Difference between revisions of "Medicine"

From Marspedia
Jump to: navigation, search
 
(6 intermediate revisions by 4 users not shown)
Line 1: Line 1:
{{two other uses|the science and art of healing|pharmaceutical drugs|Medication}}
+
Medicine on Mars will be carried out first as an element of crew work, and eventually through a [[Health Care|health care]] system for the settlements.
[http://en.wikipedia.org/wiki/File:Asklepios.3.jpg|thumb|Statue of [http://en.wikipedia.org/wiki/Asclepius], the [http://en.wikipedia.org/wiki/Greek God|Greek god] of medicine, holding the symbolic [http://en.wikipedia.org/wiki/Rod of Asclepius] with its coiled [http://en.wikipedia.org/wiki/snake|serpent]]
 
'''Medicine''' is the field of [http://en.wikipedia.org/wiki/applied science] and the [http://en.wikipedia.org/wiki/art] of [http://en.wikipedia.org/wiki/healing]. It encompasses a variety of [http://en.wikipedia.org/wiki/health care] practices evolved to maintain and restore [http://en.wikipedia.org/wiki/health] by the [http://en.wikipedia.org/wiki/prevention (medical)|prevention] and [http://en.wikipedia.org/wiki/therapy|treatment] of [http://en.wikipedia.org/wiki/illness] in [http://en.wikipedia.org/wiki/human beings].
 
  
Contemporary medicine applies [http://en.wikipedia.org/wiki/health science], [http://en.wikipedia.org/wiki/biomedical research], and [http://en.wikipedia.org/wiki/medical technology] to [http://en.wikipedia.org/wiki/diagnosis (medical)|diagnose] and treat injury and disease, typically through medication or [http://en.wikipedia.org/wiki/surgery], but also through therapies as diverse as [http://en.wikipedia.org/wiki/psychotherapy], [http://en.wikipedia.org/wiki/splint (medicine)|external splints & traction], [http://en.wikipedia.org/wiki/prostheses], [http://en.wikipedia.org/wiki/biologic medical product|biologics], [http://en.wikipedia.org/wiki/Radiation (medicine)|ionizing radiation] and others. The word ''medicine'' is derived from the [http://en.wikipedia.org/wiki/Latin] ''ars medicina'', meaning ''the art of healing''.<ref>Etymology: [http://en.wikipedia.org/wiki/Latin language|Latin]: ''medicina'', from ''ars medicina'' "the medical art", from ''medicus'' "physician". ([http://www.etymonline.com/index.php?term=medicine Etym.Online])
+
A large part of the work done over the year on the International Space Station (ISS) has been on the medical challenges of space travel. Some of this work may be adaptable to Mars; but Mars has its own specific medical challenges.
Cf. ''mederi'' "to heal", etym. "know the best course for," from [http://en.wikipedia.org/wiki/Proto-Indo-European language|PIE] base *med- "to measure, limit. Cf. [http://en.wikipedia.org/wiki/Greek language|Greek] ''medos'' "counsel, plan", [http://en.wikipedia.org/wiki/Avestan language|Avestan] ''vi-mad'' "physician")</ref><ref>[http://www.etymonline.com/index.php?term=medicine "Medicine"] ''Online Etymology Dictionary''</ref>
 
  
==History==
+
The special challenges of medicine on Mars might be:
{{Main|Timeline of medicine and medical technology}}
 
[http://en.wikipedia.org/wiki/Image:Imhotep-Louvre.JPG|thumb|200px|left||Statuette of ancient Egyptian physician [http://en.wikipedia.org/wiki/Imhotep], the first physician from antiquity known by name.]
 
  
[http://en.wikipedia.org/wiki/Prehistoric medicine] incorporated plants ([http://en.wikipedia.org/wiki/herbalism]), animal parts and minerals. In many cases these materials were used ritually as magical substances by priests, [http://en.wikipedia.org/wiki/shamans], or [http://en.wikipedia.org/wiki/medicine man|medicine men]. Well-known spiritual systems include [http://en.wikipedia.org/wiki/animism] (the notion of inanimate objects having spirits), [http://en.wikipedia.org/wiki/spiritualism] (an appeal to gods or communion with ancestor spirits); [http://en.wikipedia.org/wiki/shamanism] (the vesting of an individual with mystic powers); and [http://en.wikipedia.org/wiki/divination] (magically obtaining the truth). The field of [http://en.wikipedia.org/wiki/medical anthropology] examines the ways in which culture and society are organized around or impacted by issues of health, health care and related issues.
+
* Low gravity adaptation, such as child bearing and the effect of low gravity on development
 +
* [[Radiation sickness|Radiation]] mitigation
 +
* [[Perchlorate]] poisoning
 +
* Mental health
 +
* Isolation, disease resistance
  
[http://en.wikipedia.org/wiki/Image:Medicine aryballos Louvre CA1989-2183.jpg|thumb|200px|right|An ancient Greek patient gets medical treatment: this [http://en.wikipedia.org/wiki/aryballos] (''circa'' 480–470 BCE, now in Paris's [http://en.wikipedia.org/wiki/Louvre|Louvre Museum]) probably contained healing oil]
+
== References ==
[http://en.wikipedia.org/wiki/Image:Hippocrates.jpg|thumb|right|200px|The [http://en.wikipedia.org/wiki/Ancient Greek medicine|Greek physician] [http://en.wikipedia.org/wiki/Hippocrates] (ca. 460 BCE – ca. 370 BCE), considered the father of medicine.<ref>[http://www.ncbi.nlm.nih.gov/pubmed/18392218 Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus.], U.S. National Library of Medicine</ref><ref name="blackwellpublishing.com">[http://www.blackwellpublishing.com/eccmid16/abstract.asp?id=50854 The father of modern medicine: the first research of the physical factor of tetanus], European Society of Clinical Microbiology and Infectious Diseases</ref>]
+
Wikipedia article on [[w:Medicine|medicine]].
[http://en.wikipedia.org/wiki/Image:IbnSina-Dushanbe.jpg|thumb|200px|right|Persian polymath, [http://en.wikipedia.org/wiki/Avicenna], who, along with Imhotep and Hippocrates, has been called the "father of medicine"]
 
Early records on medicine have been discovered from [http://en.wikipedia.org/wiki/ancient Egyptian medicine], [http://en.wikipedia.org/wiki/Babylonian Medicine|Babylonian medicine], [http://en.wikipedia.org/wiki/Ayurveda|Ayurvedic] medicine (in the [http://en.wikipedia.org/wiki/Indian subcontinent]), [http://en.wikipedia.org/wiki/classical Chinese medicine] (predecessor to the modern [http://en.wikipedia.org/wiki/traditional Chinese Medicine]), and [http://en.wikipedia.org/wiki/ancient Greek medicine] and [http://en.wikipedia.org/wiki/Medicine in ancient Rome|Roman medicine].  The Egyptian [http://en.wikipedia.org/wiki/Imhotep] (3rd millennium BC) is the first physician in history known by name. Earliest records of dedicated hospitals come from Mihintale in [http://en.wikipedia.org/wiki/Sri Lanka] where evidence of dedicated medicinal treatment facilities for patients are found.<ref>Prof. Arjuna Aluvihare, "Rohal Kramaya Lovata Dhayadha Kale Sri Lankikayo" ''Vidhusara Science Magazine'', November 1993.</ref><ref>''[http://www.hsph.harvard.edu/ihsg/publications/pdf/No-42.PDF Resource Mobilization in Sri Lanka's Health Sector]'' – Rannan-Eliya, Ravi P. & De Mel, Nishan, [http://en.wikipedia.org/wiki/Harvard School of Public Health] & Health Policy Programme, [http://en.wikipedia.org/wiki/Institute of Policy Studies]{{Disambiguation needed|date=June 2011}}, February 1997, Page 19. Accessed 2008-02-22.</ref>  The Indian surgeon [http://en.wikipedia.org/wiki/Sushruta] described numerous surgical operations, including the earliest forms of [http://en.wikipedia.org/wiki/plastic surgery].<ref name = "Singh">A. Singh and D. Sarangi (2003). "We need to think and act", ''Indian Journal of Plastic Surgery''.</ref>{{Dubious|date=July 2010}}<ref name="Longfellow">H. W. Longfellow (2002). "History of Plastic Surgery in India", ''Journal of Postgraduate Medicine''.</ref>
 
  
The [http://en.wikipedia.org/wiki/Ancient Greek medicine|Greek physician] [http://en.wikipedia.org/wiki/Hippocrates], the "father of medicine",<ref name="blackwellpublishing.com"/><ref>{{cite journal|author=Grammaticos P.C. & Diamantis A. |year=2008 |title=Useful known and unknown views of the father of modern medicine, Hippocrates and his teacher Democritus |journal=Hell J Nucl Med |volume=11 |issue=1 |pages=2–4 |pmid=18392218|ref=harv}}</ref> laid the foundation for a rational approach to medicine. Hippocrates introduced the [http://en.wikipedia.org/wiki/Hippocratic Oath] for physicians, which is still relevant and in use today, and was the first to categorize illnesses as [http://en.wikipedia.org/wiki/Acute (medical)|acute], [http://en.wikipedia.org/wiki/Chronic (medicine)|chronic], [http://en.wikipedia.org/wiki/Endemic (epidemiology)|endemic] and epidemic, and use terms such as, "exacerbation, [http://en.wikipedia.org/wiki/relapse], resolution, crisis, [http://en.wikipedia.org/wiki/paroxysm], peak, and [http://en.wikipedia.org/wiki/convalescence]".<ref name=garrison97>{{Harvnb|Garrison|1966|p=97}}</ref><ref name=mart90>{{Harvnb|Martí-Ibáñez|1961|p=90}}</ref>
+
{{Subminimal}}
 
+
[[Category:Medicine]]
The Greek physician [http://en.wikipedia.org/wiki/Galen] was also one of the greatest surgeons of the ancient world and performed many audacious operations, including brain and eye surgeries. After the fall of the [http://en.wikipedia.org/wiki/Western Roman Empire] and the onset of the [http://en.wikipedia.org/wiki/Early Middle Ages], the Greek tradition of medicine went into decline in Western Europe, although it continued uninterrupted in the [http://en.wikipedia.org/wiki/Eastern Roman Empire|Eastern Roman (Byzantine) Empire].
 
 
 
Most of our knowledge of ancient [http://en.wikipedia.org/wiki/Hebrew medicine] during the [http://en.wikipedia.org/wiki/1st millennium BC|1st&nbsp;millennium&nbsp;BC] comes from the [http://en.wikipedia.org/wiki/Torah], i.e.&nbsp;the Five Books of [http://en.wikipedia.org/wiki/Moses], which contain various health related laws and rituals. The Hebrew contribution to the development of modern medicine started in the [http://en.wikipedia.org/wiki/Byzantine Era], with the physician [http://en.wikipedia.org/wiki/Asaph the Jew], and has since been tremendous.<ref>{{cite web |url=http://www.jewishvirtuallibrary.org/jsource/judaica/ejud_0002_0013_0_13493.html |title=Medicine |work=Encyclopaedia Judaica |year=2008 |first=Samuel |last=Vaisrub |first2=Michael |last2=A. Denman |first3=Yaakov |last3=Naparstek |first4=Dan |last4=Gilon |publisher=The Gale Group}}</ref>
 
 
 
After 750 CE, the Muslim world had the works of Hippocrates, Galen and Sushruta translated into Arabic, and  [http://en.wikipedia.org/wiki/Islamic medicine|Islamic physicians] engaged in some significant medical research. Notable Islamic medical pioneers include the [http://en.wikipedia.org/wiki/polymath], [http://en.wikipedia.org/wiki/Avicenna], who, along with Imhotep and Hippocrates, has also been called the "father of medicine".<ref>
 
{{cite journal
 
|journal=Cas Lek Cesk
 
|year=1980
 
|title=The father of medicine, Avicenna, in our science and culture: Abu Ali ibn Sina (980–1037) (Czech title: Otec lékaru Avicenna v nasí vede a kulture)
 
|author=Becka J
 
|volume=119
 
|issue=1
 
|pages=17–23
 
|language=Czech
 
|pmid=6989499
 
|ref=harv
 
}}</ref><ref>{{cite web|url=https://eee.uci.edu/clients/bjbecker/PlaguesandPeople/lecture5.html |title=Medical Practitioners |publisher=Eee.uci.edu |date= |accessdate=2012-04-21}}</ref> He wrote ''[http://en.wikipedia.org/wiki/The Canon of Medicine]'', considered one of the most famous books in the history of medicine.<ref>{{cite web|url=http://www.britannica.com/eb/topic-92902/The-Canon-of-Medicine|title="The Canon of Medicine" (work by Avicenna)|publisher=''[http://en.wikipedia.org/wiki/Encyclopædia Britannica]''|year=2008|accessdate=11 June 2008}}</ref> Others include [http://en.wikipedia.org/wiki/Abu al-Qasim al-Zahrawi|Abulcasis],<ref>{{Cite journal|last=Ahmad|first=Z. ([http://en.wikipedia.org/wiki/St Thomas' Hospital])|title=Al-Zahrawi – The Father of Surgery|journal=ANZ Journal of Surgery|year=2007|volume=77|issue=Suppl. 1|page=A83|doi=10.1111/j.1445-2197.2007.04130_8.x|pages=A83|ref=harv|postscript=<!--None-->}}</ref> [http://en.wikipedia.org/wiki/Ibn Zuhr|Avenzoar],<ref name=Rabie2006>Rabie E. Abdel-Halim (2006), "Contributions of Muhadhdhab Al-Deen Al-Baghdadi to the progress of medicine and urology", ''Saudi Medical Journal'' '''27''' (11): 1631–1641.</ref> [http://en.wikipedia.org/wiki/Ibn al-Nafis],<ref>Chairman's Reflections (2004), "Traditional Medicine Among Gulf Arabs, Part II: Blood-letting", ''Heart Views'' '''5''' (2): 74–85 [80].</ref> and [http://en.wikipedia.org/wiki/Averroes].<ref>
 
{{cite journal
 
|author=Martín-Araguz A, Bustamante-Martínez C, Fernández-Armayor Ajo V, Moreno-Martínez JM
 
|title=Neuroscience in al-Andalus and its influence on medieval scholastic medicine
 
|journal=Revista de neurología
 
|volume=34
 
|issue=9
 
|pages=877–892
 
|date=2002-05-01—15
 
|language=Spanish
 
|pmid=12134355
 
|ref=harv
 
}}</ref> [http://en.wikipedia.org/wiki/Muhammad ibn Zakariya Razi|Rhazes]<ref name=Tschanz>David W. Tschanz, PhD (2003), "Arab(?) Roots of European Medicine", ''Heart Views'' '''4''' (2).</ref> was one of first to question the Greek theory of [http://en.wikipedia.org/wiki/humorism], which nevertheless remained influential in both medieval Western and medieval [http://en.wikipedia.org/wiki/Islamic medicine].<ref>On the dominance of the Greek humoral theory, which was the basis for the practice of bloodletting, in medieval Islamic medicine see Peter E. Pormann and E. Savage Smith,''Medieval Islamic medicine,'' Georgetown University, Washington DC, 2007 p. 10, 43–45.</ref> The Islamic [http://en.wikipedia.org/wiki/Bimaristan] hospitals were an early example of [http://en.wikipedia.org/wiki/public hospital]s.<ref>{{Cite journal|last=Micheau|first=Françoise|contribution=The Scientific Institutions in the Medieval Near East|pages=991–2|ref=harv|postscript=<!--None-->}}, in {{Harv|Morelon|Rashed|1996|pp=985–1007}}</ref><ref name=Barrett>Peter Barrett (2004), ''Science and Theology Since Copernicus: The Search for Understanding'', p. 18, [http://en.wikipedia.org/wiki/Continuum International Publishing Group], ISBN 0-567-08969-X.</ref>
 
 
 
However, the fourteenth and fifteenth century [http://en.wikipedia.org/wiki/Black Death] was just as devastating to the Middle East as to Europe, and it has even been argued that Western Europe was generally more effective in recovering from the pandemic than the Middle East.<ref>Michael Dols has shown that the Black Death was much more commonly believed by European authorities than by Middle Eastern authorities to be contagious; as a result, flight was more commonly counseled, and in urban Italy quarantines were organized on a much wider level than in urban Egypt or Syria (''The Black Death in the Middle East'' Princeton, 1977, p. 119; 285–290.</ref> In the early modern period, important early figures in medicine and anatomy emerged in Europe, including [http://en.wikipedia.org/wiki/Gabriele Falloppio] and [http://en.wikipedia.org/wiki/William Harvey].
 
 
 
The major shift in medical thinking was the gradual rejection, especially during the [http://en.wikipedia.org/wiki/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 [http://en.wikipedia.org/wiki/Nicolaus Copernicus|Copernicus]'s rejection of [http://en.wikipedia.org/wiki/Ptolemy]'s theories on astronomy). Physicians like [http://en.wikipedia.org/wiki/Vesalius] improved upon or disproved some of the theories from the past.
 
 
 
[http://en.wikipedia.org/wiki/Andreas Vesalius] was an author of one of the most influential books on [http://en.wikipedia.org/wiki/human anatomy], ''[http://en.wikipedia.org/wiki/De humani corporis fabrica]''.<ref>{{cite web|url=http://archive.nlm.nih.gov/proj/ttp/books.htm |title=Page through a virtual copy of Vesalius's '&#39;De Humanis Corporis Fabrica'&#39; |publisher=Archive.nlm.nih.gov |date= |accessdate=2012-04-21}}</ref> French surgeon [http://en.wikipedia.org/wiki/Ambroise Paré] is considered as one of the fathers of [http://en.wikipedia.org/wiki/surgery]. Bacteria and microorganisms were first observed with a microscope by [http://en.wikipedia.org/wiki/Antonie van Leeuwenhoek] in 1676, initiating the scientific field [http://en.wikipedia.org/wiki/microbiology].<ref name=Brock>{{cite book | author = Madigan M, Martinko J (editors) | title = Brock Biology of Microorganisms | edition = 11th | publisher = Prentice Hall | year = 2006 | isbn = 0-13-144329-1 }}</ref> Partly based on the works by the Italian surgeon and anatomist [http://en.wikipedia.org/wiki/Matteo Realdo Colombo] the English physician [http://en.wikipedia.org/wiki/William Harvey] described the [http://en.wikipedia.org/wiki/circulatory system].<ref>Zimmer, Carl. 2004. ''Soul Made Flesh: The Discovery of the Brain – and How It Changed the World.'' New York: Free Press.</ref> [http://en.wikipedia.org/wiki/Herman Boerhaave] is sometimes referred to as a "father of physiology" due to his exemplary teaching in Leiden and textbook 'Institutiones medicae' (1708). It is said that the 17th century French physician [http://en.wikipedia.org/wiki/Pierre Fauchard] started [http://en.wikipedia.org/wiki/dentistry] science as we know it today, and he has been named ''"the father of modern dentistry"''.<ref>"[http://www.nature.com/bdj/journal/v201/n12/full/4814350a.html Pierre Fauchard: the 'Father of Modern Dentistry']". ''British Dental Journal'' 201, 779 – 781 (2006)</ref>
 
 
 
Veterinary medicine was for the first time truly separated from human medicine in 1761, when the French veterinarian Claude Bourgelat founded the world's first veterinary school in Lyon, France. Before this, medical doctors treated both humans and other animals.
 
 
 
Modern scientific [http://en.wikipedia.org/wiki/biomedical research] (where results are testable and [http://en.wikipedia.org/wiki/reproducible]) began to replace early Western traditions based on herbalism, the Greek "[http://en.wikipedia.org/wiki/humorism|four humours]" and other such pre-modern notions. The modern era really began with [http://en.wikipedia.org/wiki/Edward Jenner]'s discovery of the [http://en.wikipedia.org/wiki/smallpox vaccine] at the end of the 18th century (inspired by the method of [http://en.wikipedia.org/wiki/inoculation] earlier practiced in Asia), [http://en.wikipedia.org/wiki/Robert Koch]'s discoveries around 1880 of the transmission of disease by bacteria, and then the discovery of [http://en.wikipedia.org/wiki/antibiotic]s around 1900.
 
 
 
The post-18th century [http://en.wikipedia.org/wiki/modernity] period brought more groundbreaking researchers from Europe. From [http://en.wikipedia.org/wiki/Germany] and Austria, doctors [http://en.wikipedia.org/wiki/Rudolf Virchow], [http://en.wikipedia.org/wiki/Wilhelm Conrad Röntgen], [http://en.wikipedia.org/wiki/Karl Landsteiner] and [http://en.wikipedia.org/wiki/Otto Loewi] made notable contributions. In the United Kingdom, [http://en.wikipedia.org/wiki/Alexander Fleming], [http://en.wikipedia.org/wiki/Joseph Lister, 1st Baron Lister|Joseph Lister], [http://en.wikipedia.org/wiki/Francis Crick] and [http://en.wikipedia.org/wiki/Florence Nightingale] are considered important. [http://en.wikipedia.org/wiki/Spain|Spanish] doctor [http://en.wikipedia.org/wiki/Santiago Ramón y Cajal] is considered the father of modern [http://en.wikipedia.org/wiki/neuroscience].
 
 
 
From New Zealand and Australia came [http://en.wikipedia.org/wiki/Maurice Wilkins], [http://en.wikipedia.org/wiki/Howard Florey, Baron Florey|Howard Florey], and [http://en.wikipedia.org/wiki/Frank Macfarlane Burnet].
 
 
 
In the United States, [http://en.wikipedia.org/wiki/William Williams Keen], [http://en.wikipedia.org/wiki/William Coley], [http://en.wikipedia.org/wiki/James D. Watson], Italy ([http://en.wikipedia.org/wiki/Salvador Luria]), Switzerland ([http://en.wikipedia.org/wiki/Alexandre Yersin]), Japan ([http://en.wikipedia.org/wiki/Kitasato Shibasaburo]), and France ([http://en.wikipedia.org/wiki/Jean-Martin Charcot], [http://en.wikipedia.org/wiki/Claude Bernard], [http://en.wikipedia.org/wiki/Paul Broca] and others did significant work). Russian [http://en.wikipedia.org/wiki/Nikolai Korotkov] also did significant work, as did [http://en.wikipedia.org/wiki/William Osler|Sir William Osler] and [http://en.wikipedia.org/wiki/Harvey Cushing].
 
 
 
As science and technology developed, medicine became more reliant upon [http://en.wikipedia.org/wiki/medication]s. Throughout history and in Europe right until the late 18th century, not only animal and plant products were used as medicine, but also human body parts and fluids.<ref>{{cite journal |first=Peter |last=Cooper |title=Medicinal properties of body parts |publisher= The Pharmaceutical Journal, 18/25 December 2004, Vol. 273 / No 7330, pp. 900–902 |url=http://www.pharmj.com/editorial/20041218/christmas/p900bodyparts.html}}</ref> [http://en.wikipedia.org/wiki/Pharmacology] developed from [http://en.wikipedia.org/wiki/herbalism] and many drugs are still derived from plants (atropine, ephedrine, warfarin, [http://en.wikipedia.org/wiki/aspirin], digoxin, vinca alkaloids, taxol, hyoscine, etc.). [http://en.wikipedia.org/wiki/Vaccine]s were discovered by [http://en.wikipedia.org/wiki/Edward Jenner] and [http://en.wikipedia.org/wiki/Louis Pasteur].
 
 
 
The first antibiotic was [http://en.wikipedia.org/wiki/arsphenamine] / [http://en.wikipedia.org/wiki/Salvarsan] discovered by [http://en.wikipedia.org/wiki/Paul Ehrlich] in 1908 after he observed that bacteria took up toxic dyes that human cells did not. The first major class of [http://en.wikipedia.org/wiki/antibiotic]s was the [http://en.wikipedia.org/wiki/Sulfonamide (medicine)|sulfa] drugs, derived by French chemists originally from [http://en.wikipedia.org/wiki/azo compound|azo] dyes.
 
 
 
Pharmacology has become increasingly sophisticated; modern [http://en.wikipedia.org/wiki/biotechnology] allows drugs targeted towards specific physiological processes to be developed, sometimes designed for compatibility with the body to reduce [http://en.wikipedia.org/wiki/Side effect|side-effects]. [http://en.wikipedia.org/wiki/Genomics] and knowledge of [http://en.wikipedia.org/wiki/human genetics] is having some influence on medicine, as the causative [http://en.wikipedia.org/wiki/gene]s of most monogenic [http://en.wikipedia.org/wiki/genetic disorder]s have now been identified, and the development of techniques in [http://en.wikipedia.org/wiki/molecular biology] and genetics are influencing medical technology, practice and decision-making.
 
 
 
[http://en.wikipedia.org/wiki/Evidence-based medicine] is a contemporary movement to establish the most effective [http://en.wikipedia.org/wiki/algorithms] of practice (ways of doing things) through the use of [http://en.wikipedia.org/wiki/systematic review]s and [http://en.wikipedia.org/wiki/meta-analysis]. The movement is facilitated by modern global [http://en.wikipedia.org/wiki/information science], which allows as much of the available evidence as possible to be collected and analyzed according to standard protocols that are then disseminated to healthcare providers. The [http://en.wikipedia.org/wiki/Cochrane Collaboration] leads this movement. A 2001 review of 160 Cochrane systematic reviews revealed that, according to two readers, 21.3% of the reviews concluded insufficient evidence, 20% concluded evidence of no effect, and 22.5% concluded positive effect.<ref name=Ezzo2001>
 
{{cite journal
 
| author = Ezzo J, Bausell B, Moerman DE, Berman B, Hadhazy V
 
| title= Reviewing the reviews. How strong is the evidence? How clear are the conclusions?
 
| year = 2001
 
| journal = Int J Technol Assess Health Care
 
| volume = 17
 
| issue = 4
 
| pages = 457–466
 
| pmid=11758290
 
| ref = harv
 
}}</ref>
 
 
 
==Clinical practice==
 
{{Merge from|Medical practice|discuss=Talk:Medicine#Merge_from_Medical_practice|date=August 2011}}
 
[http://en.wikipedia.org/wiki/File:The Doctor Luke Fildes crop.jpg|thumb|250px|''The Doctor'', by [http://en.wikipedia.org/wiki/Sir Luke Fildes] (1891)]
 
In clinical practice, doctors personally assess patients in order to [http://en.wikipedia.org/wiki/medical diagnosis|diagnose], treat, and prevent disease using clinical judgment. The [http://en.wikipedia.org/wiki/doctor-patient relationship] typically begins an interaction with an examination of the patient's [http://en.wikipedia.org/wiki/medical history] and [http://en.wikipedia.org/wiki/medical record], followed a medical interview<ref name=Coulehan_2005>{{cite book | author =  Coulehan JL, Block MR | title =  The Medical Interview: Mastering Skills for Clinical Practice | edition = 5th | publisher = F. A. Davis | year = 2005 | isbn= 0-8036-1246-X | oclc =  232304023 }}</ref> and a [http://en.wikipedia.org/wiki/physical examination]. Basic diagnostic [http://en.wikipedia.org/wiki/medical device]s (e.g. [http://en.wikipedia.org/wiki/stethoscope], [http://en.wikipedia.org/wiki/tongue depressor]) are typically used. After examination for [http://en.wikipedia.org/wiki/sign (medical)|signs] and interviewing for [http://en.wikipedia.org/wiki/symptoms], the doctor may order [http://en.wikipedia.org/wiki/medical test]s (e.g. [http://en.wikipedia.org/wiki/blood test]s), take a [http://en.wikipedia.org/wiki/biopsy], or prescribe [http://en.wikipedia.org/wiki/pharmaceutical drug]s or other therapies. [http://en.wikipedia.org/wiki/Differential diagnosis] methods help to rule out conditions based on the information provided. During the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions.<ref name=AHIMA2005>
 
{{cite journal | author = Addison K, Braden JH, Cupp JE, Emmert D, et al. (AHIMA e-HIM Work Group on the Legal Health Record) | title = Update: Guidelines for Defining the Legal Health Record for Disclosure Purposes | journal = Journal of AHIMA | year = 2005 | month = September | volume = 78
 
| issue = 8 | pages = 64A–G | url= http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_027921.hcsp?dDocName=bok1_027921 | pmid=16245584 | last12 = Musa | first12 = D | last13 = Olenik | first13 = KL | last14 = Quinsey | first14 = CA | last15 = Reynolds | first15 = R | last16 = Servais | first16 = C | last17 = Watters | first17 = A | last18 = Wiedemann | first18 = LA | last19 = Wilkins | first19 = M | last20 = Wills | first20 = M | last21 = Vogt | first21 = NE | ref = harv}}</ref> Followups may be shorter but follow the same general procedure.
 
 
 
The components of the medical interview<ref name=Coulehan_2005/> and encounter are:
 
*Chief complaint (cc): the reason for the current medical visit. These are the 'symptoms.' They are in the patient's own words and are recorded along with the duration of each one. Also called 'presenting complaint.'
 
*History of present illness / complaint (HPI): the chronological order of events of symptoms and further clarification of each symptom.
 
*Current activity: occupation, hobbies, what the patient actually does.
 
*[http://en.wikipedia.org/wiki/Medication]s (Rx): what drugs the patient takes including prescribed, [http://en.wikipedia.org/wiki/over-the-counter drug|over-the-counter], and [http://en.wikipedia.org/wiki/Home remedy|home remedies], as well as alternative and [http://en.wikipedia.org/wiki/Herbalism|herbal medicines/herbal remedies]. [http://en.wikipedia.org/wiki/Allergy|Allergies] are also recorded.
 
*Past medical history (PMH/PMHx): concurrent medical problems, past hospitalizations and operations, injuries, past [http://en.wikipedia.org/wiki/infectious disease]s and/or [http://en.wikipedia.org/wiki/vaccination]s, history of known allergies.
 
*Social history (SH): birthplace, residences, marital history, social and economic status, habits (including [http://en.wikipedia.org/wiki/diet (nutrition)|diet], medications, [http://en.wikipedia.org/wiki/tobacco smoking|tobacco], alcohol).
 
*[http://en.wikipedia.org/wiki/Family history (medicine)|Family history] (FH): listing of diseases in the family that may impact the patient. A [http://en.wikipedia.org/wiki/family tree] is sometimes used.
 
 
 
*Review of systems (ROS) or ''systems inquiry'': a set of additional questions to ask, which may be missed on HPI: a general enquiry (have you noticed any [http://en.wikipedia.org/wiki/weight loss], change in sleep quality, fevers, lumps and bumps? etc.), followed by questions on the body's main organ systems ([http://en.wikipedia.org/wiki/human heart|heart], [http://en.wikipedia.org/wiki/human lung|lung]s, [http://en.wikipedia.org/wiki/Gastrointestinal tract|digestive tract], [http://en.wikipedia.org/wiki/Urinary system|urinary tract], etc.).
 
 
 
The [http://en.wikipedia.org/wiki/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 (e.g., in infection, [http://en.wikipedia.org/wiki/uremia], [http://en.wikipedia.org/wiki/diabetic ketoacidosis]). Taste has been made redundant by the availability of modern lab tests. Four actions are taught as the basis of physical examination: [http://en.wikipedia.org/wiki/inspection (medicine)|inspection], [http://en.wikipedia.org/wiki/palpation] (feel), [http://en.wikipedia.org/wiki/percussion (medicine)|percussion] (tap to determine resonance characteristics), and [http://en.wikipedia.org/wiki/auscultation] (listen). This order may be modified depending on the main focus of the examination (e.g., a joint may be examined by simply "look, feel, move". Having this set order is an educational tool that encourages practitioners to be systematic in their approach and refrain from using tools such as the [http://en.wikipedia.org/wiki/stethoscope] before they have fully evaluated the other modalities).
 
 
 
The clinical examination involves study of:
 
 
 
*Vital signs including height, weight, body temperature, [http://en.wikipedia.org/wiki/blood pressure], [http://en.wikipedia.org/wiki/pulse], respiration rate, hemoglobin [http://en.wikipedia.org/wiki/oxygen saturation]
 
*General appearance of the patient and specific indicators of disease (nutritional status, presence of jaundice, pallor or [http://en.wikipedia.org/wiki/Nail clubbing|clubbing])
 
*[http://en.wikipedia.org/wiki/human skin|Skin]
 
*Head, eye, [http://en.wikipedia.org/wiki/ear], nose, and throat (HEENT)
 
*[http://en.wikipedia.org/wiki/Cardiovascular] ([http://en.wikipedia.org/wiki/heart] and [http://en.wikipedia.org/wiki/blood vessel]s)
 
*[http://en.wikipedia.org/wiki/Respiratory] (large airways and [http://en.wikipedia.org/wiki/lungs])
 
*[http://en.wikipedia.org/wiki/Abdomen] and [http://en.wikipedia.org/wiki/rectum]
 
*Genitalia (and pregnancy if the patient is or could be pregnant)
 
*[http://en.wikipedia.org/wiki/Musculoskeletal] (including spine and extremities)
 
*[http://en.wikipedia.org/wiki/Neurological] (consciousness, awareness, brain, vision, [http://en.wikipedia.org/wiki/cranial nerves], spinal cord and [http://en.wikipedia.org/wiki/Peripheral nervous system|peripheral nerves])
 
*[http://en.wikipedia.org/wiki/Psychiatric] (orientation, [http://en.wikipedia.org/wiki/mental state examination|mental state], evidence of abnormal perception or thought).
 
 
 
It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.
 
 
 
[http://en.wikipedia.org/wiki/Medical laboratory|Laboratory] and [http://en.wikipedia.org/wiki/Medical imaging|imaging studies] results may be obtained, if necessary.
 
 
 
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 [http://en.wikipedia.org/wiki/differential diagnosis|differential diagnoses]), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.
 
 
 
The treatment plan may include ordering additional [http://en.wikipedia.org/wiki/laboratory] tests and studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised.
 
 
 
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.
 
 
 
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.
 
 
 
==Institutions==
 
[http://en.wikipedia.org/wiki/File:Pellegrinaio Santa Maria della Scala n5.jpg|thumb|The Hospital of [http://en.wikipedia.org/wiki/Santa Maria della Scala (Siena)|Santa Maria della Scala], fresco by [http://en.wikipedia.org/wiki/Domenico di Bartolo], 1441–1442]
 
Contemporary medicine is in general conducted within [http://en.wikipedia.org/wiki/health care system]s. Legal, [http://en.wikipedia.org/wiki/credential]ing and financing frameworks are established by individual governments, augmented on occasion by international organizations. The characteristics of any given health care system have significant impact on the way medical care is provided.
 
 
 
Advanced industrial countries (with the exception of the United States)<ref name="IOM">[http://www.iom.edu/Reports/2004/Insuring-Americas-Health-Principles-and-Recommendations.aspx Insuring America's Health: Principles and Recommendations], Institute of Medicine at the National Academies of Science, 2004-01-14</ref><ref name="ccuhc">{{cite web|url=http://cthealth.server101.com/the_case_for_universal_health_care_in_the_united_states.htm |title=The Case For Single Payer, Universal Health Care For The United States |publisher=Cthealth.server101.com |date= |accessdate=4 May 2009}}</ref> and many [http://en.wikipedia.org/wiki/Developing country|developing countries] provide medical services through a system of [http://en.wikipedia.org/wiki/universal health care] that aims to guarantee care for all through a [http://en.wikipedia.org/wiki/single-payer health care] system, or compulsory private or co-operative [http://en.wikipedia.org/wiki/health insurance]. This is intended to ensure that the entire population has access to medical care on the basis of need rather than ability to pay. Delivery may be via private medical practices or by state-owned hospitals and clinics, or by charities, most commonly by a combination of all three.
 
 
 
Most [http://en.wikipedia.org/wiki/tribe|tribal] societies, and the United States,<ref name="IOM"/><ref name="ccuhc"/> provide no guarantee of healthcare for the population as a whole. In such societies, healthcare 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.
 
 
 
[http://en.wikipedia.org/wiki/Image:Drug ampoule JPN.jpg|thumb|Modern drug [http://en.wikipedia.org/wiki/ampoule]s]
 
 
 
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 the US healthcare system has come under fire for lack of openness,<ref>
 
{{cite journal
 
|author=Martin Sipkoff
 
|title=Transparency called key to uniting cost control, quality improvement
 
|journal=Managed Care
 
|month=January
 
|year=2004
 
|url=http://www.managedcaremag.com/archives/0401/0401.forum.html
 
|ref=harv
 
}}</ref>  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.
 
 
 
===Delivery===
 
{{See also|Health care|clinic|hospital|hospice}}
 
 
 
Provision of medical care is classified into primary, secondary, and tertiary care categories.
 
 
 
[http://en.wikipedia.org/wiki/Primary care] medical services are provided by [http://en.wikipedia.org/wiki/physicians], [http://en.wikipedia.org/wiki/physician assistants], [http://en.wikipedia.org/wiki/nurse practitioners], or other health professionals who have first contact with a patient seeking medical treatment or care. These occur in physician offices, [http://en.wikipedia.org/wiki/clinic]s, [http://en.wikipedia.org/wiki/nursing home]s, 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, [http://en.wikipedia.org/wiki/preventive care] and [http://en.wikipedia.org/wiki/health education] for all ages and both sexes.
 
 
 
[http://en.wikipedia.org/wiki/Secondary care] medical services are provided by [http://en.wikipedia.org/wiki/medical specialist]s 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 [http://en.wikipedia.org/wiki/ambulatory care] and [http://en.wikipedia.org/wiki/inpatient] services, [http://en.wikipedia.org/wiki/Emergency department|emergency room]s, [http://en.wikipedia.org/wiki/intensive care medicine], surgery services, [http://en.wikipedia.org/wiki/physical therapy], [http://en.wikipedia.org/wiki/childbirth|labor and delivery], [http://en.wikipedia.org/wiki/endoscopy] units, diagnostic [http://en.wikipedia.org/wiki/Medical laboratory|laboratory] and [http://en.wikipedia.org/wiki/medical imaging] services, [http://en.wikipedia.org/wiki/Hospice care|hospice] centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting.
 
 
 
[http://en.wikipedia.org/wiki/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 [http://en.wikipedia.org/wiki/trauma center]s, [http://en.wikipedia.org/wiki/burn (injury)|burn] treatment centers, advanced [http://en.wikipedia.org/wiki/neonatology] unit services, [http://en.wikipedia.org/wiki/organ transplant]s, high-risk pregnancy, [http://en.wikipedia.org/wiki/radiation therapy|radiation] [http://en.wikipedia.org/wiki/oncology], etc.
 
 
 
Modern medical care also depends on information – still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.
 
 
 
==Branches==
 
Working together as an [http://en.wikipedia.org/wiki/interdisciplinary team], many highly trained [http://en.wikipedia.org/wiki/health profession]als besides medical practitioners are involved in the delivery of modern health care. Examples include: [http://en.wikipedia.org/wiki/nurse]s, [http://en.wikipedia.org/wiki/emergency medical technician]s and paramedics, laboratory scientists, [http://en.wikipedia.org/wiki/pharmacists], [http://en.wikipedia.org/wiki/physician assistants], [http://en.wikipedia.org/wiki/physiotherapists], [http://en.wikipedia.org/wiki/respiratory therapists], [http://en.wikipedia.org/wiki/speech therapy|speech therapists], [http://en.wikipedia.org/wiki/occupational therapy|occupational therapists], radiographers, [http://en.wikipedia.org/wiki/dietitian]s, and [http://en.wikipedia.org/wiki/bioengineering|bioengineers].
 
 
 
The scope and sciences underpinning human medicine overlap many other fields. [http://en.wikipedia.org/wiki/Dentistry], while considered by some a separate discipline from medicine, is a medical field.
 
 
 
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.
 
 
 
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.
 
 
 
The main branches of medicine are:
 
 
 
* Basic sciences of medicine; this is what every physician is educated in, and some return to in [http://en.wikipedia.org/wiki/Biomedical research#Preclinical research|biomedical research].
 
* [http://en.wikipedia.org/wiki/Medical specialties]
 
* [http://en.wikipedia.org/wiki/Interdisciplinary sub-specialties of medicine|Interdisciplinary fields], where different medical specialties are mixed to function in certain occasions.
 
 
 
===Basic sciences===
 
*''[http://en.wikipedia.org/wiki/Anatomy]'' is the study of the physical structure of [http://en.wikipedia.org/wiki/organism]s. In contrast to ''macroscopic'' or ''gross anatomy'', ''cytology'' and ''histology'' are concerned with microscopic structures.
 
*''[http://en.wikipedia.org/wiki/Biochemistry]'' is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.
 
*''[http://en.wikipedia.org/wiki/Biomechanics]'' is the study of the structure and function of biological systems by means of the methods of [http://en.wikipedia.org/wiki/Mechanics].
 
*''[http://en.wikipedia.org/wiki/Biostatistics]'' is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to [http://en.wikipedia.org/wiki/epidemiology] and evidence-based medicine.
 
*''[http://en.wikipedia.org/wiki/Biophysics]'' is an interdisciplinary science that uses the methods of [http://en.wikipedia.org/wiki/physics] and [http://en.wikipedia.org/wiki/physical chemistry] to study biological systems.
 
*''[http://en.wikipedia.org/wiki/Cell biology|Cytology]'' is the microscopic study of individual [http://en.wikipedia.org/wiki/cell (biology)|cells].[http://en.wikipedia.org/wiki/Image:Tableau Louis Pasteur.jpg|thumb|200px|[http://en.wikipedia.org/wiki/Louis Pasteur] in his laboratory, 1885]
 
*''[http://en.wikipedia.org/wiki/Embryology]'' is the study of the early development of organisms.
 
*''[http://en.wikipedia.org/wiki/Endocrinology]'' is the study of hormones and their effect throughout the body of animals.
 
*''[http://en.wikipedia.org/wiki/Epidemiology]'' is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.
 
*''[http://en.wikipedia.org/wiki/Genetics]'' is the study of genes, and their role in [http://en.wikipedia.org/wiki/biological inheritance].
 
*''[http://en.wikipedia.org/wiki/Histology]'' is the study of the structures of [http://en.wikipedia.org/wiki/biological tissue]s by light [http://en.wikipedia.org/wiki/microscopy], [http://en.wikipedia.org/wiki/Electron microscope|electron microscopy] and [http://en.wikipedia.org/wiki/immunohistochemistry].
 
*''[http://en.wikipedia.org/wiki/Immunology]'' is the study of the [http://en.wikipedia.org/wiki/immune system], which includes the innate and adaptive immune system in humans, for example.
 
*''[http://en.wikipedia.org/wiki/Medical physics]'' is the study of the applications of physics principles in medicine.
 
*''[http://en.wikipedia.org/wiki/Microbiology]'' is the study of [http://en.wikipedia.org/wiki/microorganism]s, including [http://en.wikipedia.org/wiki/protozoa], [http://en.wikipedia.org/wiki/bacterium|bacteria], [http://en.wikipedia.org/wiki/fungus|fungi], and [http://en.wikipedia.org/wiki/virus]es.
 
*''[http://en.wikipedia.org/wiki/Molecular biology]'' is the study of molecular underpinnings of the process of [http://en.wikipedia.org/wiki/DNA replication|replication], [http://en.wikipedia.org/wiki/Transcription (genetics)|transcription] and [http://en.wikipedia.org/wiki/translation] of the genetic material.
 
*''[http://en.wikipedia.org/wiki/Neuroscience]'' includes those disciplines of science that are related to the study of the [http://en.wikipedia.org/wiki/nervous system]. A main focus of neuroscience is the [http://en.wikipedia.org/wiki/biology] and physiology of the human brain and [http://en.wikipedia.org/wiki/spinal cord]. Some related clinical specialties include [http://en.wikipedia.org/wiki/neurology], [http://en.wikipedia.org/wiki/neurosurgery] and [http://en.wikipedia.org/wiki/psychiatry].
 
*''[http://en.wikipedia.org/wiki/Nutrition science]'' (theoretical focus) and ''[http://en.wikipedia.org/wiki/dietetics]'' (practical focus) is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for [http://en.wikipedia.org/wiki/diabetes], [http://en.wikipedia.org/wiki/cardiovascular disease]s, weight and eating [http://en.wikipedia.org/wiki/mental illness|disorder]s, allergies, [http://en.wikipedia.org/wiki/malnutrition], and [http://en.wikipedia.org/wiki/neoplasia|neoplastic] diseases.
 
*''[http://en.wikipedia.org/wiki/Pathology as a science]'' is the study of disease—the causes, course, progression and resolution thereof.
 
*''[http://en.wikipedia.org/wiki/Pharmacology]'' is the study of drugs and their actions.
 
*''[http://en.wikipedia.org/wiki/Photobiology]'' is the study of the interactions between [http://en.wikipedia.org/wiki/non-ionizing radiation] and living organisms.
 
*''[http://en.wikipedia.org/wiki/Physiology]'' is the study of the normal functioning of the body and the underlying regulatory mechanisms.
 
*''[http://en.wikipedia.org/wiki/Radiobiology]'' is the study of the interactions between [http://en.wikipedia.org/wiki/ionizing radiation] and living organisms.
 
*''[http://en.wikipedia.org/wiki/Toxicology]'' is the study of hazardous effects of drugs and [http://en.wikipedia.org/wiki/poison]s.
 
 
 
===Specialties===
 
{{Main|Medical specialty}}
 
In the broadest meaning of "medicine", there are many different specialties. In the UK, most specialities will have their own body or college (collectively known as the Royal Colleges, although currently not all use the term "Royal"), which have their own entrance exam. The development of a speciality is often driven by new technology (such as the development of effective anaesthetics) or ways of working (e.g., emergency departments), which leads to the desire to form a unifying body of doctors and thence the prestige of administering their own exam.
 
 
 
Within medical circles, specialities usually fit into one of 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". In the UK, this would traditionally have been evidenced by obtaining the MRCP (An exam allowing Membership of the [http://en.wikipedia.org/wiki/Royal College of Physicians] or the equivalent college in Scotland or Ireland). "Surgery" refers to the practice of operative medicine, and most subspecialties in this area require preliminary training in "General Surgery." (In the UK: Membership of the [http://en.wikipedia.org/wiki/Royal College of Surgeons of England] (MRCS).)There are some specialties of medicine that at the present time do not fit easily into either of these categories, such as radiology, pathology, or anesthesia. Most of these have branched from one or other of the two camps above – for example anaesthesia developed first as a [http://en.wikipedia.org/wiki/Faculty (teaching staff)|faculty] of the Royal College of Surgeons (for which MRCS/FRCS would have been required) before becoming the [http://en.wikipedia.org/wiki/Royal College of Anaesthetists] and membership of the college is by sitting the FRCA (Fellowship of the Royal College of Anesthetists).
 
 
 
====Surgery====
 
{{Main|Surgery}}
 
[http://en.wikipedia.org/wiki/File:Surgeons at Work.jpg|thumb|Surgeons in an [http://en.wikipedia.org/wiki/operating room]]
 
''Surgical 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. Surgeons must also manage pre-operative, post-operative, and potential surgical candidates on the hospital wards. Surgery has many sub-specialties, including ''[http://en.wikipedia.org/wiki/general surgery], [http://en.wikipedia.org/wiki/cardiovascular surgery], [http://en.wikipedia.org/wiki/colorectal surgery], [http://en.wikipedia.org/wiki/neurosurgery], [http://en.wikipedia.org/wiki/maxillofacial surgery], [http://en.wikipedia.org/wiki/oncologic surgery], [http://en.wikipedia.org/wiki/orthopedic surgery], [http://en.wikipedia.org/wiki/otolaryngology], [http://en.wikipedia.org/wiki/plastic surgery], [http://en.wikipedia.org/wiki/podiatric surgery], [http://en.wikipedia.org/wiki/transplant surgery], [http://en.wikipedia.org/wiki/trauma surgery], [http://en.wikipedia.org/wiki/urology], [http://en.wikipedia.org/wiki/vascular surgery], and [http://en.wikipedia.org/wiki/pediatric surgery].'' In some centers, [http://en.wikipedia.org/wiki/anesthesiology] is part of the division of surgery (for historical and logistical reasons), although it is not a surgical discipline. Other medical specialties may employ surgical procedures, such as [http://en.wikipedia.org/wiki/ophthalmology] and [http://en.wikipedia.org/wiki/dermatology], but are not considered surgical sub-specialties per se.
 
 
 
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.
 
 
 
===='Medicine' as a specialty====
 
{{Main|Internal Medicine}}
 
'''Internal medicine''' is the medical [http://en.wikipedia.org/wiki/specialty (medicine)|specialty] concerned with the diagnosis, management and nonsurgical treatment of unusual or serious diseases, either of one particular organ system or of the body as a whole. According to some sources, an emphasis on internal structures is implied.<ref>{{DorlandsDict|five/000063883|internal medicine}}</ref> In North America, specialists in internal medicine are commonly called "internists". Elsewhere, especially in [http://en.wikipedia.org/wiki/Commonwealth of Nations|Commonwealth] nations, such specialists are often called [http://en.wikipedia.org/wiki/physician]s.<ref name="Fowler">{{cite book |author= H.W. Fowler.|title=A Dictionary of Modern English Usage (Wordsworth Collection) (Wordsworth Collection) |publisher=NTC/Contemporary Publishing Company |location= |year= 1994|pages= |isbn=1-85326-318-4 |oclc= |doi=}}</ref> These terms, ''internist'' or ''physician'' (in the narrow sense, common outside North America), generally exclude practitioners of gynecology and obstetrics, pathology, psychiatry, and especially surgery and its subspecialities.
 
 
 
Because their patients are often seriously ill or require complex investigations, internists do much of their work in hospitals. Formerly, many internists were not subspecialized; such ''general physicians'' would see any complex nonsurgical problem; this style of practice has become much less common. In modern urban practice, most internists are subspecialists: that is, they generally limit their medical practice to problems of one organ system or to one particular area of medical knowledge. For example, [http://en.wikipedia.org/wiki/gastroenterology|gastroenterologist]s and [http://en.wikipedia.org/wiki/nephrology|nephrologist]s specialize respectively in diseases of the gut and the kidneys.<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=5 February 2008
 
|publisher=[http://en.wikipedia.org/wiki/Royal Australasian College of Physicians]
 
|archiveurl=http://web.archive.org/web/20080306053048/http://www.racp.edu.au/index.cfm?objectid=49EF1EB5-2A57-5487-D74DBAFBAE9143A3
 
|archivedate=6 March 2008}}</ref>
 
 
 
In the [http://en.wikipedia.org/wiki/Commonwealth of Nations] and some other countries, specialist [http://en.wikipedia.org/wiki/Pediatrics|pediatricians] and [http://en.wikipedia.org/wiki/Geriatrics|geriatricians] are also described as ''specialist physicians'' (or internists) who have subspecialized by age of patient rather than by organ system. Elsewhere, especially in North America, general pediatrics is often a form of [http://en.wikipedia.org/wiki/Primary care physician|Primary care].
 
 
 
There are many subspecialities (or subdisciplines) of [http://en.wikipedia.org/wiki/internal medicine]:
 
<div class="references-small" style="-moz-column-count:3; column-count:3;">
 
:*''[http://en.wikipedia.org/wiki/Cardiology]''
 
:*''[http://en.wikipedia.org/wiki/Critical care medicine]''
 
:*''[http://en.wikipedia.org/wiki/Endocrinology]''
 
:*''[http://en.wikipedia.org/wiki/Gastroenterology]''
 
:*''[http://en.wikipedia.org/wiki/Geriatrics]''
 
:*''[http://en.wikipedia.org/wiki/Haematology]''
 
:*''[http://en.wikipedia.org/wiki/Hepatology]''
 
:*''[http://en.wikipedia.org/wiki/Infectious disease]s''
 
:*''[http://en.wikipedia.org/wiki/Nephrology]''
 
:*''[http://en.wikipedia.org/wiki/Oncology]''
 
:*''[http://en.wikipedia.org/wiki/Pediatrics]''
 
:*''[http://en.wikipedia.org/wiki/Pulmonology|Pulmonology/Pneumology/Respirology]''
 
:*''[http://en.wikipedia.org/wiki/Rheumatology]''
 
:*''[http://en.wikipedia.org/wiki/Sleep medicine]''.
 
</div>
 
 
 
Training in internal medicine (as opposed to surgical training), varies considerably across the world: see the articles on [http://en.wikipedia.org/wiki/Medical education] and [http://en.wikipedia.org/wiki/Physician] for more details. In North America, it requires at least three years of residency training after medical school, which can then be followed by a one to three 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 in the USA. This difference does not apply in the UK where all doctors are now required by law to work less than 48 hours per week on average.
 
 
 
====Diagnostic specialties====
 
*''[http://en.wikipedia.org/wiki/Clinical laboratory] sciences'' are the clinical diagnostic services that apply laboratory techniques to diagnosis and management of patients. In the United States, these services are supervised by a pathologist. The personnel that work in these [http://en.wikipedia.org/wiki/medical laboratory] departments are technically trained staff who do not hold medical degrees, but who usually hold an undergraduate [http://en.wikipedia.org/wiki/medical technology] degree, who actually perform the [http://en.wikipedia.org/wiki/medical test|test]s, [http://en.wikipedia.org/wiki/assay]s, and procedures needed for providing the specific services. Subspecialties include [http://en.wikipedia.org/wiki/Transfusion medicine], [http://en.wikipedia.org/wiki/Cellular pathology], [http://en.wikipedia.org/wiki/Clinical chemistry], [http://en.wikipedia.org/wiki/Hematology], [http://en.wikipedia.org/wiki/Clinical microbiology] and [http://en.wikipedia.org/wiki/Clinical immunology].
 
* ''[http://en.wikipedia.org/wiki/Pathology as a medical specialty]'' is the branch of medicine that deals with the study of diseases and the morphologic, physiologic changes produced by them. As a diagnostic specialty, pathology can be considered the basis of modern scientific medical knowledge and plays a large role in [http://en.wikipedia.org/wiki/evidence-based medicine]. Many modern molecular tests such as [http://en.wikipedia.org/wiki/flow cytometry], [http://en.wikipedia.org/wiki/polymerase chain reaction] (PCR), [http://en.wikipedia.org/wiki/immunohistochemistry], [http://en.wikipedia.org/wiki/cytogenetics], gene rearrangements studies and [http://en.wikipedia.org/wiki/fluorescent in situ hybridization] (FISH)  fall within the territory of pathology.
 
*''[http://en.wikipedia.org/wiki/Radiology]'' is concerned with imaging of the human body, e.g. by [http://en.wikipedia.org/wiki/x-ray]s, x-ray [http://en.wikipedia.org/wiki/computed tomography], [http://en.wikipedia.org/wiki/ultrasonography], and [http://en.wikipedia.org/wiki/nuclear magnetic resonance] [http://en.wikipedia.org/wiki/tomography].
 
*''[http://en.wikipedia.org/wiki/Nuclear medicine]'' is concerned with studying human organ systems by administering radiolabelled substances (radiopharmaceuticals) to the body, which can then be imaged outside the body by a [http://en.wikipedia.org/wiki/gamma camera] or a PET scanner. Each radiopharmaceutical consists of two parts: a tracer that is specific for the function under study (e.g., neurotransmitter pathway, metabolic pathway, blood flow, or other), and a radionuclide (usually either a gamma-emitter or a positron emitter). There is a degree of overlap between nuclear medicine and radiology, as evidenced by the emergence of combined devices such as the PET/CT scanner.
 
*''[http://en.wikipedia.org/wiki/Clinical neurophysiology]'' is concerned with testing the physiology or function of the central and peripheral aspects of the nervous system. These kinds of tests can be divided into recordings of: (1) spontaneous or continuously running electrical activity, or (2) stimulus evoked responses. Subspecialties include [http://en.wikipedia.org/wiki/Electroencephalography], [http://en.wikipedia.org/wiki/Electromyography], [http://en.wikipedia.org/wiki/Evoked potential], [http://en.wikipedia.org/wiki/Nerve conduction study] and [http://en.wikipedia.org/wiki/Polysomnography]. Sometimes these tests are performed by techs without a medical degree, but the interpretation of these tests is done by a medical professional.
 
 
 
====Other major specialties====
 
The followings are some major medical specialties that do not directly fit into any of the above mentioned groups.
 
 
 
*''[http://en.wikipedia.org/wiki/Anesthesiology]'' (also known as ''anaesthetics''): concerned with the perioperative management of the surgical patient. The anesthesiologist's role during surgery is to prevent derangement in the vital organs' (i.e. brain, heart, kidneys) functions and postoperative pain. Outside of the operating room, the anesthesiology physician also served the same function in the labor & delivery ward, and some are specialized in critical medicine.
 
*''[http://en.wikipedia.org/wiki/Dermatology]'' is concerned with the skin and its diseases. In the UK, dermatology is a subspecialty of general medicine.
 
*''[http://en.wikipedia.org/wiki/Emergency medicine]'' is concerned with the diagnosis and treatment of acute or life-threatening conditions, including [http://en.wikipedia.org/wiki/physical trauma|trauma], surgical, medical, pediatric, and psychiatric emergencies.
 
*''[http://en.wikipedia.org/wiki/Family medicine]'', ''[http://en.wikipedia.org/wiki/family practice]'', ''[http://en.wikipedia.org/wiki/general practice]'' or ''primary care'' is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family physicians often provide services across a broad range of settings including office based practices, emergency room coverage, inpatient care, and nursing home care.
 
*''[http://en.wikipedia.org/wiki/Obstetrics] and [http://en.wikipedia.org/wiki/gynecology]'' (often abbreviated as ''[http://en.wikipedia.org/wiki/OB/GYN]'' (American English) or ''Obs & Gynae'' (British English)) are concerned respectively with childbirth and the female reproductive and associated organs. [http://en.wikipedia.org/wiki/Reproductive medicine] and [http://en.wikipedia.org/wiki/fertility medicine] are generally practiced by gynecological specialists.
 
*''[http://en.wikipedia.org/wiki/Medical Genetics]'' is concerned with the diagnosis and management of hereditary disorders.
 
*''[http://en.wikipedia.org/wiki/Neurology]'' is concerned with diseases of the nervous system. In the UK, neurology is a subspecialty of general medicine.
 
*''[http://en.wikipedia.org/wiki/Ophthalmology]'' exclusively concerned with the eye and ocular adnexa, combining conservative and surgical therapy.
 
*''[http://en.wikipedia.org/wiki/Pediatrics]'' (AE) or ''paediatrics'' (BE) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialties for specific age ranges, organ systems, disease classes, and sites of care delivery.
 
*''[http://en.wikipedia.org/wiki/Physical medicine and rehabilitation]'' (or ''physiatry'') is concerned with functional improvement after injury, illness, or [http://en.wikipedia.org/wiki/congenital disorder]s.
 
*''[http://en.wikipedia.org/wiki/Psychiatry]'' is the branch of medicine concerned with the [http://en.wikipedia.org/wiki/biopsychosocial|bio-psycho-social] study of the [http://en.wikipedia.org/wiki/etiology], diagnosis, treatment and prevention of [http://en.wikipedia.org/wiki/cognitive], [http://en.wikipedia.org/wiki/perceptual], [http://en.wikipedia.org/wiki/emotional] and [http://en.wikipedia.org/wiki/behavioral] disorders. Related non-medical fields include [http://en.wikipedia.org/wiki/psychotherapy] and [http://en.wikipedia.org/wiki/clinical psychology].
 
*''[http://en.wikipedia.org/wiki/Preventive medicine]'' is the branch of medicine concerned with preventing disease.
 
**''[http://en.wikipedia.org/wiki/Community health]'' or ''[http://en.wikipedia.org/wiki/public health]'' is an aspect of health services concerned with threats to the overall health of a community based on [http://en.wikipedia.org/wiki/population health] analysis.
 
**''[http://en.wikipedia.org/wiki/Occupational medicine]'''s principal role is the provision of health advice to organizations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
 
**''[http://en.wikipedia.org/wiki/Aerospace medicine]'' deals with medical problems related to flying and [http://en.wikipedia.org/wiki/Human spaceflight|space travel].
 
 
 
===Interdisciplinary fields=== <!--Interdisciplinary sub-specialties of medicine redirects here-->
 
Some interdisciplinary sub-specialties of medicine include:
 
*''[http://en.wikipedia.org/wiki/Addiction medicine]'' deals with the treatment of addiction.
 
*''[http://en.wikipedia.org/wiki/Medical ethics]'' deals with [http://en.wikipedia.org/wiki/ethic]al and [http://en.wikipedia.org/wiki/moral] principles that apply values and judgments to the practice of medicine.
 
*''[http://en.wikipedia.org/wiki/Biomedical Engineering]'' is a field dealing with the application of [http://en.wikipedia.org/wiki/engineering] principles to medical practice.
 
*''[http://en.wikipedia.org/wiki/Clinical pharmacology]'' is concerned with how systems of [http://en.wikipedia.org/wiki/therapeutics] interact with patients.
 
*''[http://en.wikipedia.org/wiki/Conservation medicine]'' studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, [http://en.wikipedia.org/wiki/environmental medicine], or [http://en.wikipedia.org/wiki/medical geology].
 
*''[http://en.wikipedia.org/wiki/Disaster medicine]'' deals with medical aspects of emergency preparedness, disaster mitigation and management.
 
*''[http://en.wikipedia.org/wiki/Diving medicine]'' (or [http://en.wikipedia.org/wiki/hyperbaric medicine]) is the prevention and treatment of diving-related problems.
 
* ''[http://en.wikipedia.org/wiki/Evolutionary medicine]'' is a perspective on medicine derived through applying [http://en.wikipedia.org/wiki/Evolution|evolutionary theory].
 
*''[http://en.wikipedia.org/wiki/Forensic medicine]'' deals with medical questions in [http://en.wikipedia.org/wiki/legal] context, such as determination of the time and cause of death.
 
*''[http://en.wikipedia.org/wiki/Gender-based medicine]'' studies the biological and physiological differences between the human sexes and how that affects differences in disease.
 
*''[http://en.wikipedia.org/wiki/Hospice and Palliative Medicine]'' is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with [http://en.wikipedia.org/wiki/terminal illness]es including cancer and [http://en.wikipedia.org/wiki/heart failure].
 
*''[http://en.wikipedia.org/wiki/Hospital medicine]'' is the general medical care of hospitalized patients. Physicians whose primary professional focus is hospital medicine are called [http://en.wikipedia.org/wiki/hospitalist]s in the USA and Canada. The term Most Responsible Physician (MRP) or attending physician is also used interchangeably to describe this role.
 
*''[http://en.wikipedia.org/wiki/Laser medicine]'' involves the use of lasers in the diagnostics and/or treatment of various conditions.
 
*''[http://en.wikipedia.org/wiki/Medical humanities]'' includes the [http://en.wikipedia.org/wiki/humanities] ([http://en.wikipedia.org/wiki/literature], [http://en.wikipedia.org/wiki/philosophy], [http://en.wikipedia.org/wiki/ethics], history and religion), [http://en.wikipedia.org/wiki/social science] ([http://en.wikipedia.org/wiki/anthropology], [http://en.wikipedia.org/wiki/cultural studies], [http://en.wikipedia.org/wiki/psychology], [http://en.wikipedia.org/wiki/sociology]), and the arts ([http://en.wikipedia.org/wiki/literature], theater, film, and [http://en.wikipedia.org/wiki/visual arts]) and their application to [http://en.wikipedia.org/wiki/medical education] and practice.
 
* ''[http://en.wikipedia.org/wiki/Medical informatics]'', ''[http://en.wikipedia.org/wiki/medical computer science]'', ''[http://en.wikipedia.org/wiki/medical information]'' and ''[http://en.wikipedia.org/wiki/eHealth]'' are relatively recent fields that deal with the application of computers and [http://en.wikipedia.org/wiki/information technology] to medicine.
 
*''[http://en.wikipedia.org/wiki/Nosology]'' is the classification of diseases for various purposes.
 
*''[http://en.wikipedia.org/wiki/Nosokinetics]'' is the science/subject of measuring and modelling the process of care in health and social care systems.
 
*''[http://en.wikipedia.org/wiki/Pain management]'' (also called ''[http://en.wikipedia.org/wiki/pain medicine]'', or ''algiatry'') is the medical discipline concerned with the relief of pain.
 
*''[http://en.wikipedia.org/wiki/Pharmacogenomics]'' is a form of ''individualized medicine''.
 
*''[http://en.wikipedia.org/wiki/Sexual medicine]'' is concerned with diagnosing, assessing and treating all disorders related to sexuality.
 
*''[http://en.wikipedia.org/wiki/Sports medicine]'' deals with the treatment and preventive care of [http://en.wikipedia.org/wiki/sportsperson|athletes], [http://en.wikipedia.org/wiki/amateur] and [http://en.wikipedia.org/wiki/professional]. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, [http://en.wikipedia.org/wiki/Coach (sport)|coach]es, other personnel, and, of course, the athlete.
 
*''[http://en.wikipedia.org/wiki/Therapeutics]'' is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health.<ref>{{cite web|url=http://www.britannica.com/eb/article-9106176?query=Therapeutics&ct= |title=therapeutics (medicine) - Britannica Online Encyclopedia |publisher=Britannica.com |date= |accessdate=2012-04-21}}</ref>
 
*''[http://en.wikipedia.org/wiki/Travel medicine]'' or ''emporiatrics'' deals with health problems of international travelers or travelers across highly different environments.
 
*''[http://en.wikipedia.org/wiki/Urgent care]'' focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department. In some jurisdictions this function is combined with the emergency room.
 
*[http://en.wikipedia.org/wiki/Veterinary medicine]; [http://en.wikipedia.org/wiki/veterinarians] apply similar techniques as physicians to the care of animals.
 
*''[http://en.wikipedia.org/wiki/Wilderness medicine (practice)|Wilderness medicine]'' entails the practice of medicine in the wild, where conventional medical facilities may not be available.
 
*Many other [http://en.wikipedia.org/wiki/health science] fields, e.g. [http://en.wikipedia.org/wiki/dietetics]
 
 
 
==Education==
 
{{Main|Medical education|Medical school}}
 
[http://en.wikipedia.org/wiki/Image:Get lautrec 1901 examination at faculty of medicine.jpg|thumb|Painted by [http://en.wikipedia.org/wiki/Henri de Toulouse-Lautrec|Toulouse-Lautrec] in the year of his own death: an examination in the Paris faculty of medicine, 1901]
 
 
 
Medical education and training varies around the world. It typically involves entry level education at a university [http://en.wikipedia.org/wiki/medical school], followed by a period of supervised practice or [http://en.wikipedia.org/wiki/medical intern|internship], and/or [http://en.wikipedia.org/wiki/residency (medicine)|residency]. This can be followed by postgraduate vocational training. A variety of teaching methods have been employed in medical education, still itself a focus of active research.
 
 
 
Many regulatory authorities require [http://en.wikipedia.org/wiki/continuing medical education], since knowledge, techniques and medical technology continue to evolve at a rapid rate.
 
 
 
==Medical ethics==
 
{{main|Medical ethics}}
 
Medical ethics is a system of moral principles that apply values and judgments to the practice of medicine. As a scholarly discipline, medical ethics encompasses its practical application in clinical settings as well as work on its history, philosophy, theology, and sociology. Six of the values that commonly apply to medical ethics discussions are:
 
* [http://en.wikipedia.org/wiki/Autonomy#medicine|autonomy] - the patient has the right to refuse or choose their treatment. (''Voluntas aegroti suprema lex''.)
 
* [http://en.wikipedia.org/wiki/Beneficence (ethics)|beneficence] - a practitioner should act in the best interest of the patient. (''Salus aegroti suprema lex''.)
 
* [http://en.wikipedia.org/wiki/Justice (ethics)|justice] - concerns the distribution of scarce health resources, and the decision of who gets what treatment (fairness and equality).
 
* [http://en.wikipedia.org/wiki/Primum non nocere|non-maleficence] - "first, do no harm" (''primum non nocere'').
 
* [http://en.wikipedia.org/wiki/respect for persons] - the patient (and the person treating the patient) have the right to be treated with dignity.
 
* [http://en.wikipedia.org/wiki/truth]fulness and [http://en.wikipedia.org/wiki/honesty] - the concept of [http://en.wikipedia.org/wiki/informed consent] has increased in importance since the historical events of the [http://en.wikipedia.org/wiki/Doctors' Trial] of the Nuremberg trials and [http://en.wikipedia.org/wiki/Tuskegee syphilis experiment].
 
 
 
Values such as these do not give answers as to how to handle a particular situation, but provide a useful framework for understanding conflicts. When moral values are in conflict, the result may be an ethical [http://en.wikipedia.org/wiki/dilemma] or crisis. Sometimes, no good solution to a dilemma in medical ethics exists, and occasionally, the values of the medical community (i.e., the hospital and its staff) conflict with the values of the individual patient, family, or larger non-medical community. Conflicts can also arise between health care providers, or among family members.  Some argue for example, that the principles of autonomy and beneficence clash when patients refuse [http://en.wikipedia.org/wiki/blood transfusions], considering them life-saving; and truth-telling was not emphasized to a large extent before the HIV era.
 
 
 
==Legal controls==
 
In 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 [http://en.wikipedia.org/wiki/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 [http://en.wikipedia.org/wiki/charlatan]s that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or [http://en.wikipedia.org/wiki/Hippocratic] Medicine, they are not intended to discourage different paradigms of health.
 
 
 
Doctors who are negligent or intentionally harmful in their care of patients can face charges of [http://en.wikipedia.org/wiki/medical malpractice] and be subject to civil, criminal, or professional sanctions.
 
 
 
==Criticism of modern medicine==
 
The Catholic social theorist [http://en.wikipedia.org/wiki/Ivan Illich] subjected contemporary western medicine to detailed attack in his ''Medical Nemesis'', first published in 1975. He argued that the [http://en.wikipedia.org/wiki/medicalization] in recent decades of so many of life's vicissitudes — birth and death, for example — frequently caused more harm than good and rendered many people in effect lifelong patients. He marshalled a body of statistics to show what he considered the shocking extent of post-operative side-effects and drug-induced illness in advanced [http://en.wikipedia.org/wiki/industrial society]. He was the first to introduce to a wider public the notion of [http://en.wikipedia.org/wiki/iatrogenesis].<ref>
 
{{cite book | title=Medical Nemesis  |author=Illich Ivan |authorlink=Ivan Illich |year=1974  |isbn=0-7145-1096-3 |oclc=224760852 | publisher=Calder &amp; Boyars | location=London}}</ref> Others have since voiced similar views, but none so trenchantly, perhaps, as Illich.<ref>{{cite book |author=Postman Neil |authorlink=Neil Postman |title=[http://en.wikipedia.org/wiki/Technopoly: The Surrender of Culture to Technology] |publisher=Knopf |location=New York |oclc=24694343 |year=1992}}</ref>
 
 
 
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 [http://en.wikipedia.org/wiki/medical model] of health, led to criticisms that medicine was neglecting a [http://en.wikipedia.org/wiki/holistic] model.{{Citation needed|date=February 2007}} The inability of modern medicine to properly address some common complaints continues to prompt many people to seek support from [http://en.wikipedia.org/wiki/alternative medicine]. Although most alternative approaches lack scientific validation, some, notably acupuncture for some conditions and certain herbs, are backed by evidence.<ref name=goodbadugly>[http://www.healthwatch-uk.org/awardwinners/edzardernst.html The HealthWatch Award 2005:] Prof. Edzard Ernst, ''Complementary medicine: the good the bad and the ugly.'' Retrieved 5 August 2006.</ref>
 
 
 
[http://en.wikipedia.org/wiki/Medical error]s and [http://en.wikipedia.org/wiki/overmedication] are also the focus of complaints and negative coverage. Practitioners of [http://en.wikipedia.org/wiki/human factors] [http://en.wikipedia.org/wiki/engineering] believe that there is much that medicine may usefully gain by emulating concepts in [http://en.wikipedia.org/wiki/aviation safety], where it is recognized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make [http://en.wikipedia.org/wiki/error]s. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice. Clinical versus statistical, [http://en.wikipedia.org/wiki/algorithmic] diagnostic methods were famously examined in psychiatric practice in a 1954 book by [http://en.wikipedia.org/wiki/Paul E. Meehl], which found statistical methods superior.<ref name=Grove2000/> A 2000 [http://en.wikipedia.org/wiki/meta-analysis] comparing these methods in both psychology and medicine found that statistical or "mechanical" diagnostic methods were, in general, although not always, superior.<ref name=Grove2000>{{cite journal | year = 2000 | title = Clinical versus mechanical prediction: A meta-analysis | journal = Psychological Assessment | volume = 12 | issue = 1 | pages = 19–30 | doi = 10.1037/1040-3590.12.1.19 | url = http://www.psych.umn.edu/faculty/grove/096clinicalversusmechanicalprediction.pdf | format = w | author = Grove WH, Zald DH, Lebow BS, Snitz BE, Nelson C. | pmid = 10752360 | ref = harv}}</ref>
 
 
 
Disparities in quality of care given are often an additional cause of controversy.<ref>{{cite web|url=http://www.ama-assn.org/ama/pub/physician-resources/public-health/eliminating-health-disparities.shtml|title=Eliminating Health Disparities|publisher=American Medical Association}}</ref>  For example, elderly mentally ill patients received poorer care during hospitalization in a 2008 study.<ref>{{cite web|url=http://archpsyc.ama-assn.org/cgi/content/abstract/65/12/1402|title=Mental Disorders, Quality of Care, and Outcomes Among Older Patients Hospitalized With Heart Failure}}</ref>  Rural poor African-American men were used in a [http://en.wikipedia.org/wiki/Tuskegee Study of Untreated Syphilis in the Negro Male|study of syphilis] that denied them basic medical care.
 
 
 
==Honors and awards==
 
The highest honor awarded in medicine is the [http://en.wikipedia.org/wiki/Nobel Prize in Medicine], awarded since 1901 by the [http://en.wikipedia.org/wiki/Nobel Assembly at Karolinska Institutet].
 
 
 
{{Nobel Medicine}}
 
 
 
==Patron saints==
 
 
 
There are a number of [http://en.wikipedia.org/wiki/Patron saints of occupations and activities|patron saints] for physicians, the most important of whom are [http://en.wikipedia.org/wiki/Saint Luke the Evangelist] the physician and disciple of [http://en.wikipedia.org/wiki/Christ], [http://en.wikipedia.org/wiki/Saints Cosmas and Damian] (3rd-century physicians from [http://en.wikipedia.org/wiki/Syria]), and [http://en.wikipedia.org/wiki/Saint Pantaleon] (4th-century physician from [http://en.wikipedia.org/wiki/Nicomedia]). [http://en.wikipedia.org/wiki/Archangel Raphael] is also considered a patron saint of physicians. In India and in [http://en.wikipedia.org/wiki/Hinduism], [http://en.wikipedia.org/wiki/Dhanavantari], a form of Lord [http://en.wikipedia.org/wiki/Vishnu] and "Vaidyanatha" meaning 'Lord of Medicine', a form of Lord [http://en.wikipedia.org/wiki/Shiva] are the patron dieties of medicine.
 
 
 
The [http://en.wikipedia.org/wiki/Patron saints of occupations and activities|patron saints] for surgeons are [http://en.wikipedia.org/wiki/Saint Luke the Evangelist], the physician and disciple of [http://en.wikipedia.org/wiki/Christ], [http://en.wikipedia.org/wiki/Saints Cosmas and Damian] (3rd-century physicians from [http://en.wikipedia.org/wiki/Syria]), [http://en.wikipedia.org/wiki/Saint Quentin] (3rd-century saint from France), [http://en.wikipedia.org/wiki/Saint Foillan] (7th-century saint from [http://en.wikipedia.org/wiki/Ireland]), and [http://en.wikipedia.org/wiki/Saint Roch] (14th-century saint from France).
 
 
 
==See also==
 
{{Main|Outline of medicine|Outline of health}}
 
 
 
{{Portal|Medicine}}
 
 
 
<div class="references-medium" style="-moz-column-count:3; column-count:3;">
 
* [http://en.wikipedia.org/wiki/List of causes of death by rate]
 
* [http://en.wikipedia.org/wiki/List of diseases]
 
* [http://en.wikipedia.org/wiki/List of disorders]
 
* [http://en.wikipedia.org/wiki/List of important publications in medicine]
 
* [http://en.wikipedia.org/wiki/Medical encyclopedia]
 
* [http://en.wikipedia.org/wiki/Medical equipment]
 
* [http://en.wikipedia.org/wiki/Medical literature]
 
* [http://en.wikipedia.org/wiki/Medical psychology]
 
* [http://en.wikipedia.org/wiki/Medical sociology]
 
* [http://en.wikipedia.org/wiki/Veterinary medicine]
 
 
 
</div>
 
 
 
==References==
 
{{Reflist|2}}
 
 
 
==External links==
 
{{Sister project links
 
|n = Health
 
|s = Category:Medicine
 
|b = Health science bookshelf
 
|wikt  = Category:Medicine}}
 
{{medicine}}
 
{{Use dmy dates|date=October 2010}}
 
 
 
[http://en.wikipedia.org/wiki/Category:Medicine| ]
 
[http://en.wikipedia.org/wiki/Category:Health sciences]
 
 
 
{{Link GA|id}}
 
<!-- interwiki -->
 
 
 
[http://en.wikipedia.org/wiki/af:Geneeskunde]
 
[http://en.wikipedia.org/wiki/als:Medizin]
 
[http://en.wikipedia.org/wiki/ar:??]
 
[http://en.wikipedia.org/wiki/an:Medecina]
 
[http://en.wikipedia.org/wiki/arc:??????]
 
[http://en.wikipedia.org/wiki/frp:Mèdecina]
 
[http://en.wikipedia.org/wiki/as:??????? ???????]
 
[http://en.wikipedia.org/wiki/ast:Medicina]
 
[http://en.wikipedia.org/wiki/ay:Qulla]
 
[http://en.wikipedia.org/wiki/az:Tibb]
 
[http://en.wikipedia.org/wiki/bm:D?k?t?r?ya]
 
[http://en.wikipedia.org/wiki/bn:??????? ???????]
 
[http://en.wikipedia.org/wiki/zh-min-nan:I-ha?k]
 
[http://en.wikipedia.org/wiki/ba:????????]
 
[http://en.wikipedia.org/wiki/be:????????]
 
[http://en.wikipedia.org/wiki/be-x-old:????????]
 
[http://en.wikipedia.org/wiki/bg:????????]
 
[http://en.wikipedia.org/wiki/bo:????]
 
[http://en.wikipedia.org/wiki/bs:Medicina]
 
[http://en.wikipedia.org/wiki/br:Mezegiezh]
 
[http://en.wikipedia.org/wiki/ca:Medicina]
 
[http://en.wikipedia.org/wiki/cv:????????]
 
[http://en.wikipedia.org/wiki/ceb:Medisina]
 
[http://en.wikipedia.org/wiki/cs:Lékarství]
 
[http://en.wikipedia.org/wiki/co:Medicina]
 
[http://en.wikipedia.org/wiki/cy:Meddygaeth]
 
[http://en.wikipedia.org/wiki/da:Lægevidenskab]
 
[http://en.wikipedia.org/wiki/de:Medizin]
 
[http://en.wikipedia.org/wiki/et:Meditsiin]
 
[http://en.wikipedia.org/wiki/el:?at????]
 
[http://en.wikipedia.org/wiki/es:Medicina]
 
[http://en.wikipedia.org/wiki/eo:Medicino]
 
[http://en.wikipedia.org/wiki/ext:Medecina]
 
[http://en.wikipedia.org/wiki/eu:Medikuntza]
 
[http://en.wikipedia.org/wiki/fa:?????]
 
[http://en.wikipedia.org/wiki/hif:Dawai]
 
[http://en.wikipedia.org/wiki/fo:Læknafrøði]
 
[http://en.wikipedia.org/wiki/fr:Médecine]
 
[http://en.wikipedia.org/wiki/fy:Genêskunde]
 
[http://en.wikipedia.org/wiki/fur:Midisine]
 
[http://en.wikipedia.org/wiki/ga:Míochaine]
 
[http://en.wikipedia.org/wiki/gv:Lheeys]
 
[http://en.wikipedia.org/wiki/gd:Eòlas-leighis]
 
[http://en.wikipedia.org/wiki/gl:Medicina]
 
[http://en.wikipedia.org/wiki/ko:??]
 
[http://en.wikipedia.org/wiki/hy:???????????]
 
[http://en.wikipedia.org/wiki/hi:????????????]
 
[http://en.wikipedia.org/wiki/hr:Medicina]
 
[http://en.wikipedia.org/wiki/io:Medicino]
 
[http://en.wikipedia.org/wiki/id:Kedokteran]
 
[http://en.wikipedia.org/wiki/ia:Medicina]
 
[http://en.wikipedia.org/wiki/ie:Medicina]
 
[http://en.wikipedia.org/wiki/iu:???]
 
[http://en.wikipedia.org/wiki/os:???????æ]
 
[http://en.wikipedia.org/wiki/is:Læknisfræði]
 
[http://en.wikipedia.org/wiki/it:Medicina]
 
[http://en.wikipedia.org/wiki/he:?????]
 
[http://en.wikipedia.org/wiki/jv:Kedhokteran]
 
[http://en.wikipedia.org/wiki/ka:????????]
 
[http://en.wikipedia.org/wiki/csb:Medicëna]
 
[http://en.wikipedia.org/wiki/kk:????????]
 
[http://en.wikipedia.org/wiki/sw:Tiba]
 
[http://en.wikipedia.org/wiki/ht:Medsin]
 
[http://en.wikipedia.org/wiki/ku:Bijîskî]
 
[http://en.wikipedia.org/wiki/ky:????????]
 
[http://en.wikipedia.org/wiki/lad:Medisina]
 
[http://en.wikipedia.org/wiki/lo:??????]
 
[http://en.wikipedia.org/wiki/la:Medicina]
 
[http://en.wikipedia.org/wiki/lv:Medicina]
 
[http://en.wikipedia.org/wiki/lb:Medezin]
 
[http://en.wikipedia.org/wiki/lt:Medicina]
 
[http://en.wikipedia.org/wiki/li:Genaeskónde]
 
[http://en.wikipedia.org/wiki/hu:Orvostudomány]
 
[http://en.wikipedia.org/wiki/mk:????????]
 
[http://en.wikipedia.org/wiki/ml:??????]
 
[http://en.wikipedia.org/wiki/mt:Medicina]
 
[http://en.wikipedia.org/wiki/mr:?????????????]
 
[http://en.wikipedia.org/wiki/ms:Perubatan]
 
[http://en.wikipedia.org/wiki/mwl:Medecina]
 
[http://en.wikipedia.org/wiki/mn:??????? ?????]
 
[http://en.wikipedia.org/wiki/my:??????]
 
[http://en.wikipedia.org/wiki/nah:Ticiyotl]
 
[http://en.wikipedia.org/wiki/nl:Geneeskunde]
 
[http://en.wikipedia.org/wiki/nds-nl:Genaeskeunde]
 
[http://en.wikipedia.org/wiki/ne:???????????????]
 
[http://en.wikipedia.org/wiki/new:????]
 
[http://en.wikipedia.org/wiki/ja:??]
 
[http://en.wikipedia.org/wiki/nap:Mericina]
 
[http://en.wikipedia.org/wiki/no:Medisin]
 
[http://en.wikipedia.org/wiki/nn:Medisin]
 
[http://en.wikipedia.org/wiki/nov:Medisine]
 
[http://en.wikipedia.org/wiki/oc:Medecina]
 
[http://en.wikipedia.org/wiki/or:???????? ???????]
 
[http://en.wikipedia.org/wiki/pnb:?????]
 
[http://en.wikipedia.org/wiki/ps:???????]
 
[http://en.wikipedia.org/wiki/nds:Medizin]
 
[http://en.wikipedia.org/wiki/pl:Medycyna]
 
[http://en.wikipedia.org/wiki/pt:Medicina]
 
[http://en.wikipedia.org/wiki/kaa:Meditsina]
 
[http://en.wikipedia.org/wiki/ro:Medicina]
 
[http://en.wikipedia.org/wiki/qu:Hampi yachay]
 
[http://en.wikipedia.org/wiki/rue:????????]
 
[http://en.wikipedia.org/wiki/ru:????????]
 
[http://en.wikipedia.org/wiki/sah:????????]
 
[http://en.wikipedia.org/wiki/sa:????????????]
 
[http://en.wikipedia.org/wiki/sc:Meighina]
 
[http://en.wikipedia.org/wiki/sco:Medicin]
 
[http://en.wikipedia.org/wiki/stq:Heelkunde]
 
[http://en.wikipedia.org/wiki/sq:Mjekësia]
 
[http://en.wikipedia.org/wiki/scn:Midicina]
 
[http://en.wikipedia.org/wiki/si:?????? ????????]
 
[http://en.wikipedia.org/wiki/simple:Medicine]
 
[http://en.wikipedia.org/wiki/sk:Medicína]
 
[http://en.wikipedia.org/wiki/sl:Medicina]
 
[http://en.wikipedia.org/wiki/sr:????????]
 
[http://en.wikipedia.org/wiki/sh:Medicina]
 
[http://en.wikipedia.org/wiki/su:Tatamba]
 
[http://en.wikipedia.org/wiki/fi:Lääketiede]
 
[http://en.wikipedia.org/wiki/sv:Medicinsk vetenskap]
 
[http://en.wikipedia.org/wiki/tl:Panggagamot]
 
[http://en.wikipedia.org/wiki/ta:??????????]
 
[http://en.wikipedia.org/wiki/tt:????????]
 
[http://en.wikipedia.org/wiki/te:??????????????]
 
[http://en.wikipedia.org/wiki/th:??????????]
 
[http://en.wikipedia.org/wiki/ti:????]
 
[http://en.wikipedia.org/wiki/tg:???????]
 
[http://en.wikipedia.org/wiki/tr:Tip]
 
[http://en.wikipedia.org/wiki/uk:????????]
 
[http://en.wikipedia.org/wiki/ur:??]
 
[http://en.wikipedia.org/wiki/vec:Medexina]
 
[http://en.wikipedia.org/wiki/vi:Y h?c]
 
[http://en.wikipedia.org/wiki/vo:Sanav]
 
[http://en.wikipedia.org/wiki/fiu-vro:Arstitiidüs]
 
[http://en.wikipedia.org/wiki/wa:Medcene]
 
[http://en.wikipedia.org/wiki/war:Medisina]
 
[http://en.wikipedia.org/wiki/wo:Paj]
 
[http://en.wikipedia.org/wiki/yi:???????]
 
[http://en.wikipedia.org/wiki/bat-smg:Medecena]
 
[http://en.wikipedia.org/wiki/zh:??]
 

Latest revision as of 14:30, 10 November 2020

Medicine on Mars will be carried out first as an element of crew work, and eventually through a health care system for the settlements.

A large part of the work done over the year on the International Space Station (ISS) has been on the medical challenges of space travel. Some of this work may be adaptable to Mars; but Mars has its own specific medical challenges.

The special challenges of medicine on Mars might be:

  • Low gravity adaptation, such as child bearing and the effect of low gravity on development
  • Radiation mitigation
  • Perchlorate poisoning
  • Mental health
  • Isolation, disease resistance

References

Wikipedia article on medicine.

This article has no or virtually no content. You can help Marspedia by adding something to it.