Physician
Specialist physician |
A physician, medical practitioner (
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.
Modern meanings
Specialist in internal medicine
Around the world the term physician refers to a
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]
Currently, a specialist
This original use, as distinct from surgeon, is common in most of the world including the
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, 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, 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
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 physicians guide patients in preventing disease and detecting health problems early while they are still treatable.[11] They are divided into two types: family medicine doctors and internal medicine doctors.[12] Family doctors, or family physicians, are trained to care for patients of any age, while internists are trained to care for adults.[13] Family doctors receive training in a variety of care and are therefore also referred to as general practitioners.[14] 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.[15]
Podiatry
In the United States, the
Podiatry residencies and/ or fellowships are not accredited by the ACGME. 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.[20] 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 obtaining their professional degree. The World Directory of Medical Schools 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 warned that the US will face a doctor shortage of as many as 90,000 by 2025.[22]
Social role and world view
Biomedicine
Within
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)[26]
In this Western tradition, physicians are considered to be members of a learned
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. [citation needed]
Alternative medicine
While contemporary biomedicine has distanced itself from its ancient roots in religion and magic, many forms of
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.[23][24][31][32]
Ayurveda, Unani medicine, and homeopathy 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.
Physicians do experience exposure to
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 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 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 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.[dubious ][38][39]
All medical practitioners
Among the English-speaking countries, this process is known either as
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 Regulation Agency (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.[40] After graduating from a first-professional school, physicians who wish to practice in the US usually take standardized exams, such as the 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
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
- ^ 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.
- ^ World Health Organization: Classifying health workers Archived 15 November 2020 at the Wayback Machine. Source: Adapted from International Labour Organization, International Standard Classification of Occupations: ISCO-08 (www.ilo.org/public/english/bureau/stat/isco/isco08/index.htm).
- PMID 11516576. Archived from the original(PDF) on 23 October 2013.
- ^ ISBN 1-85326-318-4.
- ^ ISBN 0-19-861271-0.
- ^ "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.
- PMID 8672160.
- PMID 19279342.
See also editorial by Hamel M. B. et al. on pp1141–1143 of same issue
- ^ "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.
- ^ Medline Plus (2012). "Doctor of Osteopathic Medicine". U.S. National Library of Medicine of National Institutes of Health. Archived from the original on 5 July 2016. Retrieved 22 December 2012.
- ^ "Choosing Between a Family Medicine Doctor and an Internal Medicine Doctor". beaumont.org. Beaumont Health. Archived from the original on 6 October 2021. Retrieved 14 January 2020.
- Piedmont Hospital. Archivedfrom the original on 6 October 2021. Retrieved 14 January 2020.
- ^ Bernat, Karl; Caplea, Andrea. "Family Medicine or Internal Medicine Doctor?". Duke Health. Duke University Health System. Archived from the original on 14 October 2021. Retrieved 14 January 2020.
- ^ Decker, Fred (9 August 2018). "Difference Between Internist & General Practitioner". Houston Chronicle. Hearst Newspapers, LLC. Archived from the original on 14 April 2021. Retrieved 14 January 2020.
- ^ "Internal Medicine vs. Family Medicine". acponline.org. American College of Physicians. Archived from the original on 6 October 2021. Retrieved 14 January 2020.
- ^ "About Podiatry". Apma.org. Archived from the original on 1 May 2012. Retrieved 19 September 2011.
- ^ "Podiatrist". Office of Science Education. Archived from the original on 29 April 2013. Retrieved 22 December 2012.
- ^ "Policy Finder | AMA". policysearch.ama-assn.org. Archived from the original on 13 October 2021. Retrieved 27 December 2021.
- ^ "List of Available Fellowships". American College of Foot and Ankle Surgeons. Archived from the original on 29 August 2021. Retrieved 9 July 2021.
- ^ "Scope of Practice Support". ACFAS. Archived from the original on 29 August 2021. Retrieved 29 August 2021.
- ^ "Medical doctors per 1,000 people". Our World in Data. Archived from the original on 4 November 2021. Retrieved 5 March 2020.
- ^ Bernstein, Lenny (3 March 2015). "U.S. faces 90,000 doctor shortage by 2025, medical school association warns". The Washington Post. Archived from the original on 29 June 2021. Retrieved 27 October 2016.
- ^ ISBN 90-277-1790-7.
- ^ ISBN 0-521-42576-X.
- ^ Laing, R.D. (1971). The politics of the family and other essays. London: Tavistock Publications.
- ^ Osler, Sir William (1902). "Chauvanism in medicine: address to the Canadian Medical Association, Montreal (17 September 1902)". The Montreal Medical Journal. XXXI.
- ISBN 0-02-594840-7.
- ^ 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.
- ISBN 978-1-55643-369-6.
- ^ "Complementary and Alternative Medicine – U.S. National Library of Medicine Collection Development Manual". Archived from the original on 23 December 2019. Retrieved 31 March 2008.
- ^ 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.
- ISBN 0-205-27006-9.
- S2CID 42678745.
- ^ PMID 11020591.
- PMID 9863860.
- ^ "Physician Burnout". Agency for Healthcare Research and Quality. July 2017. Archived from the original on 20 October 2021. Retrieved 31 July 2020.
- ^ Berg, Sara (3 August 2018). "Physician burnout: It's not you, it's your medical specialty". American Medical Association. Archived from the original on 20 October 2021. Retrieved 31 July 2020.
- ^ Schmidt, Sarah (30 September 2017). "Kommt ein Doktor zum Arzt ..." Sueddeutsche.de. Archived from the original on 13 April 2019. Retrieved 30 September 2017.
- ^ Kramer, Bernd (28 September 2015). "Medizin-Promotionen: Akademische Ramschware". Spiegel.de. Archived from the original on 12 April 2021. Retrieved 30 September 2017.
- ^ "AMA Links to state medical boards". Archived from the original on 29 January 2009. Retrieved 1 March 2008.
- PMID 14757804.
- ^ 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 Archived 12 November 2014 at the Wayback Machine.
- PMID 19952010.
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- ^ "Medical Board Licensing Service for Physicians seeking an Expedited Medical License with any of the 50 State Medical Boards". MedLicense.com. Archived from the original on 2 April 2021. Retrieved 19 September 2011.
- PMID 19188459.
Further reading
- Bell, Whitfield J. "Medical practice in colonial America". Bulletin of the History of Medicine 31.5 (1957): 442–453. JSTOR 44449174.
- Hamilton, Bernice. "The Medical Professions in the Eighteenth Century". Economic History Review 4#2 1951, pp. 141–169. JSTOR 2599120. In Britain
- Holloway, Sydney WF. "Medical education in England, 1830–1858: A sociological analysis". History 49.167 (1964): 299–324. JSTOR 24404427.
- 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
- Media related to Physicians at Wikimedia Commons
- The dictionary definition of physician at Wiktionary