Physician: Difference between revisions
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{{otheruses3|Doctor}} |
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{{distinguish|Physicist}} |
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{{wiktionary|Physician}} |
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{{portal|Medicine}} |
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[[Image:The Doctor Luke Fildes.jpg|right|thumb|300px|"The Doctor" by [[Luke Fildes]]]] |
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Stacey is gay and stupid [[medical degree]], practices [[medicine]], and is concerned with maintaining or restoring human [[health]] through the study, diagnosis, and treatment of [[disease]] and [[injury]]. This is accomplished through a detailed knowledge of [[anatomy]], [[physiology]], diseases and [[therapy|treatment]] — the [[science]] of medicine — and its applied practice — the art or craft of medicine. |
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==Etymology== |
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{{dablink|The word physician shares a common [[etymology]] with words such as ''physics'' & ''metaphysics'', ''physical'', ''physique'', and ''physiognomy''.}} |
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{{dablink|There are many other words that have a meaning similar to, but not exactly the same as, physician.}} |
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The word physician [[wikt:φύσις|φύσις]] (''physis'') and its derived adjective ''physikos'', meaning "nature" and "natural". From this, amongst other derivatives came the [[Vulgar Latin]] ''physicus'', which meant a medical practitioner. After the [[Norman Conquest]], the word entered [[Middle English]] via [[Old French]] ''fisicien'', as early as 1100. 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''). ''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.<ref name="newSOED">{{cite book |author=Brown, Lesley |title=The New shorter Oxford English dictionary on historical principles |publisher=Clarendon |location=Oxford [Eng.] |year=2002 |pages= |isbn=0198612710 |oclc= |doi=}}</ref><ref name="Partridge">{{cite book |author=Partridge, Eric |title=Origins: a short etymological dictionary of modern English |publisher=Macmillan |location=New York |year=1966 |pages= |isbn=0025948407 |oclc= |doi=}}</ref><ref name="Chambers">{{cite book |author=Steinmetz, Sol; Barnhart, Robert K. |title=Chambers dictionary of etymology |publisher=Chambers |location=Edinburgh |year=1999 |pages= |isbn=0550142304 |oclc= |doi=}}</ref> |
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In English, there have been many [[synonym]]s for physician, both old and new, with some semantic variation. The noun phrase ''medical practitioner'' is perhaps the most widely understood and neutral synonym. Medical practitioner is lengthy but inclusive: it covers both [[Specialty (medicine)|medical specialists]] and [[general practitioner]]s (family physician, family practitioner), and historically would include physicians (in the narrow sense), surgeons or [[apothecary|apothecaries]]. In England, apothecaries historically included those who now would be called general practitioners and [[pharmacist]]s. |
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The term doctor (''medical doctor'') is older and shorter (see [[doctor of medicine]]), but can be confused with holders of other academic doctorates. ''Doctor'' ([[Genitive case|gen.]]: ''doctoris'') means ''teacher'' in [[Latin language|Latin]] and is an agentive noun derived from the verb ''docere'' ('teach').<ref>''[[Oxford English Dictionary]]'', v. ''doctor''.</ref> In [[French language|French]], [[wikt:médecin|médecin]] (doctor, physician) is a contraction of ''docteur médecin'', a direct equivalent of ''doctor of medicine''. In current French idiom, the term [[wikt:toubib|toubib]], is now a synonym, derived from Arabic طبيب (''tabīb'', physician). |
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The [[Greek language|Greek]] word [[wikt:ἰατρός|ἰατρός]] (''iatros'', doctor or healer) is often translated as physician. Ἱατρός is not preserved directly in English, but occurs in such formations as [[psychiatrist]] (translates from Greek as ''healer of the soul''), [[Podiatry|podiatrist]] (''foot healer''), and [[Iatrogenesis|iatrogenic disease]] (''a disease caused by medical treatment''). In Latin, [[wikt:medicus|medicus]] meant much what ''physician'' or ''doctor'' does now. Compare these translations of a well-known proverb (the nouns are in [[vocative case]]): |
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<blockquote> |
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Ἰατρέ, θεράπευσον σεαυτόν (Greek [[New Testament]]: Luke, 4:23)<br /> |
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''Medice, cura tiepsum'' (from the [[Vulgate]], early 5th century)<br /> |
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Physician, heal thyself (from the [[Authorized King James Version]], 1611)<br /> |
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</blockquote> |
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The ancient Romans also had the word [[archiater]], for ''court physician''. [[wikt:archiater|Archiater]] derives from the ancient Greek ''ἀρχιατρός'' (from [[wikt:ἄρχω|ἄρχω]] + [[wikt:ἰατρός|ἰατρός]], chief healer). By contraction, this title has given modern [[German language|German]] its word for ''physician'': [[wikt:arzt|arzt]]. |
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''Leech'' and ''leechcraft'' are archaic English words respectively for ''doctor'' and ''medicine''.<ref name="newSOED"/> The [[Old English language|Old English]] word for "physician", [[wikt:læċe|læċe]], which is related to [[Old High German]] ''lāhhi'' and [[Old Irish]] ''liaig'', lives on as the modern English word [[leech]], as these particular creatures were formerly much used by the medical profession. [[Cognate|Cognate forms]] for ''leech '' exist in modern [[Swedish language|Swedish]] as [[wikt:läkare|läkare]], in modern [[Norwegian language|Norwegian]] as [[wikt:lege|lege]] and in [[Finnish language|Finnish]] as [[wikt:lääkäri|lääkäri]]; these Scandinavian words still translate as ''doctor'' or ''physician'' rather than as a blood-sucking parasite. |
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==Meanings of the word ''physician''== |
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{{dablink|In modern English, the term ''physician'' is used in two main ways, with relatively broad and narrow meanings respectively.}} |
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{{dablink|This is often confusing, especially to non-physicians. These meanings and variations are listed below.}} |
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===''Physician'' as any medical practitioner=== |
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{{main|Medicine}} |
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In North America, ''physician'' is now widely used in the broad sense, and applies to any legally qualified and licensed practitioner of [[medicine]]. In the [[United States]], the term ''physician'' is commonly used to describe any medical doctor holding the degrees of [[Doctor of Medicine]] (MD) or [[Doctor of Osteopathic Medicine]] (DO), and in certain jurisdictions, those who hold the degree [[Doctor of Naturopathic Medicine]] (ND or NMD).<ref>{{cite web|url=http://www.dora.state.co.us/opr/archive/2008NaturopathicPhysiciansSunrise.pdf|title=2008 Sunrise Review: Naturopathic Physicians|year=2008}}</ref> The term may also describe the holders of legally equivalent [[Doctor of Medicine|medical degrees]] from other countries (in the [[United Kingdom|UK]] and other [[Commonwealth of Nations|Commonwealth]] countries, such degrees are typically [[Bachelor of Medicine and Surgery| MB BS, MB BChir ''etc'']]). The [[American Medical Association]], established in 1847, uses ''physician'' in this broad sense to describe all its members. |
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===''Physician'' as specialist (or subspecialist) in internal medicine=== |
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{{main|Internal medicine}} |
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''Physician'' is still widely used in its older, narrower sense, especially outside North America. In this usage, a physician is a [[Medical specialist|specialist]] in [[internal medicine]] or one of its many sub-specialties (especially as opposed to a specialist in [[surgery]]). This traditional meaning of physician conveys a sense of expertise in treatment by drugs or medications, rather than by the procedures of surgeons.<ref name="Fowler">{{cite book |author= |title=A Dictionary of Modern English Usage (Wordsworth Collection) (Wordsworth Collection) |publisher=NTC/Contemporary Publishing Company |location= |year= |pages= |isbn=1853263184 |oclc= |doi=}}</ref> |
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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 Oxford English Dictionary]], third edition, gives a Middle English quotation making this contrast, from as early as 1400: |
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{{cquote|O Lord, whi is it so greet difference betwixe a cirugian and a physician.<ref name="newSOED"/>}} |
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[[Henry VIII of England|Henry VIII]] granted a charter to the London [[Royal College of Physicians]] in 1518. It wasn't 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 Professor of Physic (Cambridge)|Regius Professorship of Physic]] at the [[University of Cambridge]].<ref>{{cite web | url = http://www.medschl.cam.ac.uk/about/history.html | title = University of Cambridge: History of the School of Clinical Medicine | publisher = [[University of Cambridge]] | accessdate = 2008-02-05 }}</ref> 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. |
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These days, a specialist physician in this older, narrower sense would probably be described in the [[United States]] as an internist. The older, narrower usage of physician as an internist is common in [[United Kingdom]], [[Republic of Ireland|Ireland]], [[Australia]], [[Brazil]], [[New Zealand]], [[Japan]], [[South Africa]], [[India]], [[Indonesia]], [[Taiwan]], [[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).<ref>{{cite web | url = http://www.racp.edu.au/index.cfm?objectid=49EF1EB5-2A57-5487-D74DBAFBAE9143A3 | title = The Royal Australasian College of Physicians: What are Physicians? | accessdate = 2008-02-05 | publisher = [[Royal Australasian College of Physicians]] }}</ref> In [[Commonwealth of Nations|Commonwealth]] countries, specialist [[pediatrics|pediatricians]] and [[geriatrics|geriatricians]] are also described as specialist physicians who have sub-specialized by age of patient rather than by [[Organ (anatomy)|organ]] system. |
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===''Physician and Surgeon''=== |
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Around the world, the combined term "Physician and Surgeon" is a venerable way to describe either a general practitioner, or else any medical practitioner irrespective of specialty.<ref name="Fowler"/><ref name="newSOED"/> This usage still shows the older, narrower 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. |
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===Other designations=== |
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Within the United States, the term physician may also describe holders of the [[Doctor of Osteopathic Medicine]] (D.O.) degree and in some jursidictions the [[Doctor of Naturopathic Medicine]]; the DO, the ND and the MD are the only degrees permitting U.S. medical licensure. Internationally, there are [[Doctor_of_Osteopathic_Medicine#International_variations_in_the_D.O._degree|variations in the D.O. degree]] and osteopaths are recognized as physicians in 48 countries. Osteopathic education includes teaching manipulative medicine. <ref>{{cite web|url=http://www.jaoa.org/cgi/reprint/107/1/6.pdf |title= JAOA Letters |accessdate=2008-03-01}}</ref> |
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Within the United States, some providers of specific types of [[primary care]] such as [[Doctor of Chiropractic|chiropractors]] (DC), [[Naturopathic medicine|naturopaths]] (ND), or [[podiatry|podiatrists]] (DPM), [[Dentistry|dentists]] (DDS), [[Physical therapy|physical therapists]] (DPT), [[Optometry|optometrists]] (OD) maintain a relatively narrow scope of practice and are sometimes referred to as "Doctor". However, they are rarely referred to as physicians. For example, NDs are physicians in seven of the 16 states that regulate naturopathic medicine.<ref>{{cite web|url=http://www.dora.state.co.us/opr/archive/2008NaturopathicPhysiciansSunrise.pdf|title=2008 Sunrise Review: Naturopathic Physicians|year=2008}}</ref> |
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[[Nurse practitioner]]s (NPs) are not described as physicians; the [http://www.acnpweb.org/ American College of Nurse Practitioners] do not describe themselves this way. They are classified as allied healthcare professionals. Some nurse practitioners may perform work similar to that of some physicians, especially in [[primary care]], but of a lesser scope. [[Physician Assistant]]s are classed as advance practice clinicians. |
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==Social role of physicians== |
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{{Sectstub|date=May 2008}} |
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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. Physicians are often members, or fellows of professional organisations such as the [[Royal College of Physicians]] in the United Kingdom. |
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The practice of medicine has ancient associations with religion and magic; see article on [[History of medicine]]. |
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Physicians commonly 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, and may earn less than other professionals whose education is of comparable length. |
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==Education and training== |
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{{main|Medical education}} |
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[[Medical education]] and career pathways for doctors vary considerably across the world. |
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===All medical practitioners=== |
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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 take 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. |
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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 "[[medical intern|internship]]" or "conditional registration". |
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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 internship or conditional registration. |
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===Specialists in internal medicine=== |
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After graduation, medical practitioners often undertake further training in a particular field, to become a [[medical specialist]]. In North America, this is often referred to as [[residency (medicine)|residency training]]; in [[Commonwealth of Nations|Commonwealth]] countries, such trainees are often called registrars. |
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This further training typically takes from three to six years, depending on specialty and jurisdiction. [[Primary care]] is increasingly recognized as a specialty, and residency programmes in this field are becoming common. A medical practitioner who completes specialist training in [[internal medicine]] (or in one of its sub-specialties) is an internist, or a physician in the older, narrower sense. |
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In some jurisdictions, 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 six years to become a specialist. |
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==Regulation== |
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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. |
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===All medical practitioners=== |
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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]], other [[Commonwealth of Nations|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. |
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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. |
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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" or some other variation.<ref>{{cite web|url=http://www.ama-assn.org/ama/pub/category/2645.html|title=AMA Links to state medical boards|accessdate=2008-03-01}}</ref> After graduating from medical school, physicians who wish to practice in the USA usually take standardized exams, such as the [[United States Medical Licensing Examination|USMLE]] for [[Doctor of Medicine|MDs]], [[COMLEX-USA]] for osteopathic physicians, or the [[NPLEX]] for [[Doctor of Naturopathic Medicine|NDs]] which enable them to obtain a certificate to practice from the appropriate state agency. |
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===Specialists in internal medicine=== |
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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. |
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==See also== |
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* [[International medical graduate]] |
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* [[List of physicians]] |
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* [[List of medical schools]] |
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* [[Residency (medicine)]] |
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==Notes== |
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{{Commonscat|Physicians}} |
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{{reflist}} |
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{{medicine}} |
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[[Category:Healthcare occupations]] |
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[[Category:Physicians|*]] |
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[[Category:Occupations|Physician]] |
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[[ar:طبيب]] |
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[[bs:Ljekar]] |
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[[bg:Лекар]] |
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[[da:Læge]] |
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[[de:Arzt]] |
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[[et:Arst]] |
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[[es:Médico]] |
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[[eo:Kuracisto]] |
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[[eu:Mediku]] |
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[[fr:Médecin]] |
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[[ga:Dochtúir leighis]] |
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[[ko:의사]] |
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[[hi:चिकित्सक]] |
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[[hr:Liječnik]] |
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[[id:Dokter]] |
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[[it:Medico]] |
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[[he:רופא]] |
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[[la:Medicus]] |
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[[lv:Ārsts]] |
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[[lt:Gydytojas]] |
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[[mg:Dokotera]] |
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[[ms:Doktor]] |
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[[nl:Arts]] |
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[[ja:医師]] |
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[[no:Lege]] |
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[[nn:Lege]] |
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[[pl:Lekarz]] |
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[[pt:Médico]] |
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[[qu:Hampikamayuq]] |
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[[ru:Врач]] |
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[[sk:Lekár]] |
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[[sl:Zdravnik]] |
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[[fi:Lääkäri]] |
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[[sv:Läkare]] |
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[[ta:மருத்துவர்]] |
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[[th:แพทย์]] |
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[[vi:Thầy thuốc]] |
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[[tr:Doktor]] |
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[[uk:Лікар]] |
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[[yi:דאקטער (מעדיצין)]] |
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[[bat-smg:Gīdītuos]] |
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[[zh:医生]] |
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