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The word physician applies to a person who practices some type of medicine.
Such medical practitioners are concerned with maintaining or restoring human
health through the study, diagnosis and treatment of disease and injury, through
both an area of knowledge — a science — of body systems, their diseases and
treatment, and the applied practice — an art or craft — of that knowledge.
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 inflexible
hours, long work hour shifts, and generally earn less income than a business MBA
graduate, lawyer, CA (charted accountant), or managerial positions at firms such
as insurance companies and banks.
Etymology of the word "physician" and its synonyms
The word physician shares a common etymology with words such as physics &
metaphysics, physical, physique, and physiognomy.
There are also many words that have a meaning similar to, but not exactly the
same as, 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]
In English, there have been many synonyms for physician, both old and new, with
some semantic variation. 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 cover physicians (in the
narrow sense — see below), surgeons or apothecaries. The term doctor (medical
doctor) is older and shorter (see doctor of medicine), but may 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, 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 not 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 doctor does now, but the
ancient Romans also had the word archiater, for court physician. derives from
the ancient Greek αρχίατρος (from + = chief healer); by contraction, this has
given German its word for physician, .
Leech and leechcraft are archaic English words respectively for doctor and
medicine. The Old English word for "physician", , which is related to Old High
German lāhhi and Old Irish liaig, has survived as the modern English word leech,
as these particular creatures were formerly much used by the medical profession.
Cognate forms for leech exist in modern Swedish as , and in modern Norwegian as
; these Scandinavian words translate as doctor or physician — and not as a
blood-sucking parasite (see List of false friends between Swedish and English).
Different meanings of the word "physician"
In modern English, the term physician is used in two main ways, with relatively
broad and narrow meanings respectively.
This is often confusing, especially to non-physicians. These meanings and
variations are listed below.
"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 are Physicians? at The Royal Australasian College of
Physicians — the description given here applies fairly well throughout the
Commonwealth of Nations. Note that in Commonwealth countries, specialist
paediatricians and geriatricians are also described as specialist physicians
(who have subspecialized by age of patient rather than by organ system).
"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.). Unlike M.D.s or
D.O.s, these health care professionals are not licensed to practice the full
scope of medicine and are not given the title Physician and Surgeon by United
States medical boards.
Education and training
This section applies largely to physicians in the broad sense, especially in
North America.
Medical education
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 broad 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 for allopathic physicians or
COMLEX-USA for osteopathic physicians, which enable them to obtain a certificate
to practice from the appropriate state agency.
Regulation of specialists in internal medicine (physician in the narrow 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 occasionally alleged,
restriction of specialist numbers to reduce competition.
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