Medicine


Medicine is the science and practice of caring for patients, managing the diagnosis, prognosis, prevention, treatment and palliation of their injury or disease, while promoting their health. Medicine encompasses a variety of health care practices which evolved to maintain and restore health through the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through various pharmaceuticals or surgery, but also through therapies such as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others.
Medicine has been practiced since prehistoric times, and for most of this time it was an art, frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, or an ancient philosopher and physician would apply bloodletting according to the theories of humorism, or the four humors. In recent centuries, since the advent of modern science, most medicine has become a combination of art and science. For example, while stitching technique for sutures is an art learned through practice, knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science.
Prescientific forms of medicine, now known as traditional medicine or folk medicine, remain commonly used in the absence of scientific medicine and are thus called alternative medicine. Alternative treatments outside of scientific medicine with ethical, safety and efficacy concerns are termed quackery or being based on fringe science.

Etymology

Medicine is the science and practice of the diagnosis, prognosis, treatment, and prevention of disease. The word "medicine" is derived from Latin, meaning "a physician". The word "physic" itself, from which "physician" derives, was the old word for what is now called a medicine, and also the field of medicine.

Clinical practice

Medical availability and clinical practice vary across the world due to regional differences in culture and technology. Modern scientific medicine is highly developed and widespread in the Western world, whereas in some low-resource regions—including parts of Africa, the Pacific Islands of Oceania, Southeast Asia, and Latin America—populations often rely more heavily on traditional medicine. These practices consist of decentralized training structures and vary widely in empirical support; consequently, they may lack formal regulatory oversight or robust evidence for clinical efficacy.
In the developed world, evidence-based medicine is not universally applied in clinical practice; for example, a 2007 survey of literature reviews found that about 49% of medical interventions lacked sufficient evidence to support either benefit or harm. However, medical practitioners who apply an intervention with uncertain efficacy without adequate justification, transparency, or patient consent may violate the bioethical principle of non-maleficence, a core tenet of biomedical ethics historically associated with the Hippocratic Oath, which emphasizes a primary duty to "first, do no harm."
In modern clinical practice, physicians and mid-level practitioners such as physician assistants personally assess patients to diagnose, prognose, treat, and prevent disease using clinical judgment. An initial medical encounter with a patient typically begins with a review of the patient's medical history and medical record, followed by a medical interview and a physical examination. Basic diagnostic medical devices are typically used. After examining for signs and interviewing for symptoms, the doctor may order medical tests, take a biopsy, or prescribe pharmaceutical drugs or other therapies. 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 within the context of the doctor-patient relationship. The medical encounter is then documented in the medical record, which is a legal document in many jurisdictions. Follow-up encounters may be shorter but follow the same general procedure, and specialists follow a similar process. The diagnosis and treatment may take only a few minutes or a few weeks, depending on the complexity of the issue.
The components of the medical interview and encounter are:
The physical examination is the examination of the patient for medical signs of disease that are objective and observable, in contrast to symptoms that are volunteered by the patient and are not necessarily objectively observable. The healthcare provider uses sight, hearing, touch, and sometimes smell. Four actions are the basis of physical examination: inspection, palpation, percussion, and auscultation, generally in that order, although auscultation occurs prior to percussion and palpation for abdominal assessments.
The clinical examination involves the study of:
It is to likely focus on areas of interest highlighted in the medical history and may not include everything listed above.
The treatment plan may include ordering additional medical laboratory tests and medical imaging studies, starting therapy, referral to a specialist, or watchful observation. A follow-up may be advised. Depending upon the health insurance plan and the managed care system, various forms of "utilization review", such as prior authorization of tests, may place barriers on accessing expensive services.
The medical decision-making process includes the analysis and synthesis of all the above data to come up with a list of possible diagnoses, along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem.
On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, lab or imaging results, or specialist consultations.

Institutions

Contemporary medicine is, in general, conducted within health care systems. Legal, credentialing, and financing frameworks are established by individual governments, augmented on occasion by international organizations, such as churches. The characteristics of any given health care system have a significant impact on the way medical care is provided.
From ancient times, Christian emphasis on practical charity gave rise to the development of systematic nursing and hospitals, and the Catholic Church today remains the largest non-government provider of medical services in the world. Advanced industrial countries and many developing countries provide medical services through a system of universal health care that aims to guarantee care for all through a single-payer health care system or compulsory private or cooperative 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, state-owned hospitals and clinics, or charities, most commonly a combination of all three.
Most tribal societies provide no guarantee of healthcare for the population as a whole. In such societies, healthcare is available to those who can afford to pay for it, have self-insured it, or may be covered by care financed directly by the government or tribe.
Transparency of information is another factor defining a delivery system. Access to information on conditions, treatments, quality, and pricing greatly affects the choice of patients/consumers and, therefore, the incentives of medical professionals. While the US healthcare system has come under fire for its 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.
The health professionals who provide care in medicine comprise multiple professions, such as medics, nurses, physiotherapists, and psychologists. These professions will have their own ethical standards, professional education, and bodies. The medical profession has been conceptualized from a sociological perspective.