The Medicine reference article from the English Wikipedia on 24-Jul-2004
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Medicine

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See drugs, medication, and pharmacology for substances that treat patients. This article is about medical practice.

Medicine is a branch of health science concerned with restoring and maintaining health and wellness. Broadly, it is the practical science of preventing and curing diseases. However, medicine often refers more specifically to matters dealt with by physicians and surgeons.

Medicine is both an area of knowledge (a science), and the application of that knowledge (the medical profession). The various specialized branches of the science of medicine correspond to equally specialized medical professions dealing with particular organs or diseases. The science of medicine is the body of knowledge about body systems and diseases, while the profession of medicine refers to the social structure of the group of people formally trained to apply that knowledge to treat disease.

There are traditional and schools of healing which are usually not considered to be part of (Western) medicine in a strict sense (see health science for an overview). The most highly developed systems of medicine outside of the Western or Hippocratic tradition are the Ayurvedic school (of India) and traditional Chinese medicine. The remainder of this article focuses on modern (Western) medicine.

Table of contents
1 History of medicine
2 Medical sciences and health professions
3 Interdisciplinary medical fields
4 Settings where medical care is delivered
5 Teaching of medicine
6 Legal restrictions
7 Criticism
8 See also
9 External links

History of medicine

See the main articles History of medicine and Timeline of medicine and medical technology

Medicine as it is practiced now is rooted in various traditions, but developed mainly in the late 18th and early 19th century in Germany (Rudolf Virchow) and France (Jean-Martin Charcot and others). The new, "scientific" medicine replaced more traditional views based on the "Four humours". The development of clinical medicine shifted to the United Kingdom and the USA during the early 1900s (Sir William Osler, Harvey Cushing).

Evidence-based medicine is the recent movement to link the practice and the science of medicine more closely through the use of the scientific method and modern information science.

Genomics is already having a large influence on medical practice, as most monogenic genetic disorders have now been linked to causative genes, and molecular biological techniques are influencing medical decision-making.

Medical sciences and health professions

The delivery of modern health care depends, not just on medical practitioners, but on an expanding group of highly trained professionals coming together as an interdisciplinary team. A full list is given on the health profession page. Some examples include: nurses, laboratory scientists, pharmacists, physiotherapists, speech therapists, occupational therapists, dieteticians and bioengineers.

The scope and sciences underpinning human medicine overlap many other fields. Dentistry and psychology, while separate disciplines from medicine, are sometimes also considered medical fields. Physician assistants, nurse practitioners and midwives treat patients and prescribe medication in many legal jurisdictions. Veterinary medicine applies similar techniques to the care of animals.

Medical doctors have many specializations and subspecializations which are listed below.

Basic, supplementary, and related sciences

Diagnostic and imaging specialties

Disciplines of clinical medicine

Interdisciplinary medical fields

Interdisciplinary sub-specialties of medicine are:

Settings where medical care is delivered

See also
clinic, hospital, and hospice

Medicine is a diverse field and the provision of medical care is therefore provided in a variety of locations. In addition to inpatient hospital settings, medical services are often provided in locations such as clinics, emergency departments, endoscopy departments, outpatients department, operating theaters, and birth suites. Modern medical care also depends on information - still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

Teaching of medicine

See also the main articles Medical doctor (BE) and Physician (AE)

Medical training is involves several years of university study followed by several more years of residential practice at a hospital. Entry to a medical degree in some countries (such as the United States) requires the completion of another degree first, while in other countries (such as the United Kingdom) medical training can be commenced as an undergraduate degree immediately after secondary education. Once graduated from medical school most physicians begin their residency training, where skills in a speciality of medicine are learned, supervised by more experienced doctors. The first year of residency is known as the "intern" year. The duration of residency training depends on the speciality.

In the USA, physician training generally follows the following timeline (with age of completion):

The name of the medical degree gained at the end varies: some countries (e.g. the US) call it 'Doctor of Medicine' (abbreviated 'M.D.'), while others (e.g. Australia, Britain, Pakistan) call it "Bachelor of Medicine/Bachelor of Surgery" (French: "Chirurgie"); this is technically a double degree, frequently abbreviated 'M.B.B.S' or 'M.B.B.Ch.', dependent on the medical school. In either case graduates of a medical degree may call themselves physician. In the US and some other contries there is a parallel system of medicine called "osteopathy" which awards the degree D.O (doctor of osteopathy). In many countries, a doctorate of medicine does not require original research as does, in distinction, a PhD.

A medical graduate can then enter general practice and become a general practitioner (or primary care internist in the USA); training for these is generally shorter, while specialist training is typically longer.

Legal restrictions

In most countries, it is prohibited to practice medicine without a proper degree in that field and doctors must be licensed by a medical board or some other equivalent organization. This is meant as a safeguard against charlatans. These laws are obstacles to those who would want to pretend to training and expertise they have not earned, such as practitioners of alternative medicine or faith healing.

Criticism

Criticism against medicine has a long history. In the Middle Ages, it was not considered a profession suitable for Christians, as disease was considered Godsent, and interfering with the process a form of blasphemy. Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as a specialism of medicine, rather than an accessory field.

Through the course of the twentieth century, doctors naturally focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. This resulted in criticism for the loss of compassion and mechanistic, detached treatment. This issue started to reach collective professional consciousness in the 1970s and the profession had begun to respond by the 1980 and 1990s.

Perhaps the most devastating criticism came from Ivan Illich in his 1976 work Medical Nemesis. In his view, modern medicine only medicalises disease, causing loss of health and wellness, while generally failing to restore health by eliminating disease. The human being thus becomes a lifelong patient. Other less radical philosophers have voiced similar views, but none were as virulent as Illich. (Another example can be found in Technopoly: The Surrender of Culture to Technology by Neil Postman, 1992, which criticises overreliance on technological means in medicine.)

Criticism against modern medicine has led to some improvements in the curricula of medical schools, which now teach students systematically on medical ethics, holistic approaches to medicine, the biopsychosocial model and similar concepts.

The inability of modern medicine to properly address many common complaints continues to prompt many people to seek support from alternative medicine. Although a large number of alternative approaches to health await scientific validation, many report improvement of symptoms after obtaining alternative therapies.

See also

External links


Health science - Medicine
Anesthesiology - Dermatology - Emergency Medicine - General practice - Intensive care medicine - Internal medicine - Neurology - Obstetrics & Gynecology - Pediatrics - Public Health & Occupational Medicine - Psychiatry - Radiology - Surgery
Branches of Internal medicine
Cardiology - Endocrinology - Gastroenterology - Hematology - Infectious diseasess - Nephrology - Oncology - Pulmonology - Rheumatology
Branches of Surgery
General surgery - Cardiothoracic surgery - Neurosurgery - Ophthalmology - Orthopedic surgery - Otolaryngology (ENT) - Plastic surgery - Urology - Vascular surgery