States, the American Podiatric Medical Association (APMA) defines
podiatrists A podiatrist ( poh-dye-eh-trist) is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now become the accepted term in the English-spe ...
as physicians and surgeons who treat the foot, ankle, and associated structures of the leg. Podiatrists undergo training with the
Doctor of Podiatric Medicine A podiatrist (/poʊˈdaɪətrɪst/ poh-dye-eh-trist) or podiatric physician is a medical professional devoted to the treatment of disorders of the foot, ankle, and related structures of the leg. The term originated in North America but has now b ...
(DPM) degree. The
American Medical Association The American Medical Association (AMA), founded in 1847 and incorporated in 1897, is the largest association and lobby group Advocacy groups, also known as special interest groups, use various forms of advocacy Advocacy is an activity by a ...
(AMA), however, advocates for the definition of a ''physician'' as "an individual possessing degree of either a Doctor of Medicine or Doctor of Osteopathic Medicine." In the US, podiatrists are required to complete three to four years of podiatry residency upon graduating with a DPM degree. After residency, one to two years of fellowship programs are available in plastic surgery, foot and ankle reconstructive surgery, sports medicine, and wound care. Podiatry residencies and/ or fellowships are not accredited by the
ACGME The Accreditation Council for Graduate Medical Education (ACGME) is the body responsible for accrediting all Graduate medical education, graduate medical training programs (i.e., internships, residencies, and fellowships, a.k.a. subspecialty progr ...
. The overall scope of podiatric practice varies from state to state and is not similar to that of physicians holding an MD or DO degree. DPM 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. The
World Directory of Medical Schools In its most general sense, the term "world" refers to the totality of entities, to the whole of reality or to everything that is. The nature of the world has been conceptualized differently in different fields. Some conceptions see the world ...
does not list US or Canadian schools of podiatric medicine as ''medical schools'' and only lists US-granted MD, DO, and Canadian MD programs as medical schools for the respective regions.


Shortage

Many countries in the developing world have the problem of too few physicians. In 2015, the
Association of American Medical Colleges The Association of American Medical Colleges (AAMC) is a nonprofit organization based in Washington, D.C. that was established in 1876. It represents medical schools, teaching hospitals, and academic and scientific societies, while providing serv ...
warned that the US will face a doctor shortage of as many as 90,000 by 2025.


Social role and world view


Biomedicine

Within
Western culture Western culture, also known as Western civilization, Occidental culture, or Western society, is the heritage Heritage may refer to: History and society * In history History (from Greek , ''historia'', meaning "inquiry; knowledge acquired ...
and over recent centuries, medicine has become increasingly based on scientific
reductionism Reductionism is any of several related philosophical Philosophy (from , ) is the study of general and fundamental questions, such as those about existence Existence is the ability of an entity to interact with physical or mental reality ...
and
materialism Materialism is a form of philosophical monism which holds matter In classical physics and general chemistry, matter is any substance that has mass and takes up space by having volume. All everyday objects that can be touched are ultimate ...
. This style of medicine is now dominant throughout the industrialized world, and is often termed ''
biomedicine Biomedicine (also referred to as Western medicine, mainstream medicine or conventional medicine)
'' by medical anthropologists. Biomedicine "formulates the human body and disease in a culturally distinctive pattern", and is a
world view A worldview or world-view is the fundamental cognitive Cognition () refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses many aspects of intellectual ...
learnt by medical students. Within this tradition, the
medical model ''Medical model'' is the term coined by psychiatrist A psychiatrist is a physician A physician (American English), medical practitioner (English in the Commonwealth of Nations, Commonwealth English), medical doctor, or simply doctor, ...
is a term for the complete "set of procedures in which all doctors are trained", including mental attitudes. A particularly clear expression of this world view, currently dominant among conventional physicians, is
evidence-based medicine Evidence-based medicine (EBM) is "the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients." The aim of EBM is to integrate the experience of the clinician, the values of the ...
. 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 Sir William Osler, 1st Baronet, (; July 12, 1849 – December 29, 1919) was a Canadian Canadians (french: Canadiens) are people identified with the country of Canada. This connection may be residential, legal, historical or cultural. For ...
, ''Chauvanism in Medicine'' (1902)
In this Western tradition, physicians are considered to be members of a learned
profession A Profession is a disciplined group of individuals who adhere to ethical standards and who hold themselves out as, and are accepted by the public as possessing special knowledge and skills in a widely recognised body of learning derived from r ...

profession
, and enjoy high
social status Social status is the level of social value a person is considered to hold. More specifically, it refers to the relative level of respect, honour Honour ( British English) or honor (American English American English (AmE, AE, AmEng, USEng ...
, often combined with expectations of a high and stable income and
job security Job security is the probability that an individual will keep their job; a job with a high level of security is such that a person with the job would have a small chance of losing it. Basic economic theory holds that during periods of economic e ...
. 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 Ethics or moral philosophy is a branch of philosophy that "involves systematizing, defending, and recommending concepts of right and wrong action (philosophy), behavior".''Internet Encyclopedia of Philosophy'"Ethics"/ref> The field of ethics, al ...
and
legal Law is a system A system is a group of Interaction, interacting or interrelated elements that act according to a set of rules to form a unified whole. A system, surrounded and influenced by its environment, is described by its boundari ...
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 A patient is any recipient of health care services that are performed by Health professional, healthcare professionals. The patient is most often Disease, ill or Major trauma, injured and in need of therapy, treatment by a physician, nurse, psych ...
is an ancient reminder of medical duty, as it originally meant 'one who suffers'. The English noun comes from the
Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through the power of the Roman Republic, it became ...

Latin
word ''patiens'', the
present participle In linguistics, a participle () (from Latin Latin (, or , ) is a classical language belonging to the Italic languages, Italic branch of the Indo-European languages. Latin was originally spoken in the area around Rome, known as Latium. Through t ...
of the
deponent verb In linguistics Linguistics is the science, scientific study of language. It encompasses the analysis of every aspect of language, as well as the methods for studying and modeling them. The traditional areas of linguistic analysis include ph ...
, patior, meaning 'I am suffering', and akin to the
Greek#REDIRECT Greek Greek may refer to: Greece Anything of, from, or related to Greece Greece ( el, Ελλάδα, , ), officially the Hellenic Republic, is a country located in Southeast Europe. Its population is approximately 10.7 million as of ...
verb (
romanized Romanization or romanisation, in linguistics Linguistics is the scientific study of language A language is a structured system of communication used by humans, including speech (spoken language), gestures (Signed language, sign lan ...
:
''paschein'', lit. to suffer) and its cognate noun πάθος ( ''pathos'', suffering). 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 The American College of Physicians (ACP) is a national organization of internists, who specialize in the diagnosis, treatment, and care of adults.Sokanu "What is an Internist?" Retrieved 20 October 2014 With 154,000 members, ACP is the largest medi ...
or the
Royal College of Physicians The Royal College of Physicians (RCP) is a British professional membership body dedicated to improving the practice of medicine, chiefly through the accreditation of physicians by examination. Founded by royal charter from King Henry VIII in 1 ...
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 Traditional medicine (also known as indigenous Indigenous may refer to: *Indigenous peoples Indigenous peoples, also referred to as First people, Aboriginal people, Native people, or autochthonous people, are culturally distinct ethnic gr ...

traditional medicine
and
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine Medicine is the science Science (from the Latin word ''scientia'', meaning "knowledge") is a systematic enterprise that Scientific method, builds ...
continue to espouse
vitalism Vitalism is the belief that "living organisms are fundamentally different from non-living entities because they contain some non-physical element or are governed by different principles than are inanimate things". Where vitalism explicitly invoke ...
in various guises: "As long as life had its own secret properties, it was possible to have sciences and medicines based on those properties". The US
National Center for Complementary and Alternative Medicine The National Center for Complementary and Integrative Health (NCCIH) is a United States government agency which explores complementary and alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of ...
(NCCAM) classifies
complementary and alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine Medicine is the Art (skill), art, science, and Praxis (process) , practice of caring for a patient and managing the diagnosis, prognosis, Preventive me ...
therapies into five categories or domains, including: 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 Herbal medicine (also herbalism) is the study of pharmacognosy Pharmacognosy is the study of plants and other natural substances as possible sources of drug Uncoated tablets, consisting of about 90% acetylsalicylic acid, along with a mi ...
; and manipulative and body-based methods such as
chiropractic Chiropractic is a Pseudoscience, pseudoscientific complementary and alternative medicine (CAM) that is concerned with the diagnosis and treatment of mechanical disorders of the musculoskeletal system, especially the vertebral column, spine. Chi ...
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.
Ayurveda Ayurveda () is an alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine Medicine is the science Science (from the Latin word ''scientia'', meaning "knowledge") is a systema ...

Ayurveda
,
Unani medicine Unani or Yunani medicine ( Urdu: ''tibb yūnānī'') is Perso-Arabic traditional medicine as practiced in Muslim culture in South Asia and modern day Central Asia Central Asia is a region in Asia which stretches from the Caspian Sea in the w ...
, and
homeopathy Homeopathy or homoeopathy is a pseudoscientific Pseudoscience consists of statements, beliefs, or practices that claim to be both scientific and factual but are incompatible with the scientific method. Pseudoscience is often characteri ...
are popular types of alternative medicine.


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. 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,
life expectancy Life expectancy is a statistical measure of the average time an organism is expected to live, based on the year of its birth, its current age, and other demographic Demography (from prefix ''demo-'' from Ancient Greek Ancien ...

life expectancy
is slightly higher for physicians (73 years for white and 69 years for black) than lawyers or many other highly educated professionals. Causes of death which are less likely to occur in physicians than the general population include respiratory disease (including
pneumonia Pneumonia is an inflammatory Inflammatory may refer to: * Inflammation, a biological response to harmful stimuli * The word ''inflammatory'' is also used to refer literally to fire and flammability, and figuratively in relation to comments t ...

pneumonia
, pneumoconioses, Chronic obstructive pulmonary disease, COPD, but excluding emphysema and other chronic airway obstruction), alcohol-related deaths, Rectosigmoid neoplasm, rectosigmoid and anal cancers, and bacterial diseases. Physicians do experience exposure to occupational hazards, and there is a well-known aphorism that "doctors make the worst patients". Causes of death that are shown to be higher in the physician population include suicide among doctors and Self inflicted injury, self-inflicted injury, drug-related causes, traffic accidents, and cerebrovascular and ischaemic heart disease. Physicians are also prone to occupational burnout. This manifests as a long-term stress reaction characterized by poorer quality of care towards patients, emotional exhaustion, a feeling of decreased personal achievement, and others. A study by the Agency for Healthcare Research and Quality reported that time pressure was the greatest cause of burnout; a survey from the
American Medical Association The American Medical Association (AMA), founded in 1847 and incorporated in 1897, is the largest association and lobby group Advocacy groups, also known as special interest groups, use various forms of advocacy Advocacy is an activity by a ...
reported that more than half of all respondents chose "too many bureaucratic tasks" as the leading cause of burnout.


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 education, tertiary-level Course (education), 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 the 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 "medical intern, 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 medical license, licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for an 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 the 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 government spending, as medical care is commonly subsidized by national governments. In some jurisdictions such as in 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 such as 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.


All medical practitioners

Among the English-speaking countries, this process is known either as licensure as in the United States, or as Registration (occupational), registration in the
United Kingdom The United Kingdom of Great Britain and Northern Ireland, commonly known as the United Kingdom (UK) or Britain,Usage is mixed. The Guardian' and Telegraph' use Britain as a synonym for the United Kingdom. Some prefer to use Britain as shorth ...

United Kingdom
, other Commonwealth of Nations, Commonwealth countries, and
Ireland Ireland ( ; ga, Éire ; Ulster Scots dialect, Ulster-Scots: ) is an island in the Atlantic Ocean, North Atlantic. It is separated from Great Britain to its east by the North Channel (Great Britain and Ireland), North Channel, the Irish Sea ...

Ireland
. Synonyms in use elsewhere include ''colegiación'' in Spain, ''ishi menkyo'' in
Japan Japan ( ja, 日本, or , and formally ) is an island country An island country or an island nation is a country A country is a distinct territory, territorial body or political entity. It is often referred to as the land of an in ...

Japan
, ''autorisasjon'' in Norway, ''Approbation'' in Germany, and 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 Australia, officially the Commonwealth of Australia, is a Sovereign state, sovereign country comprising the mainland of the Australia (continent), Australian continent, the island of Tasmania, and numerous List of islands of Australia, sma ...

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. After graduating from a first-professional school, physicians who wish to practice in the US usually take standardized exams, such as the United States Medical Licensing Examination, USMLE for a Doctor in Medicine.


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, in particular following a critical 2000 report which "arguably launched" the patient-safety movement. In the US, as of 2006 there were few organizations that systematically monitored performance. In the US, only the Department of Veterans Affairs randomly drug tests physicians, in contrast to drug testing practices for other professions that have a major impact on public welfare. Licensing boards at the US state-level depend upon continuing education to maintain competence. 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 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. 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.


See also

* AI doctor * Doctor's office * Doctor–patient relationship * Occupations of physicians and surgeons * International medical graduate * List of countries and dependencies by number of physicians * List of medical schools * List of physicians * Medic * Physician-scientist * Physicians in Canada


References


Further reading

* Bell, Whitfield J. "Medical practice in colonial America." ''Bulletin of the History of Medicine'' 31.5 (1957): 442-45
online
* Hamilton, Bernice. “The Medical Professions in the Eighteenth Century.” ''Economic History Review'' 4#2 1951, pp. 141–169
online
in Britain * Holloway, Sydney WF. "Medical education in England, 1830–1858: A sociological analysis." ''History'' 49.167 (1964): 299-324
online
* Keevil, John Joyce. ''Medicine and the Navy, 1200-1900'' (4 vol E. & S. Livingstone, 1957) on Royal Navy * Porter, Roy. ''Disease, medicine and society in England, 1550-1860'' (Cambridge University Press, 1995).


External links

* * {{Authority control Physicians, Health care occupations