Everything about Physician totally explained
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A
physician,
medical practitioner or
medical doctor is a person who 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
treatment - the
science of medicine - and its applied practice - the
art or
craft of medicine.
Etymology
The word physician comes from an
ancient Greek noun (
physis) and its derived adjective
physikos, meaning "nature" and "natural". From this, amongst other derivatives came the
Vulgar Latin physicus, which meant a doctor of medicine. 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.
In English, there have been many
synonyms 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
medical specialists and
general practitioners (family physician, family practitioner), and historically would include physicians (in the narrow sense), surgeons or
apothecaries. In England, apothecaries historically included those who now would be called general practitioners and
pharmacists.
The term doctor (
medical doctor) is older and shorter (see
doctor of medicine), but can be confused with holders of other academic doctorates.
Doctor (
gen.:
doctoris) means
teacher in
Latin and is a contraction of the
Greek διδάκτωρ (
didaktōr, teacher), from the verb
διδάσκειν (didaskein, to teach). In
French, (doctor, physician) is a contraction of
docteur médecin, a direct equivalent of
doctor of medicine. In current French idiom, the term, is now a synonym, derived from Arabic طبيب (
tabīb, physician).
The
Greek word (
iatros, doctor or healer) is often translated as physician.
Ιατρός isn't preserved directly in English, but occurs in such formations as
psychiatrist (translates from Greek as
healer of the soul),
podiatrist (
foot healer), and
iatrogenic disease (
a disease caused by medical treatment). In Latin, meant much what
physician or
doctor does now. Compare these translations of a well-known proverb (the nouns are in
vocative case):
Ιατρε, θεράπευσον σεαυτόν (Greek New Testament: Luke, 4:23)
Medice, cura tiepsum (from the Vulgate, early 5th century)
Physician, heal thyself (from the Authorized King James Version, 1611)
The ancient Romans also had the word
archiater, for
court physician. derives from the ancient Greek
αρχίατρος (from +, chief healer). By contraction, this title has given modern
German its word for
physician: .
Leech and
leechcraft are archaic English words respectively for
doctor and
medicine.
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:
primary care hold degrees such as
Doctor of Chiropractic (D.C.),
Doctor of Naturopathic Medicine (N.D.), or
Doctors of Podiatric Medicine (D.P.M.). Chiropractors, naturopaths and podiatrists maintain a relatively narrow scope of practice compared to medical doctors and osteopaths [ M.D., D.O.], and are rarely referred to as physicians.
Nurse practitioners (NPs) are not described as physicians; the
American College of Nurse Practitioners
don't describe themselves this way. They are classified as "mid-level" healthcare providers. Some nurse practitioners may perform work similar to that of some physicians, especially in
primary care, but of a lesser level and scope.
Social role of physicians
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.
The practice of medicine has ancient associations with religion and magic; see article on
History of medicine.
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.
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 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.
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 "
internship" or "conditional registration".
Medical practitioners hold a medical degree specific to the university from which they graduated. This degree qualifies the medical practitioner to become
licensed or registered under the laws of that particular country, and sometimes of several countries, subject to requirements for internship or conditional registration.
Specialists in internal medicine
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 training; in
Commonwealth countries, such trainees are often called registrars.
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.
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 doesn't 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.
Regulation
In most jurisdictions, physicians (in either sense of the word) need government permission to practice. Such permission is intended to promote public safety, and often to protect the public purse, as medical care is commonly subsidized by national governments.
All medical practitioners
Among the English-speaking countries, this process is known either as
licensure as in the United States, or as
registration in the
United Kingdom, other
Commonwealth countries, and
Ireland. Synonyms in use elsewhere include
colegiación in
Spain,
ishi menkyo in
Japan,
autorisasjon in
Norway,
Approbation in
Germany, and "άδεια εργασίας" in Greece. In
France,
Italy and
Portugal, civilian physicians must be members of the Order of Physicians to practice medicine.
In some countries, including the United Kingdom and Ireland, the profession largely regulates itself, with the government affirming the regulating body's authority. The best known example of this is probably the
General Medical Council of Britain. In all countries, the regulating authorities will revoke permission to practice in cases of
malpractice or serious misconduct.
In the large English-speaking federations (
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. After graduating from medical school, physicians who wish to practice in the USA usually take standardized exams, such as the
USMLE for
MDs or
COMLEX-USA for osteopathic physicians, which enable them to obtain a certificate to practice from the appropriate state agency.
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.
Further Information
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