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A '''Physician''' is a [[health Sciences|health science]] professional licensed to practice [[Medicine]] and [[Surgery]]. The term physician has ancient roots, and has been used with varying shades of meaning in different cultures and eras, but currently, in most countries of the world, physicians are those professionals who are fully licensed to practice medicine and [[surgery]]. The term has [[law|legal]] implications since physicians, in practice, are ordinarily granted the power to examine the bodies, perform invasive procedures, and discuss intimate concerns of patients that are beyond the bounds of usual social interaction. Therefore, the ability to call oneself a physician and to practice Medicine is regulated by society in order to protect the patient. The qualifications required to be a physician are not uniform throughout the world, but, generally involve formal academic training in science and supervised clinical experience with patients. | |||
==Classification== | |||
* [[Primary care physician]] | |||
* Specialist physician | |||
==Expertise== | |||
===Quality of care=== | |||
Markers associated increased quality of care are: | |||
* Board certification<ref name="pmid12063199">{{cite journal |author=Sharp LK, Bashook PG, Lipsky MS, Horowitz SD, Miller SH |title=Specialty board certification and clinical outcomes: the missing link |journal=Acad Med |volume=77 |issue=6 |pages=534–42 |year=2002 |month=June |pmid=12063199 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=1040-2446&volume=77&issue=6&spage=534 |issn=}}</ref><ref name="pmid17351843">{{cite journal |author=Ang DC, Thomas K, Kroenke K |title=An exploratory study of primary care physician decision making regarding total joint arthroplasty |journal=J Gen Intern Med |volume=22 |issue=1 |pages=74–9 |year=2007 |month=January |pmid=17351843 |pmc=1824775 |doi=10.1007/s11606-007-0111-x |url=http://dx.doi.org/10.1007/s11606-007-0111-x |issn=}}</ref> | |||
* Volume/experience<ref name="pmid12230353">{{cite journal |author=Halm EA, Lee C, Chassin MR |title=Is volume related to outcome in health care? A systematic review and methodologic critique of the literature |journal=Ann. Intern. Med. |volume=137 |issue=6 |pages=511–20 |year=2002 |month=September |pmid=12230353 |doi= |url=http://www.annals.org/cgi/pmidlookup?view=long&pmid=12230353 |issn=}}</ref> This has been shown in cardioverter-defibrillator implantation.<ref name="pmid19383957">{{cite journal |author=Curtis JP, Luebbert JJ, Wang Y, ''et al.'' |title=Association of physician certification and outcomes among patients receiving an implantable cardioverter-defibrillator |journal=JAMA |volume=301 |issue=16 |pages=1661–70 |year=2009 |month=April |pmid=19383957 |doi=10.1001/jama.2009.547 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=19383957 |issn=}}</ref> | |||
* Length of outpatient visits<ref name="pmid12528590">{{cite journal |author=Wilson A, Childs S |title=The relationship between consultation length, process and outcomes in general practice: a systematic review |journal=Br J Gen Pract |volume=52 |issue=485 |pages=1012–20 |year=2002 |month=December |pmid=12528590 |pmc=1314474 |doi= |url=http://openurl.ingenta.com/content/nlm?genre=article&issn=0960-1643&volume=52&issue=485&spage=1012&aulast=Wilson |issn=}}</ref> | |||
* Use of information technology to manage outpatients<ref name="pmid12533122">{{cite journal |author=Casalino L, Gillies RR, Shortell SM, ''et al'' |title=External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases |journal=JAMA |volume=289 |issue=4 |pages=434–41 |year=2003 |pmid=12533122 |doi= |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=12533122 |issn=}}</ref> | |||
* Maintenance of certification examination scores<ref name="pmid18625919">{{cite journal |author=Holmboe ES, Wang Y, Meehan TP, ''et al'' |title=Association between maintenance of certification examination scores and quality of care for medicare beneficiaries |journal=Arch. Intern. Med. |volume=168 |issue=13 |pages=1396–403 |year=2008 |month=July |pmid=18625919 |doi=10.1001/archinte.168.13.1396 |url=http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=18625919 |issn=}}</ref> | |||
Markers ''not'' associated increased quality of care are: | |||
*Age - older physicians provide ''less'' quality.<ref name="pmid15710959">{{cite journal |author=Choudhry NK, Fletcher RH, Soumerai SB |title=Systematic review: the relationship between clinical experience and quality of health care |journal=Ann. Intern. Med. |volume=142 |issue=4 |pages=260–73 |year=2005 |month=February |pmid=15710959 |doi= |url= |issn=}}</ref> | |||
===Efficiency of care=== | |||
==Credentialing== | |||
===United States=== | ===United States=== | ||
In the USA, regulation and licensing of physicians is by state, and so, there are 50 different sets of definitions. | In the USA, regulation and licensing of physicians is by state, and so, there are 50 different sets of definitions. | ||
==Ethics== | |||
===Conflict of interest=== | |||
Phyhsicians are susceptible to financial conflicts of interests with the pharmaceutical industry<ref name="pmid33226858">{{cite journal| author=Mitchell AP, Trivedi NU, Gennarelli RL, Chimonas S, Tabatabai SM, Goldberg J | display-authors=etal| title=Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review. | journal=Ann Intern Med | year= 2020 | volume= | issue= | pages= | pmid=33226858 | doi=10.7326/M20-5665 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=33226858 }} </ref>. | |||
[[Category: | ==References== | ||
<references/>[[Category:Suggestion Bot Tag]] | |||
Latest revision as of 07:00, 4 October 2024
A Physician is a health science professional licensed to practice Medicine and Surgery. The term physician has ancient roots, and has been used with varying shades of meaning in different cultures and eras, but currently, in most countries of the world, physicians are those professionals who are fully licensed to practice medicine and surgery. The term has legal implications since physicians, in practice, are ordinarily granted the power to examine the bodies, perform invasive procedures, and discuss intimate concerns of patients that are beyond the bounds of usual social interaction. Therefore, the ability to call oneself a physician and to practice Medicine is regulated by society in order to protect the patient. The qualifications required to be a physician are not uniform throughout the world, but, generally involve formal academic training in science and supervised clinical experience with patients.
Classification
- Primary care physician
- Specialist physician
Expertise
Quality of care
Markers associated increased quality of care are:
- Board certification[1][2]
- Volume/experience[3] This has been shown in cardioverter-defibrillator implantation.[4]
- Length of outpatient visits[5]
- Use of information technology to manage outpatients[6]
- Maintenance of certification examination scores[7]
Markers not associated increased quality of care are:
- Age - older physicians provide less quality.[8]
Efficiency of care
Credentialing
United States
In the USA, regulation and licensing of physicians is by state, and so, there are 50 different sets of definitions.
Ethics
Conflict of interest
Phyhsicians are susceptible to financial conflicts of interests with the pharmaceutical industry[9].
References
- ↑ Sharp LK, Bashook PG, Lipsky MS, Horowitz SD, Miller SH (June 2002). "Specialty board certification and clinical outcomes: the missing link". Acad Med 77 (6): 534–42. PMID 12063199. [e]
- ↑ Ang DC, Thomas K, Kroenke K (January 2007). "An exploratory study of primary care physician decision making regarding total joint arthroplasty". J Gen Intern Med 22 (1): 74–9. DOI:10.1007/s11606-007-0111-x. PMID 17351843. PMC 1824775. Research Blogging.
- ↑ Halm EA, Lee C, Chassin MR (September 2002). "Is volume related to outcome in health care? A systematic review and methodologic critique of the literature". Ann. Intern. Med. 137 (6): 511–20. PMID 12230353. [e]
- ↑ Curtis JP, Luebbert JJ, Wang Y, et al. (April 2009). "Association of physician certification and outcomes among patients receiving an implantable cardioverter-defibrillator". JAMA 301 (16): 1661–70. DOI:10.1001/jama.2009.547. PMID 19383957. Research Blogging.
- ↑ Wilson A, Childs S (December 2002). "The relationship between consultation length, process and outcomes in general practice: a systematic review". Br J Gen Pract 52 (485): 1012–20. PMID 12528590. PMC 1314474. [e]
- ↑ Casalino L, Gillies RR, Shortell SM, et al (2003). "External incentives, information technology, and organized processes to improve health care quality for patients with chronic diseases". JAMA 289 (4): 434–41. PMID 12533122. [e]
- ↑ Holmboe ES, Wang Y, Meehan TP, et al (July 2008). "Association between maintenance of certification examination scores and quality of care for medicare beneficiaries". Arch. Intern. Med. 168 (13): 1396–403. DOI:10.1001/archinte.168.13.1396. PMID 18625919. Research Blogging.
- ↑ Choudhry NK, Fletcher RH, Soumerai SB (February 2005). "Systematic review: the relationship between clinical experience and quality of health care". Ann. Intern. Med. 142 (4): 260–73. PMID 15710959. [e]
- ↑ Mitchell AP, Trivedi NU, Gennarelli RL, Chimonas S, Tabatabai SM, Goldberg J (2020). "Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review.". Ann Intern Med. DOI:10.7326/M20-5665. PMID 33226858. Research Blogging.