Physician
The word physician applies to a person who practices some type of human biological medicine. Physicians are traditionally considered to be members of a learned profession, because of the extensive training requirements and also because of the occupation's special ethical and legal duties. Many children often are pushed by parents to become physicians due to a misconception of its position in society and a notion of a stable income. It is important to note however, that medical professionals especially in the United States and Canada often work inflexable work hours, long work hour shifts, and make generally earn less income than a business MBA graduate, lawyer, CA (charted accountant), and even managerial positions at most firms such as insurance companies and banks.
Etymology of the word "physician"
The Classical Greek noun physis and derived adjective physikos meant "nature" and "natural". From this, amongst other derivatives came the Late Latin physicus, which meant a doctor of medicine. After the Norman Conquest, the word entered Middle English via Old French fisicien, as early as 1200. Originally, physician meant a practitioner of physic (pronounced with a hard C). This archaic noun had entered Middle English by 1300 (via Old French fisique). The noun physic meant the art or science of treatment with drugs or medications (as opposed to surgery), and was later used both as a verb and also to describe the medications themselves. [1] [2] [3]
Different meanings of the word "physician"
"Physician" = any medical practitioner
Physician in the broad sense, usually in North America, now applies to any legally qualified practitioner of medicine. In the United States, the term physician is now commonly used to describe any medical doctor holding the Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) degree (see below). The American Medical Association, established 1847, uses physician in this broad sense to describe all its members. See the article on Medicine for more information on what physicians (in this broad sense) do in practice.
"Physician" = specialist (or subspecialist) in internal medicine
However, Physician is still widely used in an older, narrow sense, especially outside North America. In this usage, a physician is a specialist in internal medicine or one of its many sub-specialties (especially as opposed to a specialist in surgery). This traditional meaning of physician still conveys a sense of expertise in treatment by drugs or medications, rather than by the procedures of surgeons.[4]
This older usage is at least six hundred years old in English; physicians and surgeons were once members of separate professions, and traditionally were rivals. The Shorter OED, 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 phisician." [5] Henry VIII granted a charter to the Royal College of Physicians (London) in 1518, and granted the Company of Barber/Surgeons (ancestor of the Royal College of Surgeons) its separate charter in 1540. In the same year, the same English monarch established the Regius Professorship of Physic at Cambridge University [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.
These days, a specialist physician in this older, narrow sense would probably be described in the United States as a internist (a specialist in internal medicine). The older, narrow usage of physician (= internist) is common in Britain, Ireland, Canada, Australia, Brazil, New Zealand, Japan, South Africa, India, Indonesia, Republic of China, Pakistan, Bangladesh, Sri Lanka, Zimbabwe and Hong Kong. In such places, the terms doctor or medical practitioner are prevalent, to describe any practitioner of medicine (whom an American would likely call a physician, in the newer, broad sense). For information on the work of specialist physicians in the older, narrow sense, see internal medicine, or else visit the web page What are Physicians? at The Royal Australian College of Physicians — the description given here applies fairly well throughout the Commonwealth of Nations.
"Physician and Surgeon"
On both sides of the Atlantic, the combined term Physician and Surgeon is a venerable way to describe either a General Practitioner, or else any medical practitioner irrespective of specialty.[1][4] This usage still shows the older, narrow meaning of physician and preserves the old difference between a physician, as a practitioner of physic, and a surgeon. The term Physician and Surgeon may be used by state medical boards in the USA, and by equivalent bodies in provinces of Canada, to describe any medical practitioner.
Osteopaths, Chiropractors and Podiatrists
Within the United States, the term physician may also describe Doctors of Osteopathy (D.O.), who are licensed physicians within the USA. However, outside the USA, osteopaths are recognized as complete physicians in only 48 countries. For further information on osteopathy, see the entry on Differences between allopathic and osteopathic medicine.
Although some Americans may also consider to be physicians those who hold the degrees of Doctor of Chiropractic Medicine (D.C.), Doctor of Naturopathic Medicine (N.D.), or Doctors of Podiatric Medicine (D.P.M.), they are not widely considered physicians in the truest sense. Unlike M.D.s or D.O.s, neither are licensed to practice the full scope of medicine and neither are given the title Physician and Surgeon by United States medical boards.
Education and training
Medical training and career pathways vary considerably across the world.
In all developed countries, entry-level medical education programs are tertiary-level courses undertaken at a medical school pertaining to a university. Depending on jurisdiction and university, these may be either undergraduate-entry or graduate-entry programs.
Following completion of entry-level training, newly graduated medical doctors are often required to undertake a period of supervised practice before full registration is granted; this may be referred to as "internship" or "conditional registration".
Further training in a particular field of medicine may be undertaken. In some jurisdictions this is commenced immediately following completion of entry-level training, while still other jurisdictions require junior medical doctors to undertake generalist (unstreamed) training for a number of years before commencing specialization.
Various teaching methodologies have been utilized in medical education, which is an active area of educational research.
Medical doctors hold a medical degree specific to the country and sometimes university in which they graduated. This qualifies that doctor to become licensed physicians or surgeons in that country, and sometimes several countries.
Regulation
In most jurisdictions, physicians (in either sense of the word) need government permission to practice. Such permission is intended (a), to promote public safety, and (b), often to protect the public purse, as medical care is commonly subsidised by national governments.
Regulation of all medical practitioners (physician in the narrow sense)
Among the English-speaking countries, this process is known either as licensure as in the United States, or as registration, eg in the United Kingdom, the Commonwealth 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 a member 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 (USA, Canada, Australia), the licensing or registration of medical practitioners is done at a state or provincial level. Australian states usually have a "Medical Board," while Canadian provinces usually have a "College of Physicians and Surgeons." All American states have an agency which 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", etc. After graduating from medical school, physicians who wish to practice in the USA usually take standardized exams, such as the USMLE or COMLEX, which enable them to obtain a certificate to practice from the appropriate state agency.
Regulation of specialists in internal medicine (physician in the broad sense)
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. For example, in Australia, only specialist physicians (internists in USA) or specialist dermatologists may lawfully prescribe istretinoin; this is a powerful drug useful in treating severe acne, but may cause severe and varied types of adverse drug reaction). Other reasons for regulating specialists may include: standardization of recognition for hospital employment, restriction on which practitioners are entitled to receive higher insurance payments for specialist services, and, as occaisonally alleged, restriction of specialist numbers to reduce competition.
See also
- Medicine
- Allopathic physician
- General practitioner
- Internal medicine
- List of physicians
- Medical specialist
- Naturopathic medicine
- Osteopathic physician
- Foreign medical graduate
Notes
- ^ a b Shorter Oxford English Dictionary on historical principles. Fifth edition, OUP, 2002
- ^ Partidge E., Origins: a short etymological dictionary of modern English. Fourth edition, Book Club Associates, 1966
- ^ Barnhart R.K. (ed.), Chambers Dictionary of Etymology. (previously published as Barnhart's Dictionary of Etymology), New York: Chambers, 1988
- ^ a b Fowler H.W. A dictionary of modern English usage. 1926. Second edition (E. Gowers, ed.) OUP, 1965
- ^ Onions C.T. (ed.) Shorter Oxford English Dictionary on historical principles. Third edition, OUP, 1944. reprinted with corrections 1967
- ^ http://www.medschl.cam.ac.uk/about/history.html
External links
- Royal College of Physicians (London)
- American Medical Association
- Royal Australasian College of Physicians
- Dillard, David (May 6 2006). "Medical Writers of Literature and Literary Writers with Medical Issues Found in Medical Sources and Beyond". Net Gold discussion group. Yahoo. Retrieved 2006-05-08.
{{cite web}}: Check date values in:|date=(help) - General Medical Council website
- Famous Canadian Physicians at Library and Archives Canada
