is the art
It encompasses a range of health care
practices evolved to maintain and restore health
by the prevention
Contemporary medicine applies health
, and medical
, typically through medication
some other form of therapy
. The word
is derived from the Latin
, meaning the art of healing
Though medical technology and clinical expertise are pivotal to
contemporary medicine, successful face-to-face relief of actual
continues to require the
application of ordinary human feeling
, known in English as
incorporated plants (herbalism
parts and minerals. In many cases these materials were used
ritually as magical substances by priests
, or medicine
. Well-known spiritual systems include animism
(the notion of inanimate objects having
(an appeal to
gods or communion with ancestor spirits); shamanism
(the vesting of an individual with
mystic powers); and divination
obtaining the truth). The field of medical anthropology
medical systems and
their interaction with society.
Early records on medicine have been discovered from early Ayurvedic
medicine in the Indian subcontinent
, ancient Egyptian medicine
and ancient Greek
. Earliest records of dedicated hospitals come
from Mihintale in Sri
Lanka where evidence of dedicated medicinal treatment
facilities for patients are found.
Early Greek doctor
, who is called the
Father of Medicine
, and Galen
foundation for later developments in a rational approach to
medicine. After the fall of the Western Roman Empire
and the onset of
the Dark Ages
, the Greek tradition of
medicine went into decline in Western Europe, although it continued
uninterrupted in the Easern Roman Empire (Byzantium). After 750,
the Muslim Arab world had Hippocrates' and Galen's works translated
into Arabic, and Islamic physicians
engaged in some significant medical research. Notable Islamic
medical pioneers include polymath Avicenna
, who, along with Hippocrates, has also
been called the Father of Medicine, Abulcasis
, the father of surgery,
, the father of experimental
surgery, Ibn al-Nafis
, the father of
circulatory physiology, and Averroes
, who is
called the father of pediatrics
, was one
of first to question the Greek theory of humorism
, which nevertheless remained influential
in both medieval Western and medieval Islamic medicine
During the Crusades, one
Muslim observer famously expressed a dim view of contemporary
Western medicine. However, overall mortality and mordibity levels
in the medieval Middle East
Europe did not significantly differ one from the other, which
indicates that there was no major medical "breakthrough" to modern
medicine in either region in this period. The fourteenth and
fifteenth century Black Death
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. In the early
modern period, important early figures in medicine and anatomy
emerged in Europe, including Gabriele
The major shift in medical thinking was the gradual rejection,
especially during the Black Death
14th and 15th centuries, of what may be called the 'traditional
authority' approach to science and medicine. This was the notion
that because some prominent person in the past said something must
be so, then that was the way it was, and anything one observed to
the contrary was an anomaly (which was paralleled by a similar
shift in European society in general - see Copernicus
's rejection of Ptolemy
's theories on astronomy). Physicians like
improved upon or indeed rejected the
theories of great authorities from the past (such as Hippocrates
, and Galen
many of whose theories were in time discredited.
Modern scientific biomedical
(where results are testable and reproducible
) began to replace early Western
traditions based on herbalism, the Greek "four
" and other such pre-modern notions. The modern era
really began with Robert Koch
discoveries around 1880 of the transmission of disease by bacteria,
and then the discovery of antibiotics
around 1900. The post-18th century modernity
period brought more groundbreaking
researchers from Europe. From Germany and Austrian doctors such as Rudolf Virchow, Wilhelm Conrad Röntgen, Karl Landsteiner, and Otto Loewi) made contributions.
Kingdom Alexander Fleming,
Francis Crick, and Florence Nightingale are considered
important. From New Zealand and Australia came Maurice Wilkins, Howard Florey, and Frank Macfarlane Burnet).
States William Williams
Keen, Harvey Cushing, William Coley, James D. Watson, Italy (Salvador Luria), Switzerland (Alexandre Yersin),
Shibasaburo), and France (Jean-Martin Charcot, Claude Bernard, Paul
Broca and others did significant work. Russian (Nikolai Korotkov also did significant work,
as did Sir William Osler and Harvey Cushing.
As science and technology developed, medicine became more reliant
. 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
and many drugs are still derived
from plants (atropine, ephedrine, warfarin, aspirin
, digoxin, vinca alkaloids, taxol, hyoscine,
etc). The first of these was arsphenamine
discovered by Paul Ehrlich
in 1908 after he observed that
bacteria took up toxic dyes that human cells did not. Vaccines
were discovered by Edward Jenner
and Louis Pasteur
. The first major class of
was the sulfa
drugs, derived by French
chemists originally from azo
has become increasingly sophisticated; modern biotechnology
allows drugs targeted towards
specific physiological processes to be developed, sometimes
designed for compatibility with the body to reduce side-effects
and knowledge of human genetics
having some influence on medicine, as the causative genes
of most monogenic genetic disorders
have now been identified,
and the development of techniques in molecular biology
and genetics are
influencing medical technology, practice and decision-making.
contemporary movement to establish the most effective algorithms
of practice (ways of doing things)
through the use of systematic
movement is facilitated by the modern global information science
, which allows all
evidence to be collected and analyzed according to standard
protocols which are then disseminated to healthcare providers. One
problem with this 'best practice' approach is that it could be seen
to stifle novel approaches to treatment. The Cochrane Collaboration
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.
In clinical practice doctors personally assess patients in order to
, treat, and prevent
disease using clinical judgment. The doctor-patient relationship
typically begins an interaction with an examination of the
patient's medical history
, followed a medical
interview and a physical
. Basic diagnostic medical
, tongue depressor
) are typically used. After
examination for signs
interviewing for symptoms
, the doctor may
order medical tests
(e.g. blood tests
), take a biopsy
, or prescribe pharmaceutical drugs
or other therapies.
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. Followups may be shorter but follow the same general
The components of the medical interview 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
- History of present illness / complaint (HPI): the chronological
order of events of symptoms and further clarification of each
- Current activity: occupation, hobbies, what the patient
- Medications (Rx): what drugs the
patient takes including prescribed, over-the-counter, and home remedies, as well as alternative and
herbal medicines/herbal remedies. Allergies are also recorded.
- Past medical history (PMH/PMHx): concurrent medical problems,
past hospitalizations and operation,
injuries, past infectious
diseases and/or vaccinations,
history of known allergies.
- Social history (SH): birthplace, residences, marital history,
social and economic status, habits (including diet, medications, tobacco, alcohol).
- Family history (FH):
listing of diseases in the family that may impact the patient. A
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 weight
loss, change in sleep quality, fevers, lumps and bumps? etc),
followed by questions on the body's main organ systems (heart, lungs, digestive tract, urinary tract, etc).
The physical examination
examination of the patient looking for signs of disease ('Symptoms'
are what the patient volunteers, 'Signs' are what the healthcare
provider detects by examination). The healthcare provider uses the
senses of sight, hearing, touch, and sometimes smell (taste has
been made redundant by the availability of modern lab tests). Four
chief methods are used: inspection
(tap to determine resonance
characteristics), and auscultation
(listen); smelling may be useful (e.g. infection, uremia
). The clinical examination involves study
- Vital signs including height, weight, body temperature,
blood pressure, pulse, respiration rate, hemoglobin oxygen saturation
- General appearance of the patient and specific indicators of
disease (nutritional status, presence of jaundice, pallor or
- Head, eye, ear, nose, and throat (HEENT)
- Cardiovascular (heart and blood
- Respiratory (large airways and
- Abdomen and rectum
- Genitalia (and pregnancy if the patient is or could be
- Musculoskeletal (including spine
- Neurological (consciousness,
awareness, brain, vision, cranial
nerves, spinal cord and peripheral nerves)
- Psychiatric (orientation, mental state, evidence of abnormal
perception or thought)
and imaging studies
results may be obtained, if
The medical decision-making (MDM) process involves analysis and
synthesis of all the above data to come up with a list of possible
diagnoses (the differential
), along with an idea of what needs to be done to
obtain a definitive diagnosis that would explain the patient's
The treatment plan may include ordering additional laboratory tests
and studies, starting therapy
, referral to a
specialist, or watchful observation. Follow-up may be
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
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.
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. The characteristics of any given
health care system have significant impact on the way medical care
Advanced industrial countries (with the exception of the United
States) and many developing
provide medical services though a system of universal health care
which aims to
guarantee care for all through a single-payer health care
compulsory private or co-operative 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.
societies, but also some communist
countries (e.g. China) and the United States, provide no guarantee
of health care for the population as a whole. In such societies,
health care is available to those that can afford to pay for it or
have self insured it (either directly or as part of an employment
contract) or who may be covered by care financed by the government
or tribe directly.
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
health care system has come under fire for lack of openness, new
legislation may encourage greater openness. There is a perceived
tension between the need for transparency on the one hand and such
issues as patient confidentiality and the possible exploitation of
information for commercial gain on the other.
Provision of medical care is classified into primary, secondary and
tertiary care categories.
medical services are
provided by physicians
, physician assistants
or other health professionals who have first contact with a patient
seeking medical treatment or care. These occur in physician
, nursing homes
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,
and health education
for all ages and both
medical services are
provided by medical specialists
in their offices or clinics or at local community hospitals for a
patient referred by a primary care provider who first diagnosed or
treated the patient. Referrals are made for those patients who
required the expertise or procedures performed by specialists.
These include both ambulatory care
services, emergency room
intensive care medicine
services, physical therapy
, labor and delivery
units, diagnostic laboratory
and medical imaging
centers, etc. Some primary care
providers may also take care of hospitalized patients and deliver
babies in a secondary care setting.
medical services are
provided by specialist hospitals or regional centers equipped with
diagnostic and treatment facilities not generally available at
local hospitals. These include trauma
, radiation oncology
Modern medical care also depends on information - still delivered
in many health care settings on paper records, but increasingly
nowadays by electronic means.
Working together as an interdisciplinary team
besides medical practitioners are involved in the
delivery of modern health care. Examples include: nurses
, emergency medical technicians
and paramedics, laboratory scientists, (pharmacy, pharmacists),
(physiotherapy,physiotherapists), respiratory therapists
, speech therapists
, occupational therapists
The scope and sciences underpinning human medicine overlap many
other fields. Dentistry
, while a separate
discipline from medicine, is considered 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 used in Wikipedia are:
- Anatomy is the study of the
physical structure of organisms. In
contrast to macroscopic or gross anatomy,
cytology and histology are concerned with
- Biochemistry is the study
of the chemistry taking place in living organisms, especially the
structure and function of their chemical components.
- 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 epidemiology and
- Cytology is the
microscopic study of individual cells.
- Embryology is the study of
the early development of organisms.
- Epidemiology is the study
of the demographics of disease processes, and includes, but is not
limited to, the study of epidemics.
- Genetics is the study of
genes, and their role in biological inheritance.
- Histology is the study of the
structures of biological tissues
by light microscopy, electron microscopy and immunohistochemistry.
- Immunology is the study of
the immune system, which includes the
innate and adaptive immune system in humans, for example.
- Medical physics is the
study of the applications of physics principles in medicine.
- Microbiology is the study
of microorganisms, including protozoa, bacteria,
fungi, and viruses.
- Neuroscience includes
those disciplines of science that are related to the study of the
nervous system. A main focus of
neuroscience is the biology and physiology of the human brain and spinal cord.
- Nutrition science
(theoretical focus) and 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 diabetes, cardiovascular diseases, weight and
eating disorder, allergies, malnutrition, and neoplastic diseases.
- Pathology as a
science is the study of disease—the causes, course,
progression and resolution thereof.
- Pharmacology is the study
of drug and their actions.
- Physiology is the study of
the normal functioning of the body and the underlying regulatory
- Toxicology is the study of
hazardous effects of drugs and poisons.
In the broadest meaning of "medicine", there are many different
specialties. However, within medical circles, there are two broad
categories: "Medicine" and "Surgery." "Medicine" refers to the
practice of non-operative medicine, and most subspecialties in this
area require preliminary training in "Internal Medicine". "Surgery"
refers to the practice of operative medicine, and most
subspecialties in this area require preliminary training in
"General Surgery." There are some specialties of medicine that do
not fit into either of these categories, such as radiology,
pathology, or anesthesia, and those are also discussed further
employ operative treatment. In
addition, surgeons must decide when an operation is necessary, and
also treat many non-surgical issues, particularly in the surgical
intensive care unit (SICU), where a variety of critical issues
arise. Surgery has many subspecialties, e.g. general surgery, transplant surgery,
trauma surgery, cardiovascular surgery, neurosurgery, maxillofacial surgery, orthopedic surgery, otolaryngology, plastic surgery, oncologic surgery, vascular surgery, and pediatric surgery.
In some centers,
anesthesiology is part of the division of surgery (for logistical
and planning purposes), although it is not a surgical
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
is the medical 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. In North
, specialists in internal medicine are commonly called
"internists". Elsewhere, especially in Commonwealth
specialists are often called physicians
These terms, internist
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
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,
specialize respectively in diseases
of the gut and the kidneys.
other countries, specialist pediatricians
are also described as
(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 Primary care
There are many subspecialities (or subdisciplines) of internal medicine
Training in internal medicine (as opposed to surgical training),
varies considerably across the world: see the articles on Medical education
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.
- Clinical laboratory
sciences are the clinical diagnostic services which 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 medical laboratory departments are
technically trained staff who do not hold medical degrees, but who
usually hold an undergraduate medical
technology degree, who actually perform the test, assays, and
procedures needed for providing the specific services.
Subspecialties include Transfusion
medicine, Cellular pathology,
Clinical chemistry, Hematology, Clinical microbiology and Clinical immunology.
- 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 evidence-based medicine. Many modern
molecular tests such as flow
chain reaction (PCR), immunohistochemistry, cytogenetics, gene rearrangements studies and
fluorescent in situ
hybridization (FISH) fall within the territory of
- Radiology is concerned with
imaging of the human body, e.g. by x-rays,
x-ray computed tomography,
ultrasonography, and nuclear magnetic resonance
- 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 gamma camera or a PET scanner. Each
radiopharmaceutical consists of two parts: a tracer which 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.
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 Electroencephalography, Electromyography, Evoked potential, Nerve conduction study and Polysomnography. Sometimes these tests are
performed by techs without a medical degree, but the interpretation
of these tests is done by a medical professional.
Following are some selected fields of medical specialties that do
not directly fit into any of the above mentioned groups.
- Ophthalmology exclusively
concerned with the eye and ocular adnexa, combining conservative
and surgical therapy.
- Dermatology is concerned
with the skin and its diseases. In the UK, dermatology is a
subspecialty of general medicine.
- Emergency medicine
is concerned with the diagnosis and treatment of acute or
life-threatening conditions, including trauma, surgical, medical, pediatric, and
- Obstetrics and gynecology (often abbreviated as
OB/GYN (American English) or Obs
& Gynae (British English)) are concerned respectively with
childbirth and the female reproductive and associated organs.
Reproductive medicine and
fertility medicine are generally
practiced by gynecological specialists.
- Palliative care is a
relatively modern branch of clinical medicine that deals with pain
and symptom relief and emotional support in patients with terminal illnesses including cancer and heart
- 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.
medicine and rehabilitation (or physiatry) is
concerned with functional improvement after injury, illness, or
- Psychiatry is the branch of
medicine concerned with the bio-psycho-social study of the etiology, diagnosis, treatment and prevention of
cognitive, perceptual, emotional
and behavioral disorders. Related
non-medical fields include psychotherapy and clinical psychology.
Interdisciplinary sub-specialties of medicine are:
- General practice,
family medicine or
primary care is, in many countries, the first port-of-call
for patients with non-emergency medical problems.
- Many other health science fields,
- Bioethics is a field of study
which concerns the relationship between biology, science, medicine and ethics, philosophy and theology.
Engineering is a field dealing with the application of
engineering principles to medical
pharmacology is concerned with how systems of therapeutics interact with patients.
medicine studies the relationship between human and animal
health, and environmental conditions. Also known as ecological
medicine, or medical
- Disaster medicine
deals with medical aspects of emergency preparedness, disaster
mitigation and management.
- Diving medicine (or
hyperbaric medicine) is the
prevention and treatment of diving-related problems.
medicine is a perspective on medicine derived through
applying evolutionary theory.
- Forensic medicine
deals with medical questions in legal context,
such as determination of the time and cause of death.
medicine studies the biological and physiological
differences between the human sexes and how that affects
differences in disease.
- Hospital medicine is
the general medical care of hospitalized patients. Physicians whose
primary professional focus is hospital medicine are called hospitalists in the USA.
- Laser medicine involves
the use of lasers in the diagnostics and/or treatment of various
- Medical humanities
includes the humanities (literature, philosophy,
ethics, history and
science (anthropology, cultural studies, psychology, sociology),
and the arts (literature, theater,
film, and visual
arts) and their application to medical education and practice.
informatics, medical computer science,
medical information and
eHealth are relatively recent
fields that deal with the application of computers and information technology to
- Nosology is the classification
of diseases for various purposes.
- Nosokinetics is the
science/subject of measuring and modelling the process of care in
health and social care systems.
- Pain management (also
called pain medicine) is the medical
discipline concerned with the relief of pain.
- Preventive medicine
is the branch of medicine concerned with preventing disease.
medicine, a branch of the U.S. medical profession.
- Pharmacogenomics is a
form of individualized medicine.
- Sports medicine deals
with the treatment and preventive care of athletes, amateur and
professional. The team includes
specialty physicians and surgeons, athletic trainers, physical
therapists, coach, other personnel,
and, of course, the athlete.
- 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
- Travel medicine or
emporiatrics deals with health problems of international
travelers or travelers across highly different environments.
- 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
- Veterinary medicine;
veterinarians apply similar techniques
as physicians to the care of animals.
- Wilderness medicine
entails the practice of medicine in the wild, where conventional
medical facilities may not be available.
Medical education and training varies around the world. It
typically involves entry level education at a university medical school
, followed by a period of
supervised practice or internship
. 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 continuing medical education
since knowledge, techniques and medical technology continue to
evolve at a rapid rate.
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 medical board
or an equivalent national
organization, which may ask the applicant to pass exams. This
restricts the considerable legal authority of the medical
profession to physicians that are trained and qualified by national
standards. It is also intended as an assurance to patients and as a
safeguard against charlatans
inadequate medicine for personal gain. While the laws generally
require medical doctors to be trained in "evidence based", Western,
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 medical
and be subject to civil, criminal, or professional
The Catholic social theorist Ivan Illich
subjected contemporary western medicine to detailed attack in his
, first published in 1975. He argued that
in recent decades
of so many of life's vicissitudes — birth
, 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 industrial society
. He was the first to
introduce to a wider public the notion of iatrogenesis
. Others have since voiced similar
views, but none so trenchantly, perhaps, as Illich.
Through the course of the twentieth century, healthcare providers
focused increasingly on the technology that was enabling them to
make dramatic improvements in patients' health. The ensuing
development of a more mechanistic, detached practice, with the
perception of an attendant loss of patient-focused care, known as
the medical model
of health, led to
criticisms that medicine was neglecting a holistic
model. The inability of modern medicine to
properly address some common complaints continues to prompt many
people to seek support from alternative medicine
. Although most
alternative approaches lack scientific validation, some, notably
acupuncture for some conditions and certain herbs, are backed by
are also the focus of
complaints and negative coverage. Practitioners of human factors engineering
believe that there is much that
medicine may usefully gain by emulating concepts in aviation safety
, where it is recognized that
it is dangerous to place too much responsibility on one
"superhuman" individual and expect him or her not to make errors
. Reporting systems and checking mechanisms are
becoming more common in identifying sources of error and improving
practice. Clinical versus statistical, algorithmic
diagnostic methods were famously
examined in psychiatric practice in a 1954 book by Paul E. Meehl
which controversially found statistical methods superior. A 2000
comparing these methods
in both psychology and medicine found that statistical or
"mechanical" diagnostic methods were generally, although not
Disparities in quality of care given are often an additional cause
of controversy. For example, elderly mentally ill patients received
poorer care during hospitalization in a 2008 study. Rural poor
African-American men were used in a study of
that denied them basic medical care.