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, with its single snake, is an ancient Greek symbol associated with medicine. The American Medical Association, the American Osteopathic Association, the Royal Society of Medicine, the Australian Medical Association, the British Medical Association, and the World Health Organization display the Rod of Asclepius in their logos or emblems.]] [Site] National Library of Medicine Medicine is the science and art of maintaining and restoring human health through the study, diagnosis, and treatment of patients.The term is derived from the Latin ars medicina meaning the art of healing.Etymology: Latin: medicina, from ars medicina "the medical art," from medicus "physician."( Etym.Online)Cf. mederi "to heal," etym. "know the best course for," from PIE base *med- "to measure, limit. Cf. Greek medos "counsel, plan," Avestan vi-mad "physician") Online Etymology Dictionary [News] 'Operation Bad Medicine' Nets 53 Arrests The modern practice of medicine occurs at the many interfaces between the art of healing and various sciences. Medicine is directly connected to the health sciences and biomedicine. Broadly speaking, the term 'Medicine' today refers to the fields of clinical medicine, medical research and surgery, thereby covering the challenges of disease and injury. [Image]
HistoryMuseum, Paris, France.]][Video] Dr. John Schultz (Regenexx Stem Cell Research) The earliest type of medicine in most cultures was the use of empirical natural resources like plants (herbalism), animal parts and minerals. In all societies, including Western ones, there were also religious, ritual and magical resources. In aboriginal societies, there is a large scope of medical systems related to religious thinking, cultural experience, and natural resources. The religious ones more known are: animism (the notion of inanimate objects having spirits); spiritualism (here meaning an appeal to gods or communion with ancestor spirits); shamanism (the vesting of an individual with mystic powers); and divination (the supposed obtaining of truth by magic means). The field of medical anthropology studies the various medical systems and their interaction with society, while prehistoric medicine addresses diagnosis and treatment in prehistoric times. [Auction] 1643 SCIENCE PHYSICS CHEMISTRY MEDICINE MAGNETISM The practice of medicine developed gradually in ancient Egypt, Babylonia, India, China, Greece, Persia, the Islamic world, medieval Europe and early modern period in Persia (Rhazes and Avicenna), Spain (Abulcasis and Avenzoar), Syria/Egypt (Ibn al-Nafis, 13th century), Italy (Gabriele Falloppio, 16th century), England (William Harvey, 17th century). Medicine as it is now practiced largely developed during the 19th and 20th centuries in Germany (Rudolf Virchow, Wilhelm Conrad Röntgen, Robert Koch), Austria (Karl Landsteiner, Otto Loewi), United Kingdom (Edward Jenner, Alexander Fleming, Joseph Lister, Francis Crick), New Zealand (Maurice Wilkins), Australia (Howard Floery, Frank Macfarlane Burnet), Russia (Nikolai Korotkov), United States (William Williams Keen, Harvey Cushing, William Coley, James D. Watson), Italy (Salvador Luria), Switzerland (Alexandre Yersin), Japan (Kitasato Shibasaburo), and France (Jean-Martin Charcot, Claude Bernard, Louis Pasteur, Paul Broca and others). The new "scientific" or "experimental" medicine (where results are testable and repeatable) replaced early Western traditions of medicine, based on herbalism, the Greek "four humours" and other pre-modern theories. [Post] Functional Medicine - New Kid on the Block was the patron of medicine. In the image he is accompanied by two gryphons. A similar image with two snakes coiling around a rod is called the Caduceus and, although historically inappropriate, appears in the logo/emblem of a significant number of private (rather than professional or academic) medical practices.]]The focal points of development of clinical medicine shifted to the United Kingdom and the USA by the early 1900s (Canadian-born) Sir William Osler, Harvey Cushing). Possibly the major shift in medical thinking was the gradual rejection, especially during the Black Death in the 14th and 15th centuries, of what may be called the 'traditional authority' approach to science and medicine. This was the notion that because some prominent person in the past said something must be so, then that was the way it was, and anything one observed to the contrary was an anomaly (which was paralleled by a similar shift in European society in general - see Copernicus's rejection of Ptolemy's theories on astronomy). Physicians like Ibn al-Nafis and Vesalius led the way in improving upon or indeed rejecting the theories of great authorities from the past (such as Hippocrates, Galen and Avicenna), many of whose theories were in time discredited. Such new attitudes were made possible in Europe by the weakening of the Roman Catholic church's power in society, especially in the Republic of Venice. Evidence-based medicine is a recent movement to establish the most effective algorithms of practice (ways of doing things) through the use of the scientific method and modern global information science by collating all the evidence and developing standard protocols which are then disseminated to healthcare providers. One problem with this 'best practice' approach is that it could be seen to stifle novel approaches to treatment. ampoules]]Genomics and knowledge of human genetics is already having some influence on medicine, as the causative genes of most monogenic genetic disorders have now been identified, and the development of techniques in molecular biology and genetics are influencing medical practice and decision-making. [Site] eMedicine.com Pharmacology has developed from herbalism and many drugs are still derived from plants (atropine, ephedrine, warfarin, aspirin, digoxin, vinca alkaloids, taxol, hyoscine, etc). The modern era began with Robert Koch's discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of antibiotics shortly thereafter around 1900. The first of these was arsphenamine / Salvarsan discovered by Paul Ehrlich in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of antibiotics was the sulfa drugs, derived by French chemists originally from azo dyes. Throughout the twentieth century, major advances in the treatment of infectious diseases were observable in (Western) societies. The medical establishment is now developing drugs targeted towards one particular disease process. Thus drugs are being developed to minimize the side effects of prescribed drugs, to treat cancer, geriatric problems, long-term problems (such as high cholesterol), chronic diseases such as type 2 diabetes, lifestyle and degenerative diseases such as arthritis and Alzheimer's disease. 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PracticeThe practice of medicine combines both science as the evidence base and art in the application of this medical knowledge in combination with intuition and clinical judgment to determine the treatment plan for each patient.[Image] Central to medicine is the patient-physician relationship established when a person with a health concern seeks a physician's help; the 'medical encounter'. Other health professionals similarly establish a relationship with a patient and may perform various interventions, e.g. nurses, radiographers and therapists. [Video] Magic Mushrooms - A Kick In The Booty ]]As part of the medical encounter, the healthcare provider needs to:
[Auction] ESTABLISHED MEDICINE MEDICAL WEBSITE BUSINESS HAS MONEY The medical encounter is documented in a medical record, which is a legal document in many jurisdictions. [Post] Arizona's Prop. 101 is good medicine for bad politicians
Delivery systemsMedicine is practiced within the medical system, which is a legal, credentialing and financing framework, established by a particular culture or government. The characteristics of a health care system have significant effect on the way medical care is delivered.Most industrialized countries and many developing countries deliver health care though a system of universal health care which guarantees health care for all through a system of compulsory private or co-operative health insurance funds or via government backed social insurance. This insurance, (in effect, a form of taxation) ensures the entire population has access to medical care on the basis of need rather than ability to pay. The delivery systems may be provided by private medical practices or by state owned hospitals and clinics, or by charities. [Site] Medicine in the Yahoo! Directory Most tribal societies but also some communist countries (e.g. China) and at least one industrialized capitalist country (the United States) provide no guarantee of health care for the population as a whole. In such societies, health care is available to those that can afford to pay for it or have self insured it (either directly or as part of an employment contract) or who may be covered by care financed by the government or tribe directly. [News] Sick economy has patients skimping on medicine Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality and pricing greatly affects the choice by patients / consumers and therefore the incentives of medical professionals. While US health care system has come under fire for lack of openness, new legislation may encourage greater openness. There is a perceived tension between the need for transparency on the one hand and such issues as patient confidentiality and the possible exploitation of information for commercial gain on the other. [Image]
Delivery]]Medical care delivery is classified into primary, secondary and tertiary care.[Video] DCA - dichloroacetic acid hope for cancer chemo alternative Primary care medical services are provided by physicians or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, clinics, nursing homes, schools, home visits and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sexes. [Auction] TIBET NEPAL 3 metal COPPER brass weave MEDICINE ring Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency room, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting. [Post] In the New England Journal Again! CRP genetics! Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc. [Book] Step-Up to Medicine (Step-Up Series) Lippincott Williams & Wilkins Modern medical care also depends on information - still delivered in many health care settings on paper records, but increasingly nowadays by electronic means. [Site] MedicineNet.com
Patient-physician-relationshipThis kind of relationship and interaction is a central process in the practice of medicine. There are many perspectives from which to understand and describe it.[News] Medicine cabinet can be a no-pain installation An idealized physician's perspective, such as is taught in medical school, sees the core aspects of the process as the physician learning the patient's symptoms, concerns and values; in response the physician examines the patient, interprets the symptoms, and formulates a diagnosis to explain the symptoms and their cause to the patient and to propose a treatment. The job of a physician is similar to a human biologist: that is, to know the human frame and situation in terms of normality. Once the physician knows what is normal and can measure the patient against those norms, he or she can then determine the particular departure from the normal and the degree of departure. This is called the diagnosis. [Image] The four great cornerstones of diagnostic medicine are anatomy (structure: what is there), physiology (how the structure/s work), pathology (what goes wrong with the anatomy and physiology) and psychology (mind and behavior). In addition, the physician should consider the patient in their 'well' context rather than simply as a walking medical condition. This means the socio-political context of the patient (family, work, stress, beliefs) should be assessed as it often offers vital clues to the patient's condition and further management. [Video] Fungus Yields Cancer Drugs A patient typically presents a set of complaints (the symptoms) to the physician, who then obtains further information about the patient's symptoms, previous state of health, living conditions, and so forth. The physician then makes a review of systems (ROS) or systems inquiry, which is a set of ordered questions about each major body system in order: general (such as weight loss), endocrine, cardio-respiratory, etc. Next comes the actual physical examination and often laboratory tests; the findings are recorded, leading to a list of possible diagnoses. These will be investigated in order of probability. [Auction] Medicine PreTest Self-Assessment and Review by Steve... The next task is to enlist the patient's agreement to a management plan, which will include treatment as well as plans for follow-up. Importantly, during this process the healthcare provider educates the patient about the causes, progression, outcomes, and possible treatments of his ailments, as well as often providing advice for maintaining health. This teaching relationship is the basis of calling the physician doctor, which originally meant "teacher" in Latin. The patient-physician relationship is additionally complicated by the patient's suffering (patient derives from the Latin patior, "suffer") and limited ability to relieve it on his/her own. The physician's expertise comes from his knowledge of what is healthy and normal contrasted with knowledge and experience of other people who have suffered similar symptoms (unhealthy and abnormal), and the proven ability to relieve it with medicines (pharmacology) or other therapies about which the patient may initially have little knowledge. [Post] Do I Have to Take Medicine Forever? The physician-patient relationship can be analyzed from the perspective of ethical concerns, in terms of how well the goals of non-maleficence, beneficence, autonomy, and justice are achieved. Many other values and ethical issues can be added to these. In different societies, periods, and cultures, different values may be assigned different priorities. For example, in the last 30 years medical care in the Western World has increasingly emphasized patient autonomy in decision making. [Book] Yoga as Medicine: The Yogic Prescription for Health and Healing Bantam The relationship and process can also be analyzed in terms of social power relationships (e.g., by Michel Foucault), or economic transactions. Physicians have been accorded gradually higher status and respect over the last century, and they have been entrusted with control of access to prescription medicines as a public health measure. This represents a concentration of power and carries both advantages and disadvantages to particular kinds of patients with particular kinds of conditions. A further twist has occurred in the last 25 years as costs of medical care have risen, and a third party (an insurance company or government agency) now often insists upon a share of decision-making power for a variety of reasons, reducing freedom of choice of healthcare providers and patients in many ways. [Site] Home : Nature Medicine The quality of the patient-physician relationship is important to both parties. The better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about disease and life, and time available, the better will be the amount and quality of information about the patient's disease transferred in both directions, enhancing accuracy of diagnosis and increasing the patient's knowledge about the disease. Where such a relationship is poor the physician's ability to make a full assessment is compromised and the patient is more likely to distrust the diagnosis and proposed treatment. In these circumstances and also in cases where there is genuine divergence of medical opinions, a second opinion from another physician may be sought or the patient may choose to go to another doctor. [News] Man talks his way into home, steals medicine In some settings, e.g. the hospital ward, the patient-physician relationship is much more complex, and many other people are involved when somebody is ill: relatives, neighbors, rescue specialists, nurses, technical personnel, social workers and others. [Image]
Clinical skillsA complete medical evaluation includes a medical history, a systems enquiry, a physical examination, appropriate laboratory or imaging studies, analysis of data and medical decision making to obtain diagnoses, and a treatment plan.[Video] THE HAL TURNER SHOW The components of the medical history are:
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[Post] Votes and Vaccinations To Be Election Day Combo, Thanks to Yale ... The physical examination is the examination of the patient looking for signs of disease ('Symptoms' are what the patient volunteers, 'Signs' are what the healthcare provider detects by examination). The healthcare provider uses the senses of sight, hearing, touch, and sometimes smell (taste has been made redundant by the availability of modern lab tests). Four chief methods are used: inspection, palpation (feel), percussion (tap to determine resonance characteristics), and auscultation (listen); smelling may be useful (e.g. infection, uremia, diabetic ketoacidosis). The clinical examination involves study of:
[Site] eMedicine Specialties Laboratory and imaging studies results may be obtained, if necessary. [News] Govt to bring quality control in traditional medicine The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem. [Image] The treatment plan may include ordering additional laboratory tests and studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. [Video] PAYBACK. IEC This process is used by primary care providers as well as specialists. It may take only a few minutes if the problem is simple and straightforward. On the other hand, it may take weeks in a patient who has been hospitalized with bizarre symptoms or multi-system problems, with involvement by several specialists. [Auction] First Aid For The Medicine Clerkship by Latha G. Ste... On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations. [Post] Family Medicine Journal November-December 2008 Issue
BranchesWorking together as an interdisciplinary team, many highly-trained health professionals besides medical practitioners are involved in the delivery of modern health care. Examples include: nurses, emergency medical technicians and paramedics, laboratory scientists, (pharmacy, pharmacists), (physiotherapy,physiotherapists), respiratory therapists, speech therapists, occupational therapists, radiographers, dietitians and bioengineers.[Book] Energy Medicine for Women: Aligning Your Body's Energies to Boost Your Health and Vitality Tarcher The scope and sciences underpinning human medicine overlap many other fields. Dentistry and psychology, while separate disciplines from medicine, are considered medical fields. [Site] USD - New Home Page A patient admitted to hospital is usually under the care of a specific team based on their main presenting problem, e.g. the Cardiology team, who then may interact with other specialties, e.g. surgical, radiology, to help diagnose or treat the main problem or any subsequent complications / developments. [News] Traditional medicine to maintain highest standard Physicians have many specializations and subspecializations into certain branches of medicine, which are listed below. There are variations from country to country regarding which specialties certain subspecialties are in. [Image] The main branches of medicine used in Wikipedia are: [Video] LITHIVM (PART 6 a)
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Basic sciences
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SpecialtiesIn the broadest meaning of "medicine", there are many different specialties. However, within medical circles, there are two broad categories: "Medicine" and "Surgery." "Medicine" refers to the practice of non-operative medicine, and most subspecialties in this area require preliminary training in "Internal Medicine". "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." There are some specialties of medicine that do not fit into either of these categories, such as radiology, pathology, or anesthesia, and those are also discussed further below.[Book] Medicine Cards: The Discovery of Power Through the Ways of Animals St. Martin's Press
SurgerySurgical specialties employ operative treatment. In addition, surgeons must decide when an operation is necessary, and also treat many non-surgical issues, particularly in the surgical intensive care unit (SICU), where a variety of critical issues arise. Surgery has many subspecialties, e.g. general surgery, trauma surgery, cardiovascular surgery, neurosurgery, maxillofacial surgery, orthopedic surgery, otolaryngology, plastic surgery, oncologic surgery, vascular surgery, and pediatric surgery. In some centers, anesthesiology is part of the division of surgery (for logistical and planning purposes), although it is not a surgical discipline.[Site] UNC School of Medicine Surgical training in the U.S. requires a minimum of five years of residency after medical school. Sub-specialties of surgery often require seven or more years. In addition, fellowships can last an additional one to three years. Because post-residency fellowships can be competitive, many trainees devote two additional years to research. Thus in some cases surgical training will not finish until more than a decade after medical school. Furthermore, surgical training can be very difficult and time-consuming. A surgical resident's average work week is approximately 75 hours. Some subspecialties of surgery, such as neurosurgery, require even longer hours, and utilize an extension to the 80 hour regulated work week, allowing up to 88 hours per week. Many surgical programs still exceed this work hour limit. Attempts to limit the amount of hours worked has been difficult because of the large volume of patients who require surgical care, the limited amount of resources (including a shortage of people willing to enter into surgery as a career)Dorsey, et al., "Influence of Controllable Lifestyle on Recent Trends in Specialty Choice by US Medical Students, the need to perform long operations and still provide care to all pre- and post-operative patients, and the need to provide constant coverage in the OR, ICU, and ER. [News] Medicine is next field for trainers
Medicine
[Image] Generally, Pediatrics and Family Practice are also considered to fall under the category of "Medicine". [Video] NARCONON of Georgia warns about the dangers of OTC medicine Pt 3. Medical training, as opposed to surgical training, requires three years of residency training after medical school. This can then be followed by a one to two year fellowship in the subspecialties listed above. In general, resident work hours in medicine are less than those in surgery, averaging about 60 hours per week. [Auction] Last Minute Internal Medicine by George Keith Meyer,...
Diagnostic specialties
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OtherFollowing are some selected fields of medical specialties that don't directly fit into any of the above mentioned groups.[Book] Case Files Internal Medicine (Lange Case Files) McGraw-Hill Medical
[Site] Open Directory - Health: Medicine ===Interdisciplinary fields=== Interdisciplinary sub-specialties of medicine are:
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EducationMedical education is education connected to the practice of being a medical practitioner, either the initial training to become a physician or further training thereafter.[Image] Medical education and training varies considerably across the world, however typically involves entry level education at a university medical school, followed by a period of supervised practice (internship and/or residency) and possibly postgraduate vocational training. Continuing medical education is a requirement of many regulatory authorities. [Video] NARCONON of Georgia talks about the dangers of OTC medicine PT 1. Various teaching methodologies have been utilized in medical education, which is an active area of educational research. [Auction] George's Marvelous Medicine by Roald Dahl (2007) Presently, in England, a typical medicine course at university is 5 years after secondary education (4 if the student already holds a degree). Amongst some institutions and for some students, it may be 6 years (including the selection of an intercalated BSc—taking one year—at some point after the pre-clinical studies). This is followed by 2 Foundation years afterwards, namely F1 and F2. Students register with the UK General Medical Council at the end of F1. At the end of F2, they may pursue further years of study. [Post] How State Medical Boards Shoot Themselves (and You) in the Foot In the US and Canada, a potential medical student must first complete an undergraduate degree in any subject before applying to a graduate medical school to pursue a (M.D., N.D. or D.O.) program. Some students opt for the research-focused MD/PhD dual degree, which is usually completed in 7-8 years. There are certain courses which are pre-requisite for being accepted to medical school, such as general chemistry, organic chemistry, physics, mathematics, biology, English, labwork, etc. The specific requirements vary by school. [Book] The Language of Medicine Saunders In Australia, there are two pathways to a medical degree. Students can choose to take a five or six year undergraduate medical degree Bachelor of Medicine/Bachelor of Surgery (MBBS or BMed) straight from high school, or complete a bachelors degree (generally three years, usually in the medical sciences) and then apply for a four year graduate entry Bachelor of Medicine/Bachelor of Surgery (MBBS) program.
Legal restrictionsIn most countries, it is a legal requirement for a medical doctor to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to physicians that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health.[News] Sharon Medicine Shoppe robbed of drugs
CriticismCriticism of medicine has a long history. In the Middle Ages, some people did not consider it a profession suitable for Christians, as disease was often considered God-sent. God was considered to be the "divine physician" who sent illness or healing depending on his will. However, many monastic orders, particularly the Benedictines, considered the care of the sick as their chief work of mercy. Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as a specialty of medicine, rather than an accessory field.[Image] Through the course of the twentieth century, healthcare providers focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. The ensuing development of a more mechanistic, detached practice, with the perception of an attendant loss of patient-focused care, known as the medical model of health, led to further criticisms. This issue started to reach collective professional consciousness in the 1970s and the profession had begun to respond by the 1980s and 1990s. [Video] Dr Hook & The medicine show-Sylvia's Mother The noted anarchist Ivan Illich heavily criticized modern medicine. In his 1976 work Medical Nemesis, Illich stated that modern medicine "medicalizes" disease and causes loss of health and wellness, while generally failing to restore health by eliminating disease. This medicalization of disease forces the human to become 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 criticizes overreliance on technological means in medicine. [Auction] Through the Medicine Cabinet by Dan Greenburg (1996) The inability of modern medicine to properly address some common complaints continues to prompt many people to seek support from alternative medicine. Although most alternative approaches lack scientific validation, some may be effective in individual cases. Some physicians combine alternative medicine with orthodox approaches. [Post] Acid reflux relief with alternative medicine Medical errors and overmedication are also the focus of many complaints and negative coverage. Practitioners of human factors engineering believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it was long ago realized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make errors. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improvi | |
